Tag Archives: pregnancy

Diabetic pregnancy diet

 

My belly at my babyshower (6 months pregnant)
My belly at my babyshower (6 months pregnant)

 

 

First off, I’m going to assume that you want to take extra care while pregnant because you’re a diabetic and want to do everything in your power to keep your child safe.  Yes, there are women who eat anything and everything and gain 100 pounds while pregnant.  You know better and the fact that you’re reading this right now means you want to do your best.

I researched a ton while pregnant and even before getting pregnant (even though my pregnancy was unplanned).  I am a total worrier-not warrior, worry-er.  I felt that I should do everything in my power to keep my children safe (I had twins) and I wanted to have a non-guilty conscience should something go wrong.  Obviously I would be extremely sympathetic to the woman who did some things I wouldn’t and had something go wrong during her pregnancy because anything but sympathy in this case would just be cruel and illogical.  The point is we women are very sacrificial like this so I know you get what I’m saying.  I wanted to do everything I personally could stand to do right.

Anyway, I was really strict with how I ate.  I looked all around me during my pregnancy and saw all of these happy pregnant women, lounging in restaurants or parks, eating chocolate ice cream and deli meat sandwiches while drinking regular coke.  I was jealous of how relaxed they were.  I was pretty on top of things.  Especially when it came to blood sugar control-but that’s another post.

I can give you is reassurance in knowing that A:  I had out of control diabetes for over a decade before getting it well under control, B:  I had a twin pregnancy which is risky even for a non-diabetic, and C:  My babies and I ended up fine-which I hope can give you some consolation if you are feeling anxiety or worry over your own pregnancy as a diabetic.

Here is how I ate during my pregnancy:

The first trimester I was so severely nauseated that eating healthy was pretty tough.  I craved salads and carbs.  The salad part was easy and I would eat a huge salad about 3 times a week that consisted of:

-Romaine lettuce

-Iceburg lettuce

-Spinach

-Kidney beans

-Chickpeas (great source of iron which I was deficient in)

-Boiled eggs

-Carrots

-Onion (for some reason I craved lots of onions!)

-Green peppers

-Tomato

-Cheddar cheese

Dressing:  Extra virgin olive oil and vinegar plus salt, pepper, and lemon

(I would get these salads at Ukrops where I could build this huge salad in minutes!)

-Now a typical breakfast for me was 2 lightly fried eggs (sometimes raw in a milkshake) (salmonella is very rare in organic eggs by the way-I’ve had raw eggs for years and never had a problem)

Or-sometimes for breakfast I would have:

-A piece of toast with butter or cream cheese.  I didn’t have just any old bread though, I ate/still eat Ezekiel’s 7 Grain Bread which is made from sprouted grains so is much higher in nutrients and is low glycemic-great for us diabetics.  It also keeps me full for a long time.  Literally, one slice is good for my entire breakfast nowadays (keep in mind I’m naturally petite though so you may need 2-3 slices).

Let me pause right here for a second.  You may be thinking, that is all she ate for breakfast while pregnant with twins??  Yep.  I ate 3 meals, 2 snacks a day and kept everything small but healthy (except for my gigantor salads).  We are fooled into thinking that when are pregnant we need to eat, eat, eat!  Sadly, we don’t need but an extra snack a day.  If carrying twins, make that two snacks.  Pregnancy isn’t a time to go nuts with food.  It is a time to carefully eat what you and your baby need during this special journey.   It really feels nice to be almost back to normal once the baby pops out too ;)

That said, here is what a typical snack was: 

-Raw vegetables dipped in light ranch

-Fresh fruit

-Cheese (usually organic mozzarella sticks)

-More bread with butter (for some reason this made me feel really good throughout my whole pregnancy-this bread is also a miracle against constipation which I really didn’t deal with despite 2 iron pills a day for months)

I normally eat more different foods than the above but, during pregnancy lots of foods suddenly smelled awful and so I was forced to eat a lot of the same stuff.  (But, I did vary the fruit and veggies a good bit)

A typical lunch/dinner:

-Rice and black beans

-Chicken (I ate lots of organic chicken)

-Beef (I could eat it if it wasn’t cooked near me lol)

-Pasta (my mom made me a lot of different pastas which helped my nausea a lot)

I ate all of the above with some vegetable, my favorite was steamed broccoli.

I drank mostly water and caffeine-free tea.

As you see I ate plenty of protein and vegetables so that I’d have nutrient rich meals.  I would add rice, pasta, or legumes so that my body would have enough calories to do the big job it was doing.

What I strictly did NOT consume:

-No caffeine (this meant I didn’t even have a single piece of chocolate-boy did I miss this!  This also meant no caffeinated drinks like coffee, tea, sodas)

-No corn syrup (this was hard because corn syrup is in so many things but, I think it’s worth staying away from)

-No artificial sweeteners (I’ve heard this is bad news during pregnancy and for health in general so instead of risking it I just did away with it).

-No seafood whatsoever (most seafood has far too much mercury and since it can harm unborn babies I chose to just not have any-what is 9 months anyway?)

