The diabetic pregnancy survival guide

By | 10 April, 2013
Some of the weirdest pictorial filler on the website

Some of the weirdest pictorial filler on the website

At the start of my pregnancy I developed a coping strategy to try and stop me going mad from the pressure of trying not to turn my unborn child’s current home into a sticky syrup of glucose. That’s served me pretty well to be honest, although I am now trying to reduce the level of swearing involved with high blood sugars for fear that her first words won’t be suitable for public consumption.

But before I actually have the baby and start looking back with rose tinted spectacles at how wonderful pregnancy was, I thought I’d try and pick out the key things needed to survive, while I’m still in the midst of the harsh reality of it.

To survive pregnancy with diabetes, I would recommend:

A good sense of humour: even with the easiest pregnancy in the world, there are still going to be many occasions when it’s all just a bit too hard. You’re either going to have to laugh about it or go mad, so you might as well laugh.

Keeping things in perspective: at first every blood sugar over 8 feels like the end of the world. But it’s not sustainable to live like this for 9 months. A few one off highs are not going to turn your foetus into a lollypop. Acknowledge them, deal with them and work out how to stop them happening again. Take this seriously, but  don’t beat yourself up over it.

Skin as thick as a rhino: it can be very trying to spend 9 months being told by every Dr, nurse, pharmacist, street cleaner that all diabetics breed baby elephants and they’re usually so large it’s a miracle they ever manage to get them out at all without the aid of a tow truck. And if they do manage to haul them out the baby will be fat/lazy/hypo/in special care for weeks/have more bits that don’t work than do. Do your own research, understand the risks and what you can do to minimise them, and ignore ill-informed idiots who should know better but don’t.

Lots of patience: for dealing with aforementioned idiots, and also for dealing with diabetes which changes almost daily. More than ever the diabetes mantra of “just because it worked yesterday doesn’t mean it’ll work today” is fitting. The change is constant, and often unpredictable. There’s no option, you just have to go with it and accept that this is a pretty fast moving rollercoaster that you can’t get off, but it’ll be worth it when you get to the end.

An insulin pump: plenty of people manage pregnancy on MDI and I have the greatest of respect for them. Personally, I would sacrifice everything I own (except for my pillows because they’re the only way I can get my whale-like form into a comfy enough position to get any sleep) rather than give you my pump. The ability to change basal rates quickly, with almost immediate effect makes them ideal for adjusting to increasing insulin requirements. And being able to bolus at the push of a button, and use dual waves to spread boluses means I can help minimise spikes caused by even looking at carbs. And when morning sickness was rife, the ability to reduce my basal rates to help compensate for all those carbs I just reintroduced to the world was great.

Continuous glucose monitor: I’ve found mine to be invaluable, if you can get one, do. I can see easily that my BGs are starting to climb and I need to increase my basal rates – far more quickly than I would with blood tests alone. I can see impending highs and lows and head them off before they become too extreme. I can see the impact of food, and the difference injecting early makes. I can easily try out new tricks, like splitting boluses or splitting meals and monitor the effects. And I can adjust my basals to the point where I’m confident that I can go to bed as a 4 and wake up as a 4. And I know that if something does go wrong inbetween, the CGM will alarm to let me know. On the down side, it does provide me with an overwhelming volume of data which requires huge amounts of action, but I think the results are worth the extra effort.

Learn from others: there are some great forums out there where I’ve learned so much from people who’ve done this before or are going through it right now. Although its hard to believe you could ever need anything except ShootUp’s top tips on how to manage diabetes during pregnancy, if you did want to go elsewhere has a great little community of pregnant and previously pregnant diabetics full of sensible views.

A good healthcare team: different people want different things. I want a team who know their stuff, but who are willing to let me get on with it without too much interference. We eventually got to that point and it worked well. Read the NICE guidelines so you know what care you should be getting in pregnancy and talk to your team about what works for you and what doesn’t.

• Supportive family and friends: diabetes and pregnancy is bloody hard work. It’s stressful, exhausting, all consuming, uncomfortable, frustrating and emotional. Having family and friends who are there to pick you up when you’re down, to allay your fears, tell you you’re doing a good job and prop you up when you feel like you’ve run out of energy to keep going on the treadmill will make all the difference.

And finally, while the urge to smack anyone who tells me this is only for 9 months and won’t last forever is quite overwhelming, it is actually true. This will end and you’ll get the best possible reward, so keep going. And remember, you’re doing a great job.

7 thoughts on “The diabetic pregnancy survival guide

  1. lizz

    Crikey, 4 seems so low! In all the blod tests on ‘normal’ people I’ve done (surprising how many want this) only one person has been 4 or lower and that was a stressed nurse who was 3.5. The rest have been between 4.5 and 6.5. One was a 10. Still not diabetic… so I think you and the baby will be fine!

    1. Tim

      Katie once tested for about three days for an article I was going to write. Her BG was consistently about 5-6. We didn’t write the article in the end as a) Katie got fed up of testing her BG and b) in summary the article would have said “non-diabetics” have stable BGs – which wouldn’t have come as a surprise to anyone really.

      1. Alison Post author

        To be honest @lizz, 4 wasn’t the original plan. I was aiming for 5’s but kept ending up in the 4’s and found that it worked ok. As long as I have no active insulin on board and things are generally stable, I just hover there all night. If things are a bit more hit and miss I go higher.

        1. lizz

          I think ‘active insulin on board’ is my downfall – human actrapid has a fairly long action and it’s doing my joints in and pork is even longer. I’ve noticed the BS I feel fabulous at if it’s stable is 6. I suspect, as in all things, everyone has a different level which is right for them.

  2. Tim

    These are all top tips Alison and I think most of them apply whether you are with-child or not. Especially the ones about keeping things in perspective and having lots of patience!

  3. Megs

    Top tips indeed.

    We,as diabetics, should demand a whole new range of misconceptions for the public to throw at us. Having to listen to/correct the same old ill informed stuff is so tedious.

    1. Alison Post author

      I quite agree @megs. If people are going to be irritating and offensive, they should at least be under an obligation to be original.

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