Stumble It!
How to Get Pregnant with Type 1 Diabetes (All the Lifestyle Tips)
Who recognizes the name Lyrehca from the blog Managing the Sweetness Within, chronicling one woman’s efforts to get and stay pregnant while dealing with her lifelong type 1 diabetes? Yes, you guessed it: Lyrehca is coming out of the closet as herself, Cheryl Alkon, now-author of the forthcoming book Balancing Pregnancy With Pre-Existing Diabetes: Healthy Mom, Healthy Baby. Today, Lyrehca (er, Cheryl) shares a brief version of her story, and some don’t-miss tips on diabetes and pregnancy.
A Guest Post by Cheryl Alkon, D-blogger and author
When I first thought about trying to get pregnant, almost five years ago, I did everything I was supposed to do:
- I stepped up visits to my endocrinologist for pre-pregnancy consults
- I worked to get my blood sugar numbers into the tight ranges recommended for pregnancy
- I saw my eye doctor to check my eyes for any longterm damage from diabetes and learned how pregnancy mightaffect them
- I ate better and took prenatal vitamins
I also looked everywhere for books and websites about the subject and I soon met with the maternal-fetal medicine specialist who worked with my endocrinologist at my hospital’s diabetes and pregnancy program.
Despite excellent blood sugars, an overall good bill of health, and extensive knowledge about the topic, I left the specialist’s office in tears.
Why?
The doc, also known as a high-risk obstetrician, spent our appointment telling me all the terrible things that could happen in a pregnancy complicated by diabetes. Yes, tight blood sugars were necessary. Without them, the chances of having a pregnancy colored by complications, both for me and for the unborn baby, were high. The visit was a long list of all the potential things that could go wrong, from the pregnancy itself, to actually giving birth, to the health of my future child: birth defects. Potential miscarriage. Pre-ecclampsia. Vision issues. Kidney complications.
Oy.
And yet, I had a handful of friends, longtime type 1 women like me, who were in our 30’s and had had their own healthy beautiful children. They were not hobbled by illness or problems throughout. They may have had an issue here or there, but they managed things and got through them. And they were able to do it with the tight blood sugar control recommended for women with pre-existing diabetes. The truth is, with average hemoglobin A1C numbers in the 4-7 percent range, women with diabetes are no more likely to have pregnancy complications than are women without diabetes. This was recently proven by research in the journal Diabetes Care that found women diabetes who had A1C numbers 6.9 percent or lower had no more risk of “serious adverse outcome” than the non-diabetics did.
I knew I could try to do it, too.
Soon, I started blogging about my efforts to get and stay pregnant, while managing my type 1 diabetes. I liked the support I received from commenters. Plus, I wanted to connect with others who were pregnant, had given birth, or who were trying to conceive, all with type 1 diabetes.
At the same time, I found that there were no insider’s guides to pregnancy with pre-existing diabetes that were told from an actual woman with diabetes’ perspective. The books sanctioned by official diabetes organizations were written by health care professionals, and not by people with diabetes (as far as I could tell). I found Kathryn Gregorio Palmer’s excellent book, When You’re A Parent With Diabetes, which touches on pregnancy, hadn’t been published yet. And while I found an out-of-print Australian book that interviewed women with type 1, but it was actually pretty dry and clinical.
I began slowly finding other bloggers writing about pregnancy and diabetes. I found the great website DiabeticMommy.com, which is a sprawling bulletin board devoted to all things pre-pregnancy, pregnancy, and parenthood, with type 1, type 2 and gestational diabetes. There are some excellent Yahoo Groups devoted to these issues as well, particularly PositiveDiabeticPregnancies and PregnantPumpers.
Super-tight control for pre-pregnancy, as defined by my docs in my hospital’s diabetes and pregnancy program at the Joslin Diabetes Center, is having blood sugars of about 70-100 mg/dl before meals, about 120-140 mg/dl one hour after meals, and 100-140 mg/dl before bed. Once pregnant, those numbers dip even more, to 60-90 mg/dl before meals, with 120 mg/dl an hour after meals and 100-140 mg/dl before bed.
Huh?
It took a lot of trial and error, along with constant blood sugar testing (sometimes once an hour, up to 15 times a day), but I was able to figure out which foods I could eat that wouldn’t spike me too high after a meal (hello, oatmeal and whole grains, particularly mixed with some low-fat protein; goodbye, white bread). Exercise—even a stroll after a meal or a walk to my local train station—always helped smooth things out. And this was in the days before I had a continuous glucose monitor. I recently started using one and it’s sometimes really surprising to see how some meals show a nice slow and unpronounced rise in numbers after a meal, and how some meals really sent things flying high (oy, French fries, what did I ever do to you?)