What I limited:

-Non-organic food

-Non-filtered water

-Junk food (I had about 5 Hardees thickburgers during my pregnancy :D )

-Greasy or Spicy food (just because it made me feel like I was dying after eating it)

I was very careful with deli meats and soft cheeses like Brie.  It is best to know where your deli meat came from before eating it and it is best to not consume certain cheeses.  Just do a search to find out which those are ;)

Obviously some of these things are difficult to follow.  I think you should do your own research and think about what you can/can’t live without (I promise you can live without everything you think you can’t however ;)  But, just make a list of things you’re willing to sacrifice and follow that. 

-My splurge was ice cream-high quality ice cream like Haagen-Dagz. mmmm…..(but, I wouldn’t eat a pint a day mind you, maybe a pint a week, and the hubby helped)

In the end I’m sure you and the baby will be fine.  Remember, the best feeling is trying your best and having a great outcome.  The proud mama feeling will be a great source of strength for you once it’s time to change those never-ending diapers!

A note on guilt:  At 8 months old my daughter was diagnosed very allergic to peanut and egg, two allergies that cause a life-threatening condition.  This has changed our lives.  Some days I wonder if I could have done something different while pregnant to have prevented her allergies.  Yet, when I look back at what a decent job I did, I truly can’t figure out what I would have changed.  Maybe worry less?  Anyway, this is why you want to try your personal best :)  And try to relax!

So…Oh, is there anything I’ve left out?  Anything you would or wouldn’t eat while pregnant?  Share in comments, others desperately want to find out!

Interview with Cheryl Alkon, author of a great new book for diabetic women

book_cherylalkon

Cheryl Alkon has worked a long time in journalism.  She has also had type 1 diabetes for over 3 decades.  This combination seems to have produced an inquisitive diabetes researcher.  Willing to share one of the biggest issues in her life, Cheryl has blogged about infertility, pregnancy, and other diabetes related themes on her blog, Managing the Sweetness Within.  This has led her to write the new book, Balancing Pregnancy with Pre-existing Diabetes: Healthy Mom, Healthy Baby.  I just highly recommended this book in a review you can read here.

Check out this interview with Cheryl below:

Cheryl Alkon
Cheryl Alkon

 

Cheryl, in a few words, how would you best describe yourself?

 

A writer who asks a million questions and writes pretty much the same way I talk.

Big, huge, super congratulations on publishing your new book! Why did you decide to do it?

Thanks! I wrote the book because when I first thought about having a child years ago, the main message I remember is what terrible complications could happen, and what a downer the whole experience sounded like—if you were able to have a healthy child anyway.

I had a few friends, longtime type 1 women like myself, who I saw had healthy kids, and I knew it was possible. But when I went looking for an insider’s guide of how to do it, I couldn’t find one. I’d always had thoughts about writing a book, and when I realized there was no book like the one I was seeking, I decided I would need to write it myself.

What is the tone of your book?

Definitely down to earth, reassuring, and conversational. In other resources that explain diabetes and pregnancy, the info is straight from the doctor’s office: dry and clinical. I wanted my book to be completely different from that—full of advice and insight and even humor from many other type 1 and type 2 women who have dealt with pregnancy, as well as preconception, delivering, new parenthood, pregnancy loss and infertility—all with diabetes.

Do you talk a lot about your own experience in the book?

Yes—it’s a bit like a memoir at times. I am very up front about what I did to get my blood sugars in relatively tight control, what I ate, how I dealt with insulin reactions and retinopathy, delivering, and my own history with loss and infertility. While I did a ton of research and talked to many people for the book, my own experience helped me figure out what to include in the book.

How have people responded to your book thus far?

I’m thrilled to say it’s all been pretty positive. People have thanked me in reviews and emails for providing a resource that the diabetes community has lacked for so long, and people around the world have bought the book from me and from other booksellers. My own doctors—who co-wrote the forward and reviewed every word before publication—have been really supportive about it, too.

What was the hardest thing for you during pregnancy?

All of it, really. Keeping your blood sugars within the recommended ranges is really tough. I have never had more lows, or freaked out about highs more, when being pregnant. Also, I really like sushi, deli meat, all sorts of smoked meats and fish, and drinking a lot of Diet Coke; none of these foods or habits are recommended during pregnancy, and I missed them.

Raging hormones and having diabetes have the potential to create a lot of emotional havoc. Was the emotional factor a big issue for you during pregnancy? If so, what helped you stay calm?

I am actually 16 weeks pregnant again as I write this. I honestly focus so much on where my blood sugars are at any one time that I’ve barely thought about actually being pregnant except when I’m at the doctor’s office for one of my many checkups. I am lucky in that I have never felt much different while being pregnant than when I am not (except for the obvious weight gain). I’m more annoyed about how my hormones affect my blood sugars for the worse and what I can do to get them down as quickly as possible without going too low a few hours later.

I really wish your book had come out a year earlier to help me through my pregnancy! For a diabetic woman out there considering pregnancy for the first time, what advice would you have for her?

Buy and read my book!

Beyond that, I’d say if you are just thinking about pregnancy, talk to your endocrinologist and a maternal-fetal medicine specialist or a high risk obstetrician about what you need to do before you get pregnant, where you blood sugars should be, what health tests (such as a dilated eye exam) you need before getting pregnant, as well as asking how much experience your endo and your obstetrician have with pregnancy and pre-existing diabetes. You want to find doctors who are up to date, who have managed many other pregnant women with diabetes (and in particular, YOUR type of diabetes, not just a bunch of women with gestational diabetes), and how they will work with you before and during your pregnancy so that you will have the healthiest pregnancy and baby possible.

