https://type2diabetestreatment.net/diabetes-type-1/pregnancy-with-type-1-diabetes-finding-the-right-blood-sugar-range-for-you/
This unicorn is about as real as “the perfect diabetic”…
In an ideal world, we’d all be able to effortlessly keep our blood sugars between 65 and 123 mg/dL all day long. In this very same world there would probably be butterflies that left a trail of pink glitter flowing from their wings and unicorns that neighed rainbows…because that’s how realistic this world of type 1 diabetes perfection is.
During pregnancy, the pressure is on. It’s on before you even become pregnant, because, to increase your workload, your blood sugars during the 6 months prior to conception actually impact baby’s organ development! Go figure!
The pressure is on for a full 9 months after becoming pregnant, and that pressure doesn’t let up for the holidays or your birthday or while you’re sleeping. Ever. That pressure is on. It’s the pressure to be perfect. To attain perfect blood sugars so that little bambino can grow as healthfully as possible, and of course so that you, mama, can be as healthy as possible, too.
But that pressure really shouldn’t also translate into: we should all strive to keep our blood sugars between 65 and 123 mg/dL during pregnancy…because our real life while we’re pregnant doesn’t include unicorns and glittery butterflies. It’s real life.
That means that a target range of 65 to 130 mg/dL might not be the right range for you.
That means it’s up to you (with the help of your diabetes and pregnancy healthcare team) to determine what is the safest and healthiest target range for you.
During my first pregnancy, I strived to stay between 70 to 130 mg/dL for as much of the day as humanly possible.
This time, life is different. And that range, while I do strive to be in it as much as possible, isn’t an expectation I can put on myself to the same extent…because there’s a 2 year old here now!
When we go swimming at the indoor “toddler pool” (which is a very lovely 90 degrees, by the way), I don’t enter that pool with my blood sugar near 70 mg/dL or even 100 mg/dL. I always check my blood sugar before we even get out of the car–even though I just checked it before we left the house 30 minutes prior. (I should mention that I’m not wearing my CGM right now, also for personal management reasons I’ve talked about here…so that’s why I need to check 30 minutes later!) If my blood sugar is below 110 mg/dL when we’re still in the car, then I know I’m going to need 1 gluten-free “fig bar cookie” thing to ensure that I stay in a cozy range above 100 mg/dL while we’re swimming. If I check my blood sugar and it’s actually up at 150 mg/dL (wayyyy above my target range), I’m actually not going to take a correction dose of insulin! Partly because I know the swimming will bring it down a little bit, but mostly because I know I will be in a swimming pool where I am responsible for the well-being and safety of my toddler. I can’t afford to have a low blood sugar when I’m in the swimming pool with my toddler.
Fortunately, I’ve never had a low blood sugar while being in the swimming pool with my toddler! YAY! But it’s because during that activity and timeframe, my “target range” for my blood sugars are different, even when I’m pregnant.
And that’s just one example of why someone might have a broader target range during pregnancy! There are dozens, such as, perhaps:
- …you’ve experience seizures in the past from severe lows and have a very intense anxiety about low blood sugars, so you need to run a little higher, even when pregnant!
- …your day-job is very active and low blood sugars are significantly disruptive, so you need to keep your target range slightly higher than “perfect” even when pregnant!
- …you don’t feel low blood sugars easily and your insurance won’t cover a CGM…even when pregnant!
- …before getting pregnant, your A1C was around 8.0% so getting yourself down to 6.5% is actually a tremendous undertaking that you’ve accomplished and maintaining that new A1C is plenty of challenge and stress for you while you’re pregnant! (Congratulations, by the way!)
- …you know your stress load in life right now is ____ and the amount of intensity you can apply to your blood sugar management without falling apart is ___, so you need to let your A1C be ____ during pregnancy for your overall well-being.
The point is: real life happens…even when you’re pregnant!
Yes, you should ask for help from your CDE (or this awesome diabetes pregnancy coach, Jenny Smith) if you’re struggling to bring some of kind of regularity to your blood sugars, but just because you’re not scoring “PERFECT” across the board all day doesn’t mean you’re not doing a great job.
In some ideal (and very weird) world, we’d all be given paid-maternity leave so we could spend our entire pregnancy just focused on our blood sugars. There would be no bills to pay, no houses to clean, no stressful meetings or projects at work, no relationship issues…everything would just be care-free and wonderful so we could devote ourselves entirely to being the perfect diabetic during pregnancy.
But that weird world also includes unicorns and glittery butterflies…and it isn’t real. And that’s okay! Figure out the best range for you (again, with the support of your healthcare team), and congratulate yourself for being brave enough to take on this tremendously rewarding challenge! Your blood sugars don’t have to be perfect in order to create a healthy baby. Do the very best you can in any given moment, and give yourself a break for being beautifully flawed and human.
Photo credit: Adobe Stock Photo
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