Of course, everyone is different, and what works well for me, food-wise, might send another person’s numbers soaring. SO much about diabetes is trial and error, and figuring out what works for you, pre-pregnancy, can make actual pregnancy and its inevitable changes and challenges (hello, hormones and insulin resistance) easier to handle.
I’m pleased that after many long months, I finally got pregnant and knock on wood, had a pretty healthy and normal pregnancy (the details are all on my blog.) Our healthy son, known online as Toddler L, was born two years ago without any problems and thrives today as his chatty and mischievous self.
I’m also facing another kind of birth. After an equally long process, the guide I wished I had back in the day will be published in early 2010. My book, “Balancing Pregnancy with Pre-Existing Diabetes: Healthy Mom, Healthy Baby,” (see above link) will be published by Demos Medical Publishing in early 2010. It gives the insider details of pregnancy and type 1 or type 2 diabetes, using both my own experience and insights from dozens of other women who have been there. I hope it will give future readers the kind of information I was so hungry for and that it will give them the sense that a pregnancy with diabetes doesn’t have to be the horror show some doctors (or the technically accurate but extremely dated film Steel Magnolias) would lead you to believe.
Instead, pregnancy with pre-existing diabetes is a challenge and a boatload of work, no doubt, but it can be a pregnancy where the end result is a fantastically healthy and happy new mother and baby.
Explore posts in the same categories: Books & Resources, Personal Stories
I’m one person who is very glad that you’re writing this book now, Cheryl. Pregnancy isn’t on our agenda for at least another year or so, but I’ve pre-ordered the book on Amazon and will be glad to have the chance to get the information you so desperately wanted before we even start trying. Congratulations on getting the book deal – I can’t wait to read!
Posted by: Caro | August 4th, 2009 at 11:08 amCongrats on your successful pregnancy and good on you for publishing a book. Our stories are similar and our children are the same age. Some how, I never found your blog. Would have loved a “sister” to share the saga. I don’t have the strength to do it again. Will cherish my daughter.
Posted by: Chris | August 4th, 2009 at 12:01 pmI don’t understand why people feel that they are only capable of loving children with whom they share DNA. I am a type 1 diabetic and so is my little brother. I don’t think there’s anything so great about my genes — in fact, they are rather rotten, fraught with the auto-immune diseases that run in my family.
I will adopt a child, or children, when the time comes rather than risk my own health, the health of the baby, and take the chance of having a type 1 diabetic kid. I couldn’t live with myself if I were to pass this on. I don’t get the genetic narcissism that drives people to procreate even when there’s evidence that their genes are time bombs. There are plenty of beautiful children (who already exist) in need of loving parents.
Posted by: Lauren K | August 4th, 2009 at 2:28 pmI truly agree with Lauren K. My wife, a lifelong type 1 diabetic was determined to get pregnant 25 years ago and did. We had a normal, healthy beautiful boy. However, the damage the pregnancy did to her body was immeasurable. She had her first myocardial infarction (MI) about a year after our son was born. Her kidney disease reared its ugly head a few years later.
Despite being on a pump, doing everything right and being a truly motivated and pretty well controlled (h1c aroung the 6 range) diabetic, she died from kidney and heart disease at age 49.
I think the pregnancy cost her at least 20 years of life and the last 5 were no picnic with dialysis and heart surgeries. She always said that it was worth it. I love my son. However, I miss my wife every single day. I won’t get to grow old with her. It was her choice and we both thought things would go differently, but people need to know the risks.
Posted by: Dave H. | August 4th, 2009 at 3:59 pmYour information is inspiring to me and these things did helped to others.
Posted by: Joann | August 5th, 2009 at 2:56 amThanks for sharing it.
Dear People with Diabetes who have decided not to give birth,
Please take a moment to consider the fact that your diabetes may not be the same as everyone else’s diabetes. Consider that your experience with diabetes might be different than mine. Consider that your family’s incidence of and experience with chronic disease is not the same. Consider that perhaps there are those who would not be suicidal if their child developed diabetes.
Then, avoid the name calling and superior tone.
Having and raising children is a personal decision. You make yours, let me make mine (yes, knowing the risks) and have a little confidence that I might be making the right decision about my future and my family.