Something particularly shocking for me after giving birth to twins last June was that the hardship wasn’t over once the pregnancy was done. For example, I had a hard time breastfeeding and figuring out how to take naps and still keep on top of my blood sugars.

Is there anything you would advise a new mom about taking care of diabetes, post-partum?

Remember that you still need to take care of yourself as well as your newborn (or newborns!). Test your blood sugar before your meals—and remember to eat those meals.

If you’re breastfeeding, have some juice or some sort of snack or source of glucose nearby because your sugars can drop as you’re nursing or pumping breast milk.

Walking around the block with your newborn, even for just ten or 15 minutes, can help you try to bring down high blood sugars if you’ve been stuck in the house all day or night trying to calm or feed or diaper a baby.

If you have an insulin pump or a continuous glucose monitor, definitely use them. Test your blood sugar frequently.

And finally, ask for help: friends or relatives can come by and bring you healthy groceries, or a stash of juice boxes to help battle lows, or can even just watch the baby while you nap and take a shower. People are often happy to help you if you can let them know what will help you best.

In the end, you and your son are healthy. You should be proud. How do you feel when you think back on the journey of pregnancy and pre-existing diabetes?

Frankly, it’s been (and continues to be) a very long and potentially stressful haul. To me, pregnancy with pre-existing diabetes is something you have to endure to be able to hopefully have a happy and healthy baby. It was not, nor is it now, a magical time where I can just eat whatever and just plan what my kid’s nursery is going to look like. I think and thought constantly about my blood sugars, what I ate, and how it was affecting my kid-to-be. I hope my book will help others realize that pregnancy with pre-existing diabetes is tough, but it can be done.

Bottom line: my son is fabulous, and I am doing everything I possibly can and hope that my next child will be as well.

Thanks for being so candid Cheryl, I know your hard work will pay off :)

Must read book for diabetic women who are pregnant or considering pregnancy

Aurora gives the book two thumbs up

Two good reasons to buy this book              Henri does, too!

                           
 
                                                     

 

The following is a review of Cheryl Alkon’s new book, Balancing Pregnancy with Pre-existing Diabetes: Healthy Mom, Healthy Baby.

Before continuing please know I choose to only give unbiased reviews.

I was very blessed with my pregnancy last year.  All three of us ended up just fine (I had twins).  So even though this book was published just after my pregnancy I was still extremely interested in checking it out.  “How helpful would it have been?”, I thought to myself. 

If you’re reading this you are most likely a diabetic and know what it is like to worry about your health. 

Well, as you might imagine a pregnancy adds loads of worry!  I told a friend recently that I wasn’t kidding when I said I got tons of grey hairs during my pregnancy.  I was a total mess!

I would seek out information about other diabetic women having babies and wouldn’t find anything except the generic “It can be done but, pregnancy in diabetics carries many risks…blah blah blah”.  I wanted to ask women who had been there some questions but, I couldn’t find anyone to ask.  I can’t tell you how many women with gestational diabetes told me, “Oh you’ll be fine, its no biggie!”  Yet, pre-existing diabetes is a biggie and pregnancy on top of that is a biggie, too. 

I felt very alone and my 8 months of pregnancy were quite miserable-albeit spotted with a few miraculous and joyful moments like when my babies swam in my belly.

Cheryl’s book is generously filled with different women’s accounts on their pregnancies with pre-existing diabetes and after reading it, I wanted to cry.  I realized I wasn’t alone last year.  Here were all of these women feeling the same things I was and experiencing the same things and struggling with the same things. 

Had I known then about this book (and had it been published then), I would have paid many times the cost of the book.  The relief I would have experienced from all of the information in this book would have been priceless. 

So I wholeheartedly and firmly recommend this book to any diabetic woman (even with type 2 diabetes) who is considering pregnancy, trying to get pregnant, or even 6 months pregnant.  Why?  Because of mainly 2 reasons:

1.  This book is a result of a lot of well done research.  I do tons of research myself and still managed to learn a lot from this book.  I would have taken this book along to every doctor visit as a companion and reminder of things I might want to discuss with the doctor. This would have been ideal because believe me if you haven’t experienced “pregnancy brain” yet, you will and you’ll know how great it is to have a reference book to guide your concerns, questions, and issues.  Other books are helpful but, not catered to the uniqueness of a pregnancy of someone with pre-existing diabetes, be it type 1 or 2.

2.  For me this second reason is as valuable as the first.  This book will give you inspiration by knowing many other women have had successful pregnancies despite being diabetic.  You will definitely be relieved by the accounts and details bared.  Many people in today’s medical field do not place a lot of attention on a patient’s emotional and psychological state.  I think it makes an enormous difference for mom to feel assured and baby to sense that peace and calmness.  Dad will benefit from this too, I’m pretty sure ;)

I’m grateful this book is out there for women to purchase and would make a great gift for a female family member or friend.  (It would be awesome if medical facilities could distribute the book to diabetic women, as well.)

Check out Cheryl’s blog, Managing the Sweetness Within where she has chronicled her journey with infertility and a successful pregnancy.  She also just delivered super big news that you may be interested in following-I know I am.

Stay tuned for a great interview with Cheryl coming up in less than 24 hours!

