Miss T1D Had a Baby!

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It has been 10 weeks since I had a beautiful baby boy. As a precaution of my Type 1 Diabetes, I was induced at 38 weeks gestation on the 27th of April and at 1:30pm Bub came safely into the world via vaginal birth with perfect blood sugar levels and weighing in at a perfectly normal 7lb 11oz. So there you go, it happened, and it all happened without any complications due to my status as a Type 1 Diabetic (or Bubs big head).

Bub was and is healthy, happy and his father and I are over the moon to be his parents. Once he presented with four blood glucose levels (taken over his first 8 hours) that were perfectly normal for a newborn (between 2.7 and 4mmls) the doctors forgot that his gestation was within a mother whose pancreas has trouble doing what it is supposed to do. Instead they focused on the big bruise on his head, thanks to the vacuum that assisted his delivery, which turned his skin a slight hue of yellow indicating jaundice. Bub was fine though, and didn’t even need time under the lights thanks to my determination to continue to get as much breast milk into him every 2 – 3 hours as I could.

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I quickly began to realise what a busy schedule it is to be the food source of a vulnerable infant who’s tiny stomach meant he needed to feed very frequently. Throw in a bit of blood glucose monitoring and I am unsure I slept the five nights I spent in hospital (I was prescribed an extra night to the normal 4, for which I am eternally grateful). I also learnt the major affects breast feeding has on your blood glucose levels and became very good at eating while sleeping just to make sure I a) avoided any hypo’s and b) continued to produce as much milk as my body could.

I had specialist coming out of my ears! I had daily visits from Obstetricians, Dietitians, Physiotherapists, Lactation Consultants, Pharmacist, Bubs pediatrician and my endocrinologist, sometimes more than one at a time (I swear there where ten people in my little room at one stage, none of whom were simple visitors). They where all in and out keen to keep an eye on Bub and me. I felt looked after, like I didn’t have to worry about missing something, I just had to focus on my routine: Check levels, feed, burp, pump, eat, check levels (and if there was time), sleep – repeat. Dr O visited me every morning and would give me her predictions on what my blood glucose levels might do in the next 24 hours, and mostly she was spot on, it was like a prescription. I was very grateful, and glad she was my Endo at that time, to know that if there was something odd I just had to wait till morning and check with her about it was comforting.

The past 10 weeks have been great fun and a great challenge. Everything I hoped it would be. To think that not that long ago my doctors would have advise me not to carry children because I had diabetes, makes me want to hug every scientist and doctor who has made an advancement in the medical management of diabetes. Without them I would not now be exactly what I have always ALWAYS wanted to be… a Mother.

Mum and Bub

Big and Beautiful, Just Like His Mum

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This week I have reached 36 weeks pregnant, and seeing as though my induction is only a few weeks away, I thought I had better give an update on how my pregnancy has progressed, and how my baby boy has developed.

Yes, indeed, like a great many babies born to type 1 diabetic mothers, Bub is a biggin. At 32 weeks I had an ultrasound to check on Bubs development and to see how big he was getting, how fast. There are a few things the many Doctors responsible for me and my pregnancy look for when assessing what effects my T1D is having on Bub. They look at Bubs abdominal circumference, the amount of fluid he is floating in, and the blood flow to my placenta.

At my 32 week scan it was revealed that Bub had a big belly (abdominal circumference). Babies are all compared to each other on a graph know as the percentile (not really know as that but that’s what I call it), and their measurements are plotted in to show where they are in comparison to all other “average” babies. So at 32 weeks Bub had a belly in the 94th percentile (bigger than 94% of average babies at 32 weeks gestation). This indicates that my higher than the average bear (or human) blood sugars was having an effect on Bub. After all his pancreas works just fine, so it is as though he has been chomping down on high carbohydrate meals as he grows. That will make a belly big. However a lot of the time T1D mothers find their babies tummies end up big enough to be off the top end of the percentile. So 94% is still within average range… kind of… The good news however is that at my most recent ultrasound, Bubs belly had dropped to the 89th percentile. It isn’t as though he lost weight, he just didn’t gain it as fast as he had been. There is alway a chance that my boy is just, and would have always been, a big bubba.

