Pregnancy with Type 1 Diabetes: Challenges of Tight Blood Sugar Control as a Full-Time Mom to Toddler

https://type2diabetestreatment.net/diabetes-type-1/pregnancy-with-type-1-diabetes-challenges-of-tight-blood-sugar-control-as-a-full-time-mom-to-toddler/

There are a lot of things I did dutifully and consistently during my first pregnancy that are mere fantasies or merely forgotten during this second pregnancy. The difference? I have a sassy, silly, smart toddler with me all day long.

Here are a few of the things I don’t do during this pregnancy that I definitely did do during my first pregnancy:

1. I don’t go to the gym.

   Oh, well, let me clarify, because…I do go to the gym but only to drop-off my toddler (we’ll call her Lucy…because that’s her name) at the 2-hour Playspace where she plays with other kids and is cared for by a variety of amazing women who work there! Instead of exercising during this 2-hour window, I’m usually getting groceries, sitting at a nearby coffee-shop trying to make sure I complete my duties as Editorial Director at Diabetes Daily, or I’m at the dentist or the eye-doctor or simply running random errands without 26 pounds of adorable neediness on my hip. I also don’t go to the gym this time because all the action and exercise and carrying that is involved with being a full-time mom to a toddler means that the muscles across my torso are cramping regularly and walking on a tredmill is actually pretty painful (even now after healing from slipping on the ice and straining my left hip). Fortunately, I still get plenty of exercise from walking in the woods with furry creatures twice a day and chasing a toddler. We also go to the gym to swim together in the “toddler pool” once a week…which exhausts both of us in the most subtle way. If anything, my weight-gain is actually much slower this time because we are on the move all day whether we’re home or out!

2. I don’t pre-bolus my insulin.

   At this point in my first pregnancy (22 weeks along), I was a masterful diligent soldier when it came to taking my insulin at least 15 minutes before eating. This time, I’m just grateful for the chance to eat. I eat my breakfast usually without effort, but it could be a good 4 to 6 hours before I eat again, and in pregnancy land, that creates a hungry mama. I try to balance this blatant lack of pre-bolusing by eating meals that are carbs paired with fat or protein (like apple + cheese) and blatantly low-carb meals (bacon + bell pepper). When I am eating real carbs, I try try try very hard to get a good 10 minutes in between taking my insulin and eating, and I consider that an A+ at the moment because I’m so darn hungry by the time I get to eat I really don’t care about the pre-bolus! My most recent A1C was 5.7 percent, so my approach is working, but as I approach the 3rd trimester, I’ll have to be more diligent in this area.

3. I don’t get wonderful naps (or daily showers)…

   When Lucy was under the age of 2 (the 1st trimester and half of the 2nd) of my second pregnancy, getting a nap in while she was napping was pretty easy because she was a consistent napper! At the beginning, she still napped twice a day, then it switched to one long afternoon nap (which was glorious for me), and now, perfectly on cue with her 2nd birthday, she doesn’t want her nap until close to 3 p.m. By 3 p.m. I am so far past needing a nap that my body is probably running on cortisol and adrenaline, and falling asleep during the short window of her new nap routine is a ridiculous fantasy. There was one day this week that felt like a belated Christmas miracle during which everyone got a 2-hour nap and oh, it was joyous! I was overwhelmed with happiness, and just thinking about it brings a smile to my face today. (As for the showering, well, it honestly only occurs to me about twice a week now…but my husband says he can’t even tell, so I guess I’m just magically self-cleaning? There have been many times when he’s come home at 7 p.m., looked at me, and said, “Wow, I like what you did with your hair!” I laugh and I say, “I haven’t showered in 5 days.”)

4. I don’t wear my CGM.

   I’ve written about this in more depth here, but in a nutshell, I found that for me wearing a CGM while being on-call for a toddler all day long left me feeling anxious and stressed rather than supported and informed. Instead, I’m really so grateful I went “against the grain” and took my CGM off because the week or two that I had it on, my blood sugars were a rollercoaster from making impulse decisions under the pressure of “you’ve gotta take care of this now because you won’t have a chance to correct this potential high or low again for another 30 minutes.” When I took my CGM off and just used good old fashioned logic and knowledge that I’ve been building especially since the start of my first pregnancy, my blood sugars were far more predictable and steady. This is what works for me — I won’t be shocked if most people feel the opposite, but I am glad I made this decision. Since my last A1C came back at 5.7 percent, I plan on continuing what I’m doing (and thanks to becoming a member of OneDrop, I now get unlimited test-strips so I can test 10-15 times per day without worrying about using up my strips too fast). I suspect in the last month of pregnancy, I will put my CGM on so it’s in place if I go into labor and to help me pre-bolus my insulin safely by at least 30 minutes before eating.

5. I don’t stress as much about my blood sugars.

   (This is an added BONUS of being a mom with type 1 diabetes to a toddler.) During my first pregnancy, tight-tight-tight blood sugar management was my entire focus. This isn’t shocking considering my only other daily distractions were working, walking dogs, and regular cooking and cleaning chores. But it’s not just a lack of time that’s different–it’s also the addition of confidence. Sure, I’m still checking my blood sugar about 12 times a day, but there isn’t as much emotion or concern attached to the number, partly because I know how to stay in that tighter range…and because I’ve done this before. I know I can maintain an A1C below 6.0 ’cause I’ve done it. I know I can create a healthy, beautiful baby as a mom with type 1 diabetes because I’ve done it! During your first pregnancy with type 1 diabetes, all you ever hear is the risks and the risks and the risks, and then out pops this gorgeous baby and you realize that for most of us, all those risks are statistics that apply to a huge population of people…and I am just one tiny fraction of that population. I’ve done this. Period. There is no fear or worry this time, just lots of quiet effort. I did it once and I know I can do it again.

What was different about your first pregnancy and all the others that followed?

Photo credit: Ginger Vieira

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