What the first year with twins was like for this diabetic

 

Aurora and Henri
Aurora and Henri

I get so many questions about what life is like with twin babies plus diabetes.  I certainly don’t think life is “typical” for me but, it is gradually settling down to something more recognizable.  Henri and Aurora just turned a year old.  As I look back I’m unbelievably relieved to have made it this far in one piece.  If you think I’m being dramatic here is a monthly run down of the past year :)

June 2009

I am due in a month and as big as a whale.  In fact I no longer fit into any maternity clothes because my belly is too big.  The rest of me is beginning to swell.  I am not able to sleep more than 4-5 hours a night.  My son has positioned himself for birth with his head very low in the birth canal.  Every time I sit down I feel I’m squishing his head and worry about how he’ll turn out.  I’m testing my blood sugar 12-18 times a day.  June 15th I’m admitted into the hospital with preeclampsia.  I want a natural childbirth with no pain meds so despite not dilating past 1 centimeter, I wait it out with birth inducing medicine.  My husband endures the meanest woman ever for the next 20 hours.  Late the next day I get an epidural (kind of like heaven at this point) and because my blood pressure is so high the Doc says, “please let me take your babies by c-section”.  I finally say Ok, after all, I’m still not dilating past 1 centimeter.  (What is wrong with me?)  I’m fully awake while my babies are delivered and each one is in need of zero assistance despite being born a month early.  I am so happy.  Now I thought I was going to get to rest.  Ha!  I carried 30 pounds of water weight for 3 weeks.  I could barely walk from being so swollen.  I get tons of permanent spider veins on my legs from this.  My c-section scar hurts so much because I don’t take pain medicine (since it passes into breastmilk).  Post-partum depression comes a knockin’.  Many tears are shed.

July 2009

I’m sleeping about 2-3 hours every 24 hours.  I’m still testing a lot.  I’m so frustrated because I can’t get the babies to latch on.  I am pumping every 3 hours and not making much milk.  I pump in front of the computer and begin this website.  Oh what we can accomplish in desperate times.  I get a nipple infection and mastitis-both of which are very painful.  Henri begins throwing up every hour or so and doesn’t stop for 9 months.  He has reflux.  Aurora gets thrush.  She doesn’t get rid of it for 4 months (which reallyyy worries me).  Family wants to visit but, some of them don’t realize I’m walking around all exposed and only able to shower every couple of days.  When you are pumping for 30-45 minutes every 3 hours you practically just walk around naked.  So excuuuse me for not wanting happy and clean visitors.  I felt like I was gone. 

August 2009

I almost call 911 to request someone to pick me up due to exhaustion and for “seeing things”.  Instead I call the doctor and am told to go to the ER for evaluation for those hallucinations.  Then I think to myself, “who wouldn’t hallucinate in my position?!”  I’m still not sleeping and its been weeks like this.  My mother practically lives at my house and cooks meals, bathes the babies, cleans…and it is still hectic!  Every time I look in the mirror I want to scream.  The body I had before getting pregnant is probably gone forever and I can’t help but mourn it because damnit I worked really hard to lose weight and get in shape!  And in 8 months It disappeared.  My stretch marks are not the main problem, its the amount of lose skin that horrifies me (and anyone who sees it).  When you quickly go from a 26 inch waist to growing out of maternity clothes…I guess skin can only stretch so much huh?  I look at my husband’s tight stomach and think, “Why couldn’t he have carried one?”

September 2009

I finally begin to sleep more.  I now sleep 4-5 hours every 24 hour period.  Sometimes there are sleepless nights but, not as often as before!  I’m not as pale now.  The green and sallow tint to my face is beginning to lift.  I’m making more milk and happy about that.  Yet, I’m still battling nipple and breast infections.  Summer has just passed me by this year.  I finally fall in love with my babies.  It takes a while because severe exhaustion didn’t really give me a chance before.  I still can’t get them to latch on so I continue to pump.  This breaks my heart but, I decide to quit struggling and just focus on pumping as much as possible. 

December 2009

Skipping on to December.  I only step out of the house one hour a week to the grocery store and that’s it.  I am lonely and tired.  Now I’ve developed carpel tunnel in both hands and I have injured tendons in each arm.  I begin to live on Advil.  I just quit pumping because I almost had a meltdown from the relentless and painful process that pumping was for me.  I was proud to last 4 months doing it.  I was terribly sad to be giving my babies full time formula.  For the first time in so long I sleep 5-6 hours of interrupted sleep during the night.  Ahhh feels so good.  My husband gets laid off of work.  Financially times are rough for a while.  We just hold tight, stop spending, and spend quality time together.  Christmas Day is spent taking my daughter to the emergency room for a shoulder that has popped out of place.  My poor girl is forced still under bright lights for x-rays.  I am emotionally drained.  I was the one holding her when her shoulder pops so I think it is my fault.  Those post partum hormones are still stabilizing, mind you.

January 2010

Snow, snow, snow.  My husband and I turn into a pretty good team.  Each one of us has a baby and takes care of them.  We switch babies every couple of hours and learn to accurately throw bottles as if they were footballs.  My hand and arm injuries are bad.  I wake up and literally cannot move a finger in either hand.  I wake up during the night and morning and run to the faucet to put my hands under hot water to get them painfully moving again. 