My Doctors have not been worried about him though, as my amniotic fluid measurements have always been just where they should be. Apparently this means that conditions inside my womb are good, and don’t require as early an exit for Bub.

My blood flow to my placenta has also always been good. However this is what my Doctors and I expected as less than good blood flow is usually associated with T1D mothers who have been T1D for many years and have encountered some blood vessel damage. Babies of these mothers usually end up at the other end of the percentile, small.

The only surprise at my most recent ultrasound at 36 weeks was Bubs head size. It measured in the 98th percentile!! I do not actually know, but I was under the impression that T1D would not have an affect on Bubs head size, so my conclusion is that I was correct in thinking maybe I just have a big Bubba. We will find out when I have my appointment with my Obstetrician in a few days. Though looking at that number… 98th percentile… bigger than 98% of average babies… will this mean a conventional exit is out of the picture for him? Would I prefer it to be? What are my chances of an emergency caesarian from Bubs big head getting stuck if I opt to attempt induction? Should I return the baby beanie I purchased in “0000” newborn size?

Otherwise my pregnancy has been going well, I have impressed Dr O with my blood glucose control (despite feeling like they have been totally out of control), and I have been acing a number of CTG’s (Cardiotacograph, or non-stress tests). I feel very blessed that, for at least this pregnancy, I was able to maintain my honeymoon period, and know that my T1D has had less of an impact into the growth and development of my baby. Let’s see what happens to my blood glucose control after this “little” guy arrives.

A Day without “D”

When talking about the anniversary of my T1D diagnosis, a well-meaning friend suggested I should spend the day eating really well all day, then just eat junk food all night. A nice sentiment, yes, but just completely and utterly wrong about how T1D works. One of the hardest aspects of T1D is there is no way to take a break. No matter what you do beforehand, what you do at any given time affects your diabetes. If I didn’t eat any carbs for a week then had a big bowl of pasta, I would still need to count the carbs, inject insulin and check my sugars before and after. That’s just how my body will (won’t) work.

Even when there is no food involved, diabetics need to be thinking about their base line of insulin (basal), whether it is via the long acting insulin that comes from an injection every 12 or 24 hours, or via the constant slow drip of short acting insulin via an insulin pump. That dosage needs to be just right to keep our blood glucose from creeping up and up, or from causing it to drop too fast because we walked to the bus station today rather than getting dropped off: constant management, constant consideration.

So I started to think about a day, just one, without diabetes. What would I do? Eat? Drink? If I was given the chance to have just one day without diabetes, where my own body would take care of itself and let me take a holiday.

pancakesFirst cab of the rank, I would eat pancakes, ice-cream and maple syrup for breakfast with a big glass of juice, and get to eat them while they are hot! No need to delay for an injection or finger prick. I honestly didn’t think I would miss drinking juice spontaneously, but I do. Then I would find the smallest bag I own, put my keys, phone and wallet in it, and go shopping. Not having to cart my giant bag of supplies around the shopping centre, or having to constantly look out for the inevitable “shopping hypo” that always slows down my retail progress, would be totally freeing.

MandMsNext I would drive somewhere far away and sunny, leave my bag in the car and enjoy the beach, without being concerned that my insulin was getting too hot, or that someone would steal my meter case mistaking it for my wallet (“steal my wallet but please leave my meter and insulin!”). I would have lunch (hot chips and crumbed fish) without a care, then go and get an ice-cream straight after (no waiting 2 hours after lunch).  Then snack all afternoon on nuts, chips, lollies, flavoured milk and crispy M&Ms!

