5 Things I Wish I'd Known Before My Diabetes Pregnancies.
Reflecting on the road to motherhood five years later
Today my oldest son turns five years old.
Becoming a mom with diabetes was something that for a long time, I didn’t think I could do. Or wanted to do. It felt daunting, almost impossible, with a list of requirement and expectations that (pre-CGM and pre-modern insulin pumps) felt totally out of reach.
Thankfully, over the subsequent years, I had a lot of role models of people who became pregnant with diabetes. I’ve watched their journey through lowering their A1C to a safe range, how they managed the ceaseless changes in insulin needs during pregnancy, and then balancing the complicated dual obligations of caring for a newborn and diabetes. (Which is more baby-like than I care for!)
But education on pregnancy and diabetes is still not very user-friendly. Like a lot of diabetes education, there’s a big emphasis on scare tactics, which is one of the reasons why I wasn’t sure I wanted to pursue it. Inspiration and role models felt limited. Advice seemed contradictory.
So I wanted to do something about it. Which is why I created the T1D & the 3Ps class last spring, which I have now taught four times to more than 30 people. I literally gave birth to my second son in the middle of the class when he came early due to my preeclampsia and it’s those kinds of honest, real-world stories that I try to deliver to my students.
I try to deliver (pun intended) the information that I wish I’d had before I became pregnant (the first time, and also the second).
Here are five things that surprised me about a diabetes pregnancy:
1. I wish I knew that blood sugars could change early on.
One of the common things you’ll hear people talk about is how much insulin needs increase at the end of pregnancy. So I was shook to see my BG levels rising shortly after I got that second line. I was not expecting that and I thought I had failed as a mom before my first ultrasound. Luckily, Ginger Vieira, a T1D who was pregnant with her second, let me know that was a normal reaction to the hormonal changes my body was experiencing.
2. I wish I knew that not everyone is induced or had a c-section.
In my preconception interview with my OB (something I go over in class), we chatted about what delivery could look like. She told me that deliveries run the gamut, and that I wasn’t destined for an induction or c-section. My first son did end up being delivered via c-section, but not because of some predetermined “you have diabetes” rule.
3. I wish I knew that I could still eat carbs.
Totally thought that I would have to restrict my carb intake during pregnancy. While I did change how I ate carbs (as in, my dosing strategy, what I paired it with, when I ate certain foods), I didn’t drastically reduce my carbohydrate intake or feel deprived.
4. I wish I knew that insulin resistance was more of a slow incline on a rollercoaster than an on/off switch.
Insulin resistance did not behave the way I expected. I expected my insulin needs to suddenly jump dramatically starting in my third semester, but it was more like a quiet creeping starting in the middle second. Insulin resistance also affected more than just how much insulin I needed it, but when. My prebolusing time gradually moved from 15 minutes to 45 minutes by the end of the third trimester.
5. I wish I knew how to put it all into perspective.
Blood sugars are obviously very important to the baby’s health. But on social media I would see everything from “don’t worry about highs as long as its not for days on end” to “every single high blood sugar is going to negatively impact your baby’s health.” Getting straight-forward guidance from my diabetes educator, Jenny Smith, at Integrated Diabetes Services, gave me the reality check I needed. As a T1D mom of two herself, she explained how to properly emphasize both in-the-moment blood sugars and my overall blood sugar trends in a way that would help me know how to respond to the information, without going into a shame spiral. Having a quality diabetes and pregnancy support team was vital not just to my physical health but also my mental health.
I so enjoy being part of the support team for a diabetes pregnancy, whether that’s in the capacity as a teacher of the T1D & the 3Ps class or as a diabetes health coach. Registration is now open for the fall class, which starts on Thursday, September 8.
I am also accepting applications for 1-on-1 coaching and have a variety of packages available. If you’re looking for a more personalized approach to your pregnancy journey or if the group class isn’t your style, please reach out to learn more.