March 2010

My husband goes back to work.  I still have tons of help from my mom which turns out to be a lifesaver.  She visits each day and helps me take care of the babies.  Just as I get a hang of things something changes.  I take Aurora to my allergist for testing.  I see she has more of my genes, like dry skin and eczema.  So I worry she has allergies as she also has diaper rashes and her brother does not.  Turns out she is very allergic to peanut and egg.  These two food allergies cause severe reactions in people-they could stop breathing.  My husband and I have a mini breakdown and are too afraid to go anywhere with the babies for fear that our little girl with come into contact with one of these foods and be seriously NOT ok. 

May 2010

We learn to make egg and peanut free foods.  We carry an antihistamine everywhere.  We are very paranoid and don’t leave our children with anyone other than my mom.  Even then, I am away from my kids for no more than a couple of hours at a time.  I can’t bear the thought of something happening and not being there.  We spend a lot of time at parks, the pool, taking the babies to the mall in their double stroller.  People say, “Oh what beautiful and healthy babies!”, “How did you get your body back?” and “How did you ever afford a Maclaren double stroller?!”  My husband and I laugh. 

June 2010

And we’re still laughing.  We take turns working out while the other stays with the children.  We definitely are not rich, we just prioritize.  The babies get a nice sturdy stroller and we don’t own an IPOD or a Blue Ray Dvd player.  We enjoy our children more now than ever because…well, because now we aren’t so exhausted!  My diabetes is still a priority but, I can admit this past year wasn’t my best for blood sugars.  It was my best for effort, however.  Who knew having twins would give so much energy and passion and ideas to a newlywed couple who felt the hardest thing they had ever done before was plan a wedding.  I think we could do anything now. 

Henri and Aurora,  you bring more joy and love into our lives than we could have ever imagined.  This first year with you pretty much cemented our new family.  We learned quickly that we can get through rough times together and come out doing A-ok!  Your daddy and I owe you so much already.  Beyond that you are the two funniest, sweetest, and gorgeous beings I’ve ever seen!  And to top it all off-you’re mine!  I feel like the luckiest mom in the world.

Alex, as soon as we married I got pregnant and things got crazy for us.  You hung in there with me through it all and then became the kind of dad women dream of.  The dad that does as much as the mom.  The dad that lets his wife sleep while he gets up in the middle of the night to to feed a baby (or two).  I’m glad I married my best friend because only a best friend would have gone through this difficult journey with me.  Life is a lot more fun than a year ago and I have a feeling it will only get better :)

To diabetic women (and men) out there contemplating a family, you know it won’t be easy…but, what you may not know yet is that it will be magical and truly worth it.  Do your best with every decision you have to make and every task you have to do and everything else will sort of just take care of itself.  

If you’re pregnant with twins….God bless ya!  Get lots of help lined up for when the babies are born.  Seriously!

5 Things a diabetic woman should do before getting pregnant

Me, 2 days before giving birth to twins
Me, 2 days before giving birth to twins

 

A lot of women have told me something like this:  “My husband and I are trying to get pregnant but, my numbers are not where I’d like them to be so I’m scared.”   Whoa whoa…stop right there. 

If this sounds at all like you then read the following 5 things a diabetic woman should do BEFORE getting pregnant.  (Because remember, you can try one day and be pregnant the very next ;)

 

1.  Stabilize blood sugars. 

By nature, when a woman is pregnant her blood sugar levels lower a bit.  During the beginning of my pregnancy my OB suggested I keep this fact in mind and strive for blood sugars that were consistent and within the right range.  I’ve often strived for blood sugar around 120.  During pregnancy I tried for blood sugars around 80-90 and for less swinging numbers. 

So get your A1c checked and get a go ahead from your doctor before trying to conceive.  Also, be honest.  If you know your A1c is a combination of many lows and highs, aim for more steady glucose numbers. 

If your blood sugars are not in the right place, hold off until they are.  You owe yourself and your child this.

2.  Go get a full check-up

Have your doctor do a full blood panel on you.  Make sure your pancreas and liver are functioning well.  Get your eyes checked.  Let your doctor know you want to know exactly how things are going before you begin trying to get pregnant.

3.  Exercise

I was in pretty good shape before getting pregnant with twins about 2 years ago.  This turned out a blessing because a twin pregnancy doesn’t often allow much movement for many months. 

Also, it helps to start out at a healthy weight.  If you begin pregnancy overweight, you will have a higher risk for a more complicated pregnancy.  And you don’t want that on top of the diabetes.  I must admit, I wish I had lost my last 20 pounds before getting pregnant.  They are so much harder to lose now that I’m busy with 2 babies.

 

4.  Find an OB you love

Get acquainted with several doctors so you can choose one which will ultimately be your partner in what may be a difficult journey.  I was lucky to have a doctor who took her time to listen to me and be patient.  She also trusted my handle on the diabetes which I found refreshing.  She answered all of my questions thoroughly and even eased my fears and gave me compliments on my maternity wear and pregnancy glow.  You also deserve a doctor you can count on for all of these things.

5.  Buy Cheryl Alkon’s new book called Balancing Pregnancy with Pre-Existing Diabetes.

It is the first book out there to talk about pregnancy and pre-existing diabetes and so far I’ve heard nothing but great things about it.

Stay tuned for an interview with Cheryl and my review of her book coming up very soon!

