I know before I had my first child it was hard to find examples of what life looked like with diabetes and pregnancy. There is plenty of medical literature but I wanted to hear from a real life mom who was juggling life, motherhood and diabetes and see what it actually looked like. I decided to write a post like that here in my own little corner of the internet.
Keep in mind that diabetes care looks different for everyone and I know stereotypes about what diabetes care should look like can be annoying. This is what it looks like for me today in this stage of pregnancy (31 weeks.)
I decided for the sake of sharing that as I went about my day when ever I stopped to do something diabetes or pregnancy care related I would snap a picture to give a little insight into what my everyday looks like.
It’s a little after 1:00 a.m and I woke up to use the restroom. I don’t set a timer to take a night time finger prick but the more information I can gather about what my blood sugar is doing the better, so if I wake up I’ll do a finger prick.
Your wake up number is one of the most important numbers of the day to get. Mine was 90 which was fine. Around 80 is normal but anything under 100 is acceptable. I wake up around 5:30am but I don’t eat breakfast until my daughter does around 7:30 to 8:00 and since my blood sugar was not high this morning I don’t take any extra insulin at this time. I am on an insulin pump (the t slim) so through that I get small amounts of insulin dripped in me around the clock (called a basal insulin) If I eat or need to correct a high number I will take a dose called a bolus.
To cut out some of the variables that could cause fluctuating blood sugar when I am pregnant I usually eat the same thing for breakfast every day or something very similar. I am having 2 fried eggs with two pieces of Ezekiel bread (a high protein high fiber bread.) 2 slices after subtracting the dietary fiber equals 26 carbs. I take a small correction to try and lower my number of 97 to my goal of 80 and the rest is to cover the toast. For breakfast I take 1 unit of insulin for every 6 carbohydrates. For me this is quite a bit of insulin. My pre pregnancy carb to insulin ratio was 1:10 but pregnancy causes both insulin resistance and an increased need for insulin to grow a baby. I take a pre breakfast number in addition to my wake up number because although todays number was very close some days my pre breakfast number is much higher due to something called the dawn phenomenon where hormones that become active after we wake up cause insulin resistance and high blood sugar.
I take my vitamins at this time which consist of a prenatal and extra folic acid. Extra folic acid is generally recommend to pregnant diabetics, especially those with type 1, because the fluctuating blood sugars can cause our babies to have an increased risk of neural tube defects such as spina bifida and folic acid is known to help prevent spinal cord defects. As you can see I drink water in the a.m. For all types of diabetes, 1, 2 and gestational, during pregnancy, it is usually recommended to have no fruit or milk before noon as that is when the hormones that cause insulin resistance are in full swing and it is the hardest time of the day for the insulin to work with the fast acting sugar in milk and fruit.
I set a timer to remind myself to do a finger prick 2 hours after the time I begin eating.
The timer goes off and my 2 hour post breakfast number is is 193. Normal is under 130 preferably under 120 during pregnancy. I take 2.48 units of insulin as my correction factor at the moment is set at 1:25. This means that 1 unit of insulin will lower my blood sugar about 25 points. My pre pregnancy corrections factor was something like 1:60. Again, blame it on those pregnancy hormones!
With type 1 diabetes you will record all your blood sugars and be in contact with your doctor as much as every 3-7 days for 9 loooong months. The needs of your body and your babies body changes rapidly. What may have worked yesterday as far as insulin requirements may not work today and things may be different tomorrow. Especially in the third trimester. Here I am using the computer program that comes with the T slim insulin pump that downloads all my information that I have entered into my pump, then puts it into pdf form that I can email to my endocrinologist.
Speaking of endocrinologists, before you get pregnant or as soon as you get pregnant you need to get one. Most OBGYN’s even the high risk ones don’t know a lot about about type 1 diabetes and would rather an endocrinologist take care of your diabetes. If you are doing shots an OBGYN may be willing to take care of your diabetes but if you are on a pump even the high risk OBGYN’s are pretty clueless. They simply don’t get trained in insulin pumps. If they do their knowledge is still limited compared to an endocrinologists.
Which brings me to this;
I have four doctors overseeing my pregnancy. Four doctors that I, as the patient must make sure are all communicating and on the same page. Get a pocket calendar! As you near the third trimester the number of appointments gets insane! Non stress tests to listen to the baby’s heart will start twice weekly at 32 weeks. In my situation my doctor is about 1 1/2 hours away. He wants to do one of the NST’s per week but said another doctor in the town I live in can do the other one. It’s up to me to get these NST’s set up starting next week but I have been calling for days without getting through to scheduling. Diabetes and pregnancy consists of lots of paper work, phone calls and driving!
Speaking of driving.. driving is my pump charging time! Thankfully my car has a USB outlet in it. Today while driving to and from my daughters music class I juiced it up! Others tell me they charge their pumps while they shower but other moms know showers for us last like 5 minutes so I had to find another time to charge it and this works for me!
Lunch time! It’s sometime after 1:00 and my blood sugar is 64. Pre pregnancy this would be considered low but during pregnancy when your goal pre meal number is 70-80 then 64 isn’t really that low. I had 60 carbs; chicken noodle soup, 1 cup milk (yes i drank right out of the measuring cup!), raw veggies, a cheese stick and a granola bar. I took a little less insulin than i normally would due to the lower blood sugar and took 8.57 units of insulin.
It’s dinner! Did a finger prick, my number had come down to 89 and I was going to eat 50 carbs. I took 8.33 units of insulin to cover my meal of sweet potato, hamburger patty, 1 cup milk, salad and 2 prunes and 1 tbs peanut butter for dessert. (weird I know!)
Two hours later I was 76. I had a half cup of milk (6 carbs) since I only wanted to bring it up a little. By 10:00 p.m I was still in the 70’s so I had a little more milk and near midnight I was still shaking and unable to sleep so I went ahead and treated with some juice. Unfortunately I woke up the next morning with a high of 136.
So there it is! An “average day” of balancing pregnancy, diabetes and motherhood. Of course those who have been here realize there is really no such thing as an “average day.”
Anyways, I’m hoping this turns out to be helpful to someone! I know I would have been interested in a post like this when I first started having my babies.
Since this is the internet and the internet can be a weird place, I’ll post a disclaimer saying this is in no way “medical advice” just my own experience of living with diabetes