As an aside, there is a great story in my book about a woman who chose adoption over pregnancy. She considered all the risks to her and decided that she wanted to be a mom, not necessarily give birth. Her decision based on careful thought, and a beautiful one at that.
Kassie
Posted by: kassie | August 5th, 2009 at 11:41 amType 1
Parent of a Type 1 child
Dear Mr. H & Lauren K,
Posted by: Sunni H | August 15th, 2009 at 11:54 pmI appreciate you taking the time to share your opinions w/ those wishing to start families & give my sympathies for losing your wife Mr. H- I too have lost family members to type 1 & know what the last 5 yrs are like.
As a women with type 1, pregnancy is a very tough decision. I know that I could love any child as much as my own. So why risk it?
Being diagnosed at age 10, I can attest that there are many psychological impacts most people don’t know about which result from diabetes. I’m sure you both have some level of understanding. But for those that don’t, her is a small insight:
Diagnosed rather young, I was convinced that I was no longer “me”, I was “a diabetic” because in order to have good control, diabetes had to control just about everything!
Of course, what I could and could not eat: At 10, watching my brothers eat pop tarts as I ate toast everyday – made me really hate diabetes.
It controlled thoughts:
Thinking about everything you put in your mouth not just the carbs and sugars and fats it contains – but calculating how it will affect the rest of your day’s decisions, about whether you can take a nap or exercise and how that affects your basal rate, where you will be and where your supplies will be. Creating a plan for PE, how to work diabetes into my soccer games and summer camps w/o Mom around.
It has to control your choices:
Suddenly being in a swimming situation and not having the cap you need to cover your pump, not going somewhere spur of the moment because even your back up supplies won’t do because they’ve expired, or the thousands of times you eat when you don’t want to because your bloodsugar is too low.
Being told your entire life:
“your body is not life everyone else’s” or “you should hurry and get married so you can have kids” or worrying your whole life that the person you fall in love with may not want to be with someone or may not be able to handle marrying someone who poses such a health risk to herself or their child/ren.
Finally, just dealing with the small irritation of having to tell every teacher about it, or every person you know and the 10 million questions that follow and them thinking you have it because you eat too much. Or better yet, being asked, “can you eat that”, “are you allowed to have that?”, “I thought diabetics can’t have that?”, only because people CARE about you.
So for those of us IN CONTROL, the real decision about diabetic pregnancy comes down to, “Will diabetes stop me from living the life I want to have?” Lauren – perhaps your rotten DNA does not contain this maternal drive, but many women have always dreamed of pregnancy, of that maternal connection, of being able to breastfeed and feel the first kick.
I am so happy for your wife Mr. H, that diabetes didn’t stop her from living the life she deserved to have . Don’t forget your wife decided OVER 20 years ago to make that decision also – and with all due respect, in terms of medical technology that is EXTREMELY OUTDATED data. Regardless, she told you herself she wouldn’t have changed anything – so don’t ever regret the decision you made together. Congratulations to you both on healthy children and happy lives, and may you respect the blessings of modern day miracles and medical advancements.
Sunni H
Type 1
Great post! For so many of us with diabetes (whatever kind) all we hear is the bad stuff. Let’s keep in mind that many of the horror stories we hear are from the past – before good home glucose meters, rapid acting insulins, pumps etc etc etc. I find what most people know about D pregnancy is all from “Steel Magnolias” which, while being a true story, is also not much relevant to how diabetic pregnancies go these days. A lot has changed. Yes, we may be more prone to complications, but really, look at those numbers, with good control they are still extremely small. Read the medical journals on the studies done and you will see that the risk of higher complications is minuscule with good control and a well monitored pregnancy.
I am so glad I chose to have my children. I have one perfectly healthy daughter and a son on the way in 13 days. I have had Type 1 for over 15 years. Not once did my excellent team of doctors ever tell me not to do it, or that I would be harming myself or my baby. We just made a plan and I have followed it, and everything has turned out excellent.
To Lauren – where in the world did you get “people feel that they are only capable of loving children with whom they share DNA” – that was not mentioned anywhere in the post. Also, your statement that you “don’t get the genetic narcissism that drives people to procreate even when there’s evidence that their genes are time bombs” is ridiculous on many levels. Genetic narcissism to want to have your own children? Hardly. And I am really sorry for you that you feel your genes are ticking time bombs. I’m sure that even if my daughter or son comes down with Type 1, they will still be happy to be alive, just as I am. Diabetes sucks, sure, but it doesn’t make me wish I were never born.
