Getting pregnant, having a healthy pregnancy, and finally having a gorgeous bundle of joy is on the mind of many women in child-bearing age. But what about women who want to have children but also have type 1 diabetes? How does that dream of mamahood fit into our daily sugar level checks, our insulin shots, and our concerns around chronic illnesses that tend to come hand in hand with our diabetes diagnosis? Well, I am that woman and let me tell you how my journey went, from my diagnosis in my teenage years, to finally having my gorgeous, healthy baby girl.
My name is Sarah T. and I had a relatively uneventful childhood. I played with my 2 older brothers and our friends on our bikes and in the local park, had tea parties with my stuffed animals, and was obsessed with swimming like a mermaid at every chance I got. Oh, and I LOVED to listen to bedtime stories by my dad who made the funniest voices
for the different characters in the books. I was a happy child. Enter my early teenage years, puberty hits, mood swings around the time of my period that I had never had before, yet the best part about that time was my newly found independence and space
to make my own choices. Everything was going according to the plan of an average teenage girl until a few weeks after my 14th birthday. I noticed that I had become a lot more thirsty than I usually was, which led to frequent trips to the bathroom. I didn’t think much of it until one night I woke up to a wet bed! Ummm, WHAT HAPPENED?! I was so embarrassed and went to wake my parents up who were amazing and helped me change the sheets. I went back to sleep, ashamed and grossed out by what happened. We didn’t talk about it again, but the thirst kept getting worse and the bathroom visits became more frequent.
A couple of months later, it was time for my annual physical and my parents brought up the issue and discussed that awful night with my doctor. She told us that she’d like to run a few tests to rule out some things - just a blood and urine sample was all I had to do. A week later we were asked to come back to the doctor’s office and she sat us down and told us that something came up in my test results - I had type 1 diabetes! What? How? No one in my family has type 1 diabetes - heck, no one in my family has ANY type of diabetes! Why now, and of course, why ME? I went from a regular little girl with a secret crush on her brother’s best friend, to this person who now has a life-long chronic illness that has to check her blood sugar levels with this silly machine and having to calculate carbs in everything I eat, oh, and the cherry on top, shoot insulin into MY BELLY!
The transition was hard - very very hard. I had to get a whole new team of doctors
onboard instead of just my pediatrician who I’ve been going to my entire life. I now had appointments with different specialists to follow up on my condition: a nephrologist (I didn’t even know that this specialty existed - it’s a kidney specialist BTW), an ophthalmologist (another word I didn’t know which meant an eye doctor), a cardiologist to check my heart health, and a neurologist (yes, apparently type 1 diabetes could affect everything, including your nerves!). It was a crazy time of never ending appointments and tests. Luckily everything checked out but I had to keep an especially close eye (no pun intended) on my eyes. The ophthalmologist mentioned that a very common complication for people with type 1 diabetes is a condition called diabetic retinopathy, which is a leading cause of blindness if not managed well.
The insanity of the diagnosis phase faded into the “management” phase of any chronic illness. I had the system down to a T within a few months and my diabetes took a bit of a backseat in my conscious thinking (although I managed it very well - it just became an automatic response rather than an active thing to think about). I cruised through life, graduated high school and university, got my first job, met my soulmate and got married in my late 20’s - and that’s when my diabetes took center stage again. Will I be able to get pregnant? Will I be able to maintain a healthy pregnancy? Will my child have diabetes? Will my future husband be ok with all this? I started to panic and quickly got an appointment to see an OB/GYN.
The visit with my new doctor was very encouraging and very calming to my nerves. He mentioned that I can go on and have a very normal, healthy pregnancy and that my diabetes does not necessarily mean that my baby would automatically be diabetic. The one thing he kept hammering was the importance of keeping my blood sugar levels normal (or as close to normal as possible) and that I speak to all my doctors to ensure a safe pregnancy - that included my endocrinologist, nephrologist, and my ophthalmologist. I had to run many tests (many of which I was doing routinely anyway) BEFORE we started trying to have a baby. Those tests included:
Eye Exam Pregnancy can lead to people with diabetes to develop diabetic retinopathy, and I was already closely monitoring it with my eye doctor. I had already started developing retinopathy at 26 so the aim here was to ensure that there is no progression of the disease (and in case you’re curious, my retinopathy is currently stable)
Physical Exam (including the following tests):
Blood pressure
Blood work
Complete Blood Count (because why not, right?)