On a final note, I’d suggest thinking nothing but positive thoughts.  Picture your perfect baby in your mind and see yourself as the healthiest mom and baby cuddling together.  It may seem like a miracle and it is!  And you can certainly do it!

Scary diabetic hospital stories

 

I’ve been in the hospital four times since being diagnosed diabetic (15 years ago).  Once for accidentally giving humalog instead of lantus insulin, a memorable story you can read here.  Another time 4 years ago because of kidney stones, another more recently for ruptured ovarian cysts, and lastly when I gave birth to my twins last June. 

Each time, I noticed something which frankly, bewildered me.  The medical staff didn’t know much about diabetes. 

I can explain…

The time I was in the hospital for my accidental insulin switcheroo I came in fully in control and explaining to the staff I would need intravenous glucose ASAP because even though I ingested a lot of sugar on the way to the hospital, I did the math and knew it wasn’t enough.  There seemed to be more focused on how I made the mistake.  I was even asked if I was having a fight with my fiancé or suicidal.  When we got past that they decided they would check my blood sugar every hour.  I instead checked it every 20 minutes.  It is a good thing I did because each time my sugar was low and coming down really fast.  We would call the nurse and she would say something like, “wow you’re coming down quick! we need to give you more glucose!”  At one point she pushed the glucose in my vein so quick something strange happened to my vein.  It protrudes now and looks bumpy along the inside of my wrist and forearm.  She said, “oops, what did I do here…?”  I thought, seriously??!!  Thanks a lot!  Anyway…I don’t like to think what would have happened to me had I not checked my sugar more frequently than they saw fit. 

The time I had kidney stones was scary, too.  Not once did anyone care about what my glucose numbers were running.  I was in there hours and it was as if I wasn’t a diabetic.  I had a procedure done to laser blast a huge stone and before I went under anesthesia no one seemed concerned with what my blood sugar was.  Again, I was kind of baffled.  I wasn’t worried too much because I purposely didn’t give any insulin 2 hours prior to the procedure so that I would only have my steady basal rate functioning and just before they came and got me I made sure my sugar was 160.  Not too high, not too low.

When I went into the ER for major pain from ruptured cysts I asked if my polycystic ovarian syndrome could be tied to my diabetes.  The doctor said no.  She said there was nothing I could do to help it either, except take birth control pills-oh but those are bad for diabetics because of the blood clot risk, yikes!  I went home and searched medical journals for information and found many links between that syndrome and diabetes.  I also found out what diet changes to make and other helpful things to do.  My new doctor also told me the diabetes is probably to blame for the syndrome and after discussing with her the changes I have been trying to make she said, “good, keep that up”.  So far I haven’t had any more cysts form.  Let’s hope I can say that next year. 

The worst experience of them all, you won’t believe this…

When I had my babies last year I had an extremely hard time at the hospital.  They wouldn’t allow me to administer my own insulin, which ok, I understand.  They couldn’t get humalog so they gave me novolog instead and said, “Is this switch ok?”  I was like, “I don’t know ask my doctor?”  They asked me how many units of insulin I typically gave with meals.  I told them it varied all the time, you know, sometimes I had an egg and other times toast.  They didn’t seem to understand and instead attempted to administer me their own measure of 5 units of insulin before breakfast, lunch, and dinner.  (Regardless of my glucose at the time and regardless of what meal I was brought.  Then I was given a diabetic diet which consisted of all fat free and all sugary stuff.  When I tried to send it back there was a huge set of hurtles which had to be cleared first.  They didn’t think it was good I ate anything like meat because “diabetics can’t have fat” said one nurse.

Perhaps the most shocking thing was when they couldn’t figure out how to use their own insulin pens (“no one ever showed me” said one nurse) and at first gave me only a partial dose (the nurse pulled the pen out early and insulin squirted everywhere which was supposed to go in me).  From that point on I requested to use the pen myself, with two nurses watching for liability reasons.  On another day they were 2 hours late with my lantus (which is VERY important to take on time) and at one point they “lost” my insulin (I had asked for it to be stored in a fridge to be kept cool).  It took 1 whole day to recover.  

On one occasion the nurse was coming to test my blood sugar.  I felt my blood sugar was high so when she came to prick my finger I licked it so saliva would mix with my blood (I know I know-I’m awful) The reading came out 102 so she said “great!” and left.  I immediately got out my meter and checked my own blood sugar and saw it was 209.  I gave myself an insulin shot.  My mother and husband saw all this and jaws dropped to the floor.  I explained that they would have taken so long to get my insulin and so in a moment of exasperation I took matters into my own hands.  I didn’t want to be up to 250 by the time they brought it!  (I don’t support this behavior I’m just showing you how fed up I got).  

I was very confused and now a sore, exhausted, and overwhelmed new mom was losing her patience with an ignorant system.  After a couple of glucose readings in the 200’s (because of the hospital being late with my humalog delivery-meaning I also ate cold meals) I finally told a nurse I was going to adjust the humalog amount the way I had been taught by my diabetes educator and endocrinologist.  She was very sweet and said, “alright you do that and just let me know how many units you’re giving so I can put it into the computer where we log everything”.  I said, “sure, no problem”.  Well, moments later a doctor comes in to check on me and looks at the computer.  He takes the nurse outside and in a very upset tone says, “We cannot allow patients to decide on how much insulin they give themselves, that is a hospital policy!”  They argued back and forth and I took a deep breathe and thought, “man, this is hard on everyone!”  The doctor was worried, the nurse got scolded for trying to trust my experience, and I had to be at the mercy of a system that just tries to cover itself it seems. 

