My friend whom we’ll affectionately call Reem, so as not to use her real name, is a type 1 diabetic and pregnant! She writes at her blog, The Misadventures of Peabody. The number one thing people email me about is diabetes and pregnancy. I’ve written all I can on the subject but, it’s a unique experience, like every pregnancy, and I thought she would be a great person to interview. She has an amazing attitude, a big sense of humor, and she only has a few weeks left until giving birth! So here is how it’s been going for her…
GG: How many months pregnant are you?
GG: Has there been a particularly tough month during this pregnancy? Why so?
I would say that the entire three months of the second trimester were particularly rough. Gosh, the insulin resistance is no joke! As your baby begins to actually build in size, your body and placenta are crazily releasing so much growth hormone to help the little one grow. Sometimes it made me so frustrated; I thought I was doing something wrong and would feel so guilty. But working with the diabetes educators at the high-risk clinic I’m going to is honestly the key to my success! These people deal with pregnancy and diabetes all day long. Whenever I describe a problem, they know exactly what to do. They know the common patterns of insulin use throughout pregnancy, and so it’s always just a matter of my staying in contact with them throughout the week and making adjustments to my insulin doses—no matter how small.
GG: I can’t help but notice you’re maintaining a healthy weight gain during the pregnancy (meaning you seem to be gaining neither too much nor too little). What does a typical dinner look like for you?
Well, to be fair, I want to first say that I have always been a tiny gal. So I want all those gals reading this who maybe struggle a bit more with weight in general to go easy on themselves. I was actually a bit underweight when I got pregnant, so I had some leeway in the beginning. I’ve now gained about forty pounds, which is simultaneously amazing and comical to me! A typical dinner for me is to try to eat how I’ve learned from Michael Pollan (the food activist): When you look at your plate, break it into quarters. Make one-half non-starchy vegetables (lots of color, thank you!), one quarter carbohydrate, and one quarter protein. And then I always have a little dark green salad, going easy on the dressing. It may appear like I’m limiting carbs, but what I’m really trying to do is make most of them come from good veggies, thus preventing some of those scary blood sugar spikes so common with high-carb meals. I’ve noticed when I do spike, it comes down more quickly this way. I also try not to eat too much at each meal (which is not that hard to do after a while with how the growing baby pushes up into your stomach and you find yourself feeling fuller, faster). This leads you to have small snacks throughout the day and then eating smaller meals—which means less chance of miscalculating your bolus and spiking or crashing. But believe me, I still have days I feel like the Cookie Monster; I’m just careful not to overdo the treats everyday, all day long.
GG: Are you still able to exercise at this point and if so, what activities do you do?
I love to walk! Honestly, I despise gyms! Am I allowed to admit that?! We live in New Mexico where the hiking is just fabulous, and so I hiked into my second trimester (taking it easier and always a bit more tired than usual towards the end of each hike, I’ll admit) And so, my biggest form of exercise now that I’m in my third trimester has been regular walking. I also do a series of yoga stretches specific to pregnancy just to keep my body in all-around good condition for the actual labor. These two things together have also really helped with the mental stresses of pregnancy. I think every pregnant woman has a lot on her mind, but when you’re so focused on tackling an already challenging disease during pregnancy, it’s easy to get anxious and start worrying too much. All that fresh air and deep breathing (go ahead and laugh, but I’m not kidding, it works!) really brings your stress levels down. It’s even helped stabilize my blood sugars.
GG: What would you say is the most difficult aspect regarding type 1 diabetes
Not beating yourself up over every little number. The key is to start off with a good A1c. This reduces the risk of so many fetal problems, but after that, you’re in regular mom mode, wanting to do everything to protect the baby. With diabetes, it can feel like this times ten, at times. I’ve had to remind myself (along with the amazing help I’ve received from my regular visits to the pregnancy diabetes educators!) that not having a “perfect 100” blink at me from my BG meter is not a judgement. It’s just a number; it’s just information. And all you can do is fix it and move on, or start paying attention to a possible pattern so you can work quickly with the pregnancy CDE to make some changes to your basal or bolus needs.
GG: In all your blog posts you sound very positive and energetic, how do you manage to be this way? (I ask because during my pregnancy I found staying positive an extremely hard task!)
Well, I’m sure you’ve noticed after reading to this point in the interview that I’ve had my share of highs and lows, no pun intended! Part of the answer is that it’s part of my personality. I have always worked to see the brighter side of life, the light at the end of the tunnel. Some days are easier than others, I’ll admit, but planning a pregnancy with one of the most non-pregnancy-friendly diseases is no small feat, and everyday I’m reminded of all my hard work and dedication to this little person growing inside me, depending on me. That’s a huge accomplishment in and of itself! The other part of it is that while I’ve never been a very competitive person, diabetes brought out in me a “personally” competitive streak. Every time I feel overwhelmed or chewed up and spit out by diabetes, I remember that I am not going to let this disease ruin or run my life. That taking a hold of it, owning it as best I can, and working to make it a friend (of sorts!) is the only way for me to learn how to manage it for what it is: daily work that never goes away. And so, a whole lot of optimism and a bit of a “tough girl” approach has taken me a long way with this disease in general, but especially with my pregnancy. If you knew me in person, you would fall into hysterical laughter hearing that, considering the first thing that comes to mind about me with most people is not exactly, “oh ya, her. You mean the tough girl?”
GG: Do you have a mantra or motto that guides your outlook on life?
