Tuesday, February 28, 2012

Diabetes, Pregnancy, & Steel Magnolias

Like I said in a previous post, I watched Steel Magnolias over the weekend (if you haven't seen it, spoiler alert below!). I have heard people refer to this movie when talking about diabetes and/or pregnancy. No wonder so many have a distorted view of diabetes and a healthy pregnancy! So just in case you may be wondering, I thought I'd try to clear up a few things. I'm not a medical professional, but I do have 20+ years experience as a type 1 diabetic and have learned a lot over the past year when it comes to diabetes and pregnancy. And because I have had my share of hearing "Isn't it harder for diabetics to get pregnant?" "Are you going to have a big baby?" etc etc, so I thought I'd just share a little about where I'm coming from and what it means to be pregnant and a type 1 diabetic.


#1. Healthy diabetics can have very healthy pregnancies and healthy, "normal sized" babies. It is recommended to have an A1c (a number that correlates to your average blood sugar over a 3 month time) of 6% below before conceiving and while pregnant. A woman with an A1c of 6% or below carries as much risk (as far as birth defects go) as a healthy woman without diabetes. My last A1c before getting pregnant was 6.8%. While this was not optimal, my risk is only increased by 1% (I know every bit counts, but just to show that it is not drastic). I have not had my A1c checked since finding out I was pregnant, but will soon and I suspect it will be much lower.

#2. High blood sugars=big baby. As long as a diabetic woman keeps her blood sugars in tight control, her baby should be born at a "normal" weight.  When mom's blood sugars are up, this causes the baby (who does not have diabetes) to produce more insulin, which isn't needed because the mom is taking insulin, and this extra insulin is stored as fat. This is why I check my blood sugars an average of 12 times a day  :) Also, diabetic women are immediately considered high risk pregnancies. While it does sound scary and puts a lot more responsibility on the mom to be (along with making sure she's eating enough, getting enough nutrients, watching weight gain, drinking enough water, etc, she also has to check blood sugars more frequently (for example, before I checked 6-8 times a day- now 10-14), be in contact with the doctor's office weekly to review blood sugars/make insulin adjustments, counting carbs correctly, more frequent doctor visits), it does allow mom and baby to be more closely monitored and probably the healthiest mom has ever been. Which.I.love. From the first appointment at 6 1/2 weeks, I have gone to the doctor every 2 weeks AND already had 2 ultrasounds! This means we get to hear the baby's heartbeat on the doppler every 2 weeks, I'll take it! And at 32 weeks, I will start going twice a week, every week for a non-stress test and an ultrasound (more check ins and looking at baby? Yep, I'm there!). They also monitor the baby's size at these appointments, so they can induce before baby gets TOO big!

#3.Will your baby have diabetes?
The chance of our baby having diabetes is pretty low. The risk is different for each person with diabetes. For example, our child is at less risk since the diabetes is on the maternal side and not paternal (risk is higher if dad has it). However, he or she is at a slightly higher risk since I was diagnosed at a young age (8). I am hoping that since my diagnosis was so random (I am the only known person in my entire family- past or present- to be diagnosed with Type 1 Diabetes), that the risk is very, very low.

So no, diabetes does not make it harder to get pregnant. It does not make you have big babies. Yes, it does cause you to be at a higher risk for some issues, but there are still more healthy diabetic pregnancies than not. Is there a lot more to deal with? Yes. But is it worth it? MOST definitely!!

Although they don't go into it much in the movie, Shelby had to have been a very brittle diabetic. AND they mention that the doctor told her not to have children because her body couldn't handle it...BUT she didn't listen to the doctors, and therefore led to a grim outcome. My diabetes has never been in excellent control, but when J and I started thinking about wanting to have kids, I knew I was going to have to buckle down and get serious. I wanted to do everything I could ahead of time to create a healthy environment for our future baby. Of course diabetics, like anyone else, can get pregnant without planning to, but with diabetes it is very important to plan and get your body ready for pregnancy. Once we knew we were ready to really think about having a baby, we made an appointment with a Maternal Fetal Medicine specialist to go over all of the risks, what to expect while pregnant, and where I optimally needed to be health-wise (they didn't even want us to try before I got my A1c down). That was in April of last year- months before I would even stop taking birth control pills. I immediately started zoning in on my blood sugars to get them under better control and get my A1c down...it took several months, but it was slowly but surely making it's way down! We actually got pregnant a lot faster than expected, but after so many months of really working on my blood sugars I was in a good spot and things have only gotten better since! I posted a link to an article below, but like she says "Nothing mattered more than keeping myself healthy so that my daughter would be healthy." Exactly. When it's in the best interest of your baby, it's not hard to say no to treats when you have to or checking your blood sugar umpteen times a day and changing your insulin requirements weekly. All worth it!

I read this article today and thought I would share! I have a while longer to go in my pregnancy, but I can definitely relate to a good portion of her story.

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