Posted by: Ruby | August 21st, 2009 at 7:16 pmRuby, if it’s not genetic narcissism that drives people to have biological children, what is the drive to have them? When there are so many children in the world who need loving homes, why create more children, unless you want to propagate your own genetic lineage?
And yes, it annoys me when people say they want to have their “own” children. Any child that you raise and love becomes yours.
Posted by: Lauren K | September 8th, 2009 at 10:49 pmI am 35 years old and have known about my type 1 diabetes for only 1 1/2 years. My husband and I are planning to have children as soon as we can. I understand that as a type 1 that you are considered high risk, but I would also like to believe that as long as you take very good care of yourself and have faith that we have the chance to have perfectly healthy normal babies. I guess anything is possible, but I believe in God and if he wants me to have a child then nothing…no disease will stop that. If I am able to have a child then my biggest dream will have come true and if I die from complications soon after then I will have died a very happy person. It’s very personal decision to have a child and we shouldn’t critisize others for their peronal decisions. Good luck to all of you.
Posted by: Priya Srivastava | September 11th, 2009 at 1:26 pmI am sooooooo glad I found this. I too experienced nothing but horror from doctors the moment I became a type I diabetic 10 years ago.
All POV’s expressed here are valid and reflect my thoughts and experiences, both positive and negative.
Cheryl, you rock, for your ability to express yourself and get it out there to make a difference for others. I am so thankful. Thank you.
I have been so frustrated for the past few years with the lack of facts, common sense, and bedside manner when it comes to Diabetes. I have had most trouble with insurance. I have lived under the poverty line for most of my life and many doctors stare in disbelief as I say I have no insurance….or had no insurance.
Then of course many doctors don’t know what they are doing.
Yes, the prenatal specialists just look sat you severely and basically all but says you will miscarry but “good luck”. Overcautious to the point of ridiculousness.
I am pregnant again and this time I don’t feel so alone.
My dream is to have a diabetes wellness center run by diabetics for diabetics. Without all the concerns of lack of healthcare, To be penalized for a preexisting condition? Are you kidding me?
I have a great health team of 4 people, one of which, my endo, is also a type I diabetic, who in fact became so 10 years ago as well.
It took me ten years to find these great people.
I hope that your book and the posts of all these courageous people become the shoulders others can stand on to live the best life possible.
thanks again.
Posted by: Ocean | September 12th, 2009 at 6:27 amAn informative story, useful to everyone who has diabetes and wanted to become pregnancy, particularly important points are:
Posted by: Diabetes Pregnancy | September 29th, 2009 at 4:23 am# stepped up visits to my endocrinologist for pre-pregnancy consults
# worked to get my blood sugar numbers into the tight ranges recommended for pregnancy
# saw my eye doctor to check my eyes for any longterm damage from diabetes and learned how pregnancy mightaffect them
# ate better and took prenatal vitamins
I get the diabetics past 14 yrs i get marriage before 2 yrs i went for pregnancy treatment but the result all negative now i did n’t went for treatment i want special doctors who treating for type 1 diabetics patient for pregnancy.
Posted by: p indumathi | October 20th, 2009 at 2:29 amNice post. For those who have trouble in getting pregnant, then worry no more because I have found a great and effective ways that will help you conceive in just weeks, just follow the tips on tipstogetpregnant.co.uk
Posted by: Alvin | January 21st, 2010 at 12:26 amThe most important thing to do while trying to get pregnant is to keep the faith and courage. Without both, we will give up quickly and the miracle will never come.
Posted by: Claryssa | January 21st, 2010 at 4:46 pmNice post. For those who have trouble in getting pregnant, then worry no more because I have found a great and effective ways that will help you conceive in just weeks, just follow the tips on tipstogetpregnant.co.uk
Posted by: Kelvin | January 28th, 2010 at 4:12 amIn response to Lauren K’s comment, I have Type I Diabetes, have only had it for 2 years, I am 29 now, and can’t wait to have children! I don’t believe that because you have this disease, which I agree is terrible, you should deprive yourself the chance to experience a baby of your own. There is no way to know that you will pass the gene on to your children, I bet your parents had no idea they would create a child with diabetes. I know my parents never thought they would have a child who developed diabetes, especially since it does not run in our family and I am the only one who has the disease. What if my kids are healthy and never develop Type I Diabetes? Adopting does not mean you are going to have a Type I Diabetes-free kid. They could develop it late into their 20’s or 30’s. Then what would you say, you shouldn’t adopt either?
Posted by: Alicia | February 15th, 2010 at 5:36 pm