I left the hospital after 5 days, healing well from the c-section, but in a lot of pain and very tired-in part because I felt I had to be ultra-vigilant about my diabetes, even in a hospital.  I thought they could take care of me but, I don’t think so anymore. 

I absolutely loved my doctors and nurses.  99% of them were kind, intelligent, hardworking, compassionate, and efficient at their job.  The problem (and several nurses admitted to me) was that they just didn’t have the training and knowledge needed to really take care of a type 1 diabetic. 

A word of caution to you if you ever have to be in the hospital-stay on top of your diabetes! and err..don’t cheat the meter…;)

Diabetic pregnancy and low blood sugar

 

7 months pregnant with twins

7 months pregnant with twins

I’m going to share my experience with low blood sugars during my pregnancy

It was very challenging for me.  I had twins and because of this the doctor told me I would pretty much feel double the amount of everything (including low blood sugar and nausea-ugh not fair). 

Anyway, during the middle of the 1st trimester I began having lows.  Worst time for me was the middle of the night.  Maybe because I had to snack all day to help with the nausea at this point.  I bought an alarm clock with dual settings so that I could automatically set it for two times at night. 

I was exhausted during this time so would go to bed around 9pm and set the alarm for midnight and 3 am.  I got up at 6am to go to work. 

I didn’t want my babies to suffer any highs or lows so I checked before bed, twice during the night, and then in the morning.  This helped me adjust my insulin and avoid dangerous lows. 

My doctor felt it was extremely unnecessary but, he doesn’t know how bad it feels to have blood sugar in the 30s, doesn’t know how much worry a mother feels when carrying her child or children and, and doesn’t know how horrified a husband feels when he sees his wife unconscious from low glucose.  My husband doesn’t know what that feels like either and I’d like to keep it that way, thank you very much.

So yes, I did this throughout the entire pregnancy.  I had to because as soon as I adjusted my insulin and survived a week with great numbers, my body’s changes sent my sugars down again and I had to keep steadily lowering the insulin amounts. 

And to complicate things…

At one point in the middle of winter I got a stomach flu and spent days throwing up every 2 hours, almost becoming dehydrated, and suffering a lot of lows.  The only reason I didn’t end up in the hospital was because I checked so frequently and enlisted my husband’s help with bringing me lots of juice while I laid on the floor of the bathroom.  

Important:

If you are pregnant and do not own a glucagon and glucose gel do get these items ASAP. 

Glucose gel can be bought at the pharmacy and is used in the case you pass out or are so low you can’t help yourself. 

A Glucagon injection kit is also used if you pass out from a low.  This requires a prescription from your doctor and does expire so routinely check the label.

Train someone responsible living with you how to use both of these items. 

By the 2nd trimester I got a break from low blood sugars-but then came a problem with highs!

During the middle of the 2nd trimester I began needing more and more insulin.  (At the peak of this increase I was giving 3 times the amount of insulin I did before getting pregnant!) 

During the 32nd week of pregnancy something strange started happening.  I began having a lot of lows again.  I was getting up to pee at night about every 1 or 2  hours (no kidding) and so I left my glucose meter on the bathroom sink so I could check that often. 

I knew the babies might come early and I knew if I kept my blood sugars near perfect, their blood sugar would most likely be perfect as well!  Had I had too many highs-they might have been born with low blood sugar.  And I didn’t want them to be fed glucose water instead of my colostrum as their first welcoming meal so I checked VERY frequently. 

The adjusting of insulin because of lows continued until I gave birth to the twins via c-section at 35 weeks.  Their blood sugar was fine and they needed no help whatsoever.  My hard work paid off!

I needed about the same amount of insulin for a day or two after the c-section and then began to slowly reduce insulin towards pre-pregnancy levels.  Do remember, if you weigh more after pregancy than you did before you became pregnant- you will need more insulin simply because you weigh more. 

Also, If you are breastfeeding do know you will definitely need less insulin since breastfeeding kills so many calories.  I lowered my lantus and ended up giving the same amount of fast acting insulin before eating.  Why?  Because I ate 3 times as much as I did before the pregnancy.  I even ate more than while I was pregnant!  (Big perk for you breastfeeding mothers).  Oh, did I mention I didn’t gain any weight for months while breastfeeding and eating all I wanted?

There it is, my long struggle with lows during pregnancy.  Checking frequently is your best defense. 

Good luck when and if its your turn!

My successful twin pregnancy as a type 1 diabetic

 

Mother's Day 2009 at 7 months pregnant

Mother's Day 2009 at 7 months pregnant

Recently in history, Type 1 diabetes and pregnancy did not mix.  However, now that we have insulin pumps and better insulin and meters, healthy pregnancies in type 1 diabetic women are a norm.  Yes, pregnancy as a type 1 diabetic does carry extra risks.  Obviously the risk level changes depending on the person as well. 