Go ahead and laugh, but that transition point where Thomas the Train is chanting “I think I can, I think I can” to “I know I can, I know I can” is one of the lines that always goes through my head when I feel like throwing my hands up and saying “ok, enough already!” As cheesy as it sounds, that silly song from the Little Engine That Could has gotten me through some rough times in general in my life, not to mention, given me a good laugh that “at a time like this I’m being motivated by Thomas the Train?!”
GG: What prompted you to affectionately name your pancreas “Peabody”?
I was 27 years old, sitting in a hospital bed after having just been diagnosed with type 1 diabetes, and I said to Matthew, my honey: “Well, this is just great! Just great! I feel like I need to have a talk with my stupid pancreas!” The diagnosis was a shock indeed, and as in most cases of being diagnosed with type 1 diabetes, its suddenness was so impersonal and made me feel so robbed; I felt detached from my body. Anyone that knows me knows I’m huge on silly nicknames. I literally felt this need to name my pancreas right there, considering it was the first time we had become formally “acquainted”. The name just popped into my head and that was that: Peabody, the pooped out pancreas was born. Blogging about his misadventures came shortly after…
GG: Do you feel your diabetes will be easier to manage after your baby is born?
I wonder about this a lot now as my due date nears. I read other bloggers and talk to other moms and it seems to depend on so many factors that I’m honestly not sure what to say about what my postnatal diabetes will be like. At this point, I’ve learned to never expect diabetes to be easier—but we can hope, right? I have to say (as I said before) I’ve found that no matter the number I get when I test, whether good or bad, it’s just a number. It’s just information for me to use to make decisions about what to do. And all the studies show that people who test more often have better control of their diabetes. My hope is that even if I am struggling with it after the little one arrives, that I will remember how much work I put into getting pregnant, having a healthy pregnancy, and having a healthy baby. All of that depended on using insulin most effectively, and using insulin most effectively depends on knowing your numbers. My hope is that even if it’s not easy (which, let’s be honest, when is it ever?) I can remember my Thomas the Train motto (!) my desire to live a long, healthy life with my family, and to celebrate the small victories even on those “it’s a bad day to have diabetes” days.
GG: Are you planning on breastfeeding?
Absolutely! I feel aligned with a more Attachment Parenting theory approach, and so I’ve worked on learning as much as possible about baby-led breastfeeding, pumping to store as much milk as possible, and even how to babywear and breastfeed. This answer doesn’t even touch on the studies that show the many health benefits of breastfeeding to both baby and mother, but I’ll leave that up to the reader to decide on, since there’s so much information out there about it.
GG: Did you experience any morning sickness and if so, what helped you deal
I honestly only had queasiness (I know, very lucky!) Being the nerdy gal that I am though, I researched this heavily before I even got pregnant because I was very nervous about the “what if I have morning sickness so bad I can’t stop vomiting?” question. We all know diabetes and vomiting are a dangerous combination, too. I found that by drinking some herbal pregnancy tea first or with my breakfast (and going easy on heavy breakfasts—something more like fruit, cheese slices, nuts, a handful of whole grain crackers) really took the edge off. Also, because you can really be hit by a wave of nausea anytime throughout the day, I was sure to always have a small snack with me that included some carb with some protein, to keep my blood sugar from swinging.
GG: Is there anything you are afraid of right now?
I really want my blood sugars to remain stable throughout the labor and delivery so that my baby’s system is not taxed in any way (if you have too much of a spike during the delivery, the baby’s pancreas will release insulin and they can end up with low blood sugar). But I’m also afraid of low blood sugars in myself, simply because we all know how awful and exhausted you feel after having to treat a low BG. I want all of my energy to be focused on the baby’s birth, but I know that my diabetes is an inherent part of the delivery. With so many things to juggle during that time, I sometimes become afraid that something will surely fall. But then I’m reminded of how nervous I was to get pregnant, how nervous I’d get throughout the pregnancy…and how I’m now in the home stretch with a baby who’s showing to be completely healthy and normal according to my perinatologist. I have to remind myself this is all because of hard work and dealing with diabetes for the ever-changing situation that it is. Sometimes you just need to literally take diabetes moment by moment.
GG: What has been your favorite part of this pregnancy so far?
Just knowing that after all that baby-dreaming and hard work to keep my diabetes stable, we have a little person on the way! I have always dreamt of being a mom, and not allowing diabetes to stop me in my path for any reason whatsoever (especially becoming a parent) has been the most exciting thing to me for the entire course of my pregnancy. Believe me, I’ve met some people along the way who felt the need to share their misinformed “diabetes and pregnancy” comments, but what’s been so wonderful is when I’d meet someone who simply said, “Wow! You look amazing! You look so healthy! I’m so proud and happy for you!”
GG: Is there anything you’d like diabetic women out there thinking about having a baby to know before they get pregnant?
All of the practical things that you’ve read a million times are true. Getting an A1c in range is so vital! But don’t beat yourself up about it by simply contemplating the work and translating it into a number; you’ll get frustrated and overwhelmed. Look at making small changes for better health that you know are possible to make, such as rebalancing your diet, but not driving yourself crazy over it. Test your blood sugar often, so that you can find patterns and get to know your own diabetes in an intimate way. Stay active and stay positive; stress does such a number on all of us, let alone our diabetes. Know ultimately that planning a pregnancy with diabetes is just a matter of taking it day by day (and sometimes moment by moment) to get where you want to be. Soon, you’ll find yourself there. I promise.
Thank you Reem Bee for taking the time to answer these questions! You’re a great mom, already. Here’s wishing you a great pregnancy finale, a healthy you, and a healthy new baby!
PS, you’ve probably heard this a million times already, however I can’t help but suggest: sleep while you can! :)