Blood sugar levels (obviously!)
HbA1C (also, obviously!)
TSH and T3/T4 (thyroid levels - critical to be in order for the baby to develop normally and for me to maintain a healthy pregnancy)
Urine analysis
To check for infections
To check for protein in the urine to indicate the health of my kidneys - too much protein could lead to problems with both my organs and those of my developing baby (and even problems with the placenta!)
I also did a very thorough review of all the medications that I was taking with all my healthcare providers, including my new OB/GYN to ensure that they will be safe to take during conception and pregnancy. He also put me on a couple of new supplements, a prenatal multivitamin as well as a Folic Acid supplement before I got pregnant (apparently they are more effective if they’ve been in your system for a few months BEFORE you get pregnant).
Luckily it didn’t take us too long to get pregnant! A few months of trying and voila, I got the infamous “||” sign on my home pregnancy test. Adam (my hubby) was ecstatic! Family was over the moon. And friends couldn’t believe that we’ll have our first “baby of the group.” But to be honest with you, I was a little worried. There was a little voice that kept nagging at me “what if I miscarried?” and “will I have to have a c-section?” and of course “will my baby be ok!?” I shared all these issues with my family and medical team and they were amazing. This was our plan:
Keep my blood sugar at the most optimal level as possible (I had to start increasing my insulin dosage towards the end of my second trimester, at around 22 weeks, and kept adjusting it to ensure that my levels are good. I ended up reaching a level of about 2.5 times my normal dose throughout the remainder of my pregnancy)
Check my blood pressure regularly - a spike in blood pressure could lead to a miscarriage in the first 20 weeks of pregnancy and could lead to complications such as pre-eclampsia and eclampsia later on. I actually had to take medication towards the middle of my pregnancy to control my newly diagnosed gestational hypertension (quite common for diabetic mamas to be) so my medical team put me on a pregnancy-safe alpha and beta blocker - it worked wonders for me!
Do frequent bloodwork and urine tests to ensure that my kidneys are functioning well without any additional pressure from the pregnancy on my already-stressed diabetic kidneys. Happy to report that this was something I did not have to deal with and my nephrologist was happy with my results throughout my 9 months
Continue with my exercise regimen, which included daily walks and 2 - 3 times a week of swimming
As with most diabetic women, I was at risk of preterm labor so I started to take it easy towards the beginning of my third trimester. By week 38, I was considered full term so I was super happy and excited to meet my little munchkin whenever she was ready to come out. However, she exceeded all our expectations and decided to show up a week and a half past her due date! We opted for a c-section delivery although my original preference was for a vaginal birth. My doctors felt that the controlled environment that the c-section provided was the safest option for my overall health condition. I was like, “I’ll take it!” considering the relatively smooth pregnancy I had, despite the close followup, numerous tests and pricks, and frequent usage of my new, home blood pressure monitor.
I am now 15 weeks postpartum and everything seems to be settling back into place. We have a beautiful and HEALTHY baby girl who is the image of perfection. My insulin levels are back to my pre-pregnancy doses and all my numbers seem to be controlled quite well. My advice to you, my sister in diabetes, is just don’t worry - you got this! As long as you are diligent with your medical care and are closely monitored throughout your pregnancy, you too can have a healthy and hopefully uneventful 9 months and a fantastic outcome at the end that will (positively) change your life forever!
Sarah T. is a diabetes health advocate and Mama to Jude, her beautiful 15-month old bundle of joy. Sarah believes that through proper nutrition, healthcare, and consistent monitoring, anyone with diabetes can manage their condition and live a full life.