But, I can tell you personally that it CAN be done.  I have had diabetes for 15 years this November.  I am 26 years old.  I got married a year ago and last October I became pregnant  (After being told I may never conceive due to endometriosis).  I was so pleasantly surprised!  Then terror struck me.  I thought of all that could go wrong either with me or my baby.  I was told by an obstetrician that my pregnancy was considered very high risk even though I was in good health.  So of course that freaked me out.   

My first month pregnant was easy because I didn’t know I was pregnant and didn’t notice any symptoms.  During the second month I worried my tail off but, still didn’t feel much.  I noticed I was outgrowing my clothes very rapidly though and starting to feel a little nauseated.  I had an ultrasound at two and a half months to see how things were progressing and discovered alongside my mom that I would be having twins!  I called my husband and informed him we’d have to sell his nice truck because our family would not be fitting in it.

Well, now my pregnancy was even more high risk than previously believed.  I am a spiritual person and thought to myself, “well…maybe this is God’s way of telling me that he knows I am capable of doing this and to just trust him”.  And so I tried.  I had to somehow eat an extra 600 calories a day and check my blood glucose more often and still manage my busy work routine.  All this on what they affectionately call “prego brain”.  Not to mention along with severe morning sickness which should really have been called 24/7 sickness.  I worked in a human resources office and can’t tell you how many times I threw up in the office bathroom. 

My Christmas was pretty miserable as I hugged the toilet bowl, wondering if my last glucose readings of 200 were going to kill my babies or deform them somehow.  My A1c around this time was a 4.6 but, being so sick made me start having lots of readings around 200.  I was in a constant state of worry.  The first trimester also held something new.  Low insulin resistance.  Suddenly at night my insulin needs would decrease and I would have to adjust my lantus every night for 2 months because my blood sugar would get to the 30’s range.  I woke up my husband every night with a low blood sugar for about 1 month I think.  Poor guy.  I even began talking in my sleep and one night repeatedly muttered “I can’t do this anymore”, prompting him to shake me violently until I awoke.  I would have nightmares very often because of the dips in blood sugar. 

Throughout this entire time I am setting my alarm for twice during the night so that I can catch lows before they get too low.  I would hate to know what would have happened had I not done this the entire pregnancy.  My doctor didn’t like that I did this.  He said I should “cut myself a break” but, it was my life and my children’s life at stake, not his.  My insulin needs were fluctuating too much for me not to hover over top of my blood sugars. 

The second trimester was a tiny bit easier.  My morning sickness began to subside a bit.  I was shocked about still being pregnant and almost congratulated myself.  Yet, being the worrywart I am, continued to freak out about daily 200 readings-usually only one but, that was enough to make me believe a baby wasn’t getting a limb formed.  My boss at work kept the work coming strong and I felt I couldn’t keep up.  And my boss was a woman.  She had no children, that’s for sure.  And those progesterone levels really played a number on my brain.  Remember, they’re twice as high in a twin pregnancy.  I felt so much compassion for the diabetic woman who might become pregnant.  It isn’t easy to go 9 months or so feeling the weight of the world on one’s shoulders. 

I made it to the 3rd trimester.  WOW.  Now I had to cope with being HUGE.  I was at 6 months already bigger than most women are when they give birth with one baby!  I had only gained 20 pounds at this point.  I have to say, I really ate healthy throughout my pregnancy.  I made sure to eat a lot of vegetables and fruit and whole grain bread.  Eating was a huge challenge because normally, I control glucose in part by limiting carbohydrate intake.  Yet, being pregnant with twins meant I had to eat more and I craved carbs all day long.  Carbs were the only thing that made the dizziness go away.  Go figure.  So, I ate more carbs in the form of complex carbs such as beans and whole grain Ezekiel bread. 

I was put on medical leave from work so that I could focus on blood sugar control from home.  This helped tremendously and I did improve control.  My A1c was a 5.3 when checked during my 6th month.  Not to shabby.  Now my insulin requirements began changing again.  I needed more and more insulin now.  At 7 months pregnant I needed 3 times the normal amount of insulin!  I checked my blood sugar extremely often and was now checking 4 times a night-which was every time I got up to pee.  No more alarm clock necessary. 

During the 7th month I began having to decrease insulin needs again.  This might have been due to an aging placenta.  I still have had no signs of preeclampsia but, with my belly so huge, I worried about the possibility.  At the end of my pregnancy I began feeling that I wasn’t going to make it again.  I felt so tired of my ongoing anemia, never ending finger sticks, and incessant worrying. 

At 35 weeks and a few days I had an appointment with my OB (mind you I was now going 3 times a week!) and she took one look at me and sent me in for a non stress test.  The babies were fine.  Then they checked my blood pressure.  It was really high.  My ankles were swollen, my vision blurry, I had preeclampsia.  The doctor sent me to the hospital.  Mom was not fine and these babies were coming out early. 

Fears of the NICU struck me and I wondered if my babies were going to be ok.  I wanted a natural child birth and hung in there for a while-no pain medicine for 12 hours of induced labor and back to back contractions.  Finally I took a mild pain medication.  The doctor spoke of c-section which I was not excited about.  36+ hours and no sleep or food later I had an epidural and one hour later a c-section.  I had only dilated 1 cm throughout all this. 

My babies came out screaming and in no need of any assistance.  I was elated.  What a dream come true.  A type 1 diabetic could have a healthy baby-in fact could have two!!!

(Thats me in the picture, believe it or not I got a lot bigger than that, lol)

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