 

 

 

I would visit my favourite pasta restaurant for dinner and order a big glass of coke, full of fast acting sugar! Then I would go to a late movie where 10PM would roll around without me noticing or injecting my basal insulin in the dark theatre by phone light. Nor would I need to stop once I had eaten 1/3 of my packet of pop-corn; I would have exactly as much as I felt like or didn’t feel like. Then, half asleep I would wander from the car to my bed, no need to rouse or wake to check my blood glucose or eat a snack to bring my numbers up to a safe level before bed. I could just fall asleep without the fear of not waking up to a midnight hypo, or not waking up at all. Bliss.

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But that’s not how T1D works: 24/7, 365 days a year. Always. No matter how much that fact sucks, it is still fun to dream! I bet other T1D’ers would come up with better ideas for a day without D, but this is what I came up with and it makes me smile. Now, excuse me while I go check my blood sugars; I feel a hypo coming on.

New Vs Experienced T1D ft Diabetogenic

I read a fair amount of stories, concerns and questions other T1D’ers have posted over the internet and sometime I find it interesting what worries people, what challenges others have and how other T1D’s feel about certain topics and how this is different to me. It made me wonder if over time I will also start to think about diabetes differently, treat my diabetes in a different way or feel different about it. I have come to realise that since being diagnosed almost 12 months ago these changes have already taken place, so I thought it would be a good idea to compare the answers to a few questions related to living with type 1 diabetes of a T1D novice (such as myself) and a more experienced T1D survivor.

In case you’ve not had the pleasure, let me introduce you to the brutally honest writer over at Diabetogenic, Renza Scibilia. Renza has been living the T1D life for going on 17 years, has used an insulin pump for over 12, and has been a mother for 10 years. In her blog Diabetogenic, Renza openly gives a hilarious, and frank account of her daily life, which happens to include T1D. I would like to thank Renza for contributing her “experienced diabetic” answers to the following questions.

(Note: Nor Renza or I had read each other’s answers before providing our own).

What effects do your blood glucose levels have on your emotions each day?

Renza:

RenzaHmm… that’s an interesting question and a little ‘chicken and egg’ really. I am not sure if my BGLs affect my emotions, or if my emotions affect my BGLs. I think that it is probably both.

When I am feeling stressed or anxious, my BGLs are likely to be higher and far more stubborn. And then if I manage to address whatever it is that is making me feel that way, I end up have a crashing hypo. Fun!

When I’ve had a particularly nasty hypo, I often feel really down and start to worry about how diabetes is going to play out long term.

There is a real and clear link between emotions and BGLs. Unfortunately, it’s unpredictable. The behavioural side of diabetes is one that is really not discussed enough. It’s great to see that there is more discussion about diabetes and mental health, but I believe there needs to be more, including regular and routine monitoring. I know that when I am feeling more emotionally robust and ‘together’, I am able to manage my diabetes far more effectively. And conversely, when I am feeling down, I struggle to care for myself. It’s a catch 22, which is why we need to be looking at ways to help people work through the times when they are experiencing diabetes distress – both short and long term.

Miss T1D:

misst1dI haven’t had all that much experience with this one to determine if my blood glucose levels have a definite effect of my emotions. I know that when I am hypo I feel so devoid of energy that I am sure I am short with my husband at times, until my BG comes back up, which rarely takes more than some jelly beans and a piece of toast. I get more cranky if my BG is too low to go to bed when I am already half way asleep (which happens most nights), but that is more frustration at having to wake up and eat something.

Recently I had a not so happy day, I was overwhelmed with a few situations I am dealing with and just felt under the weight of it all, on this day my BG results tended towards high, and I couldn’t put it down to any other reason other than my emotions that day, so I would say in that instance, my emotions had an effect on my BG results.

How do you feel about when you get ‘good’ and ‘bad’ results

Renza:

RenzaI really don’t see results as good and bad. I’ve made a huge effort to remove judgement words from my diabetes management and results. My BGLs are ‘high’ or ‘low’ or ‘in target’. It has taken a long time for me to do that with real meaning, but that is how I see things most of the time now. That doesn’t mean I don’t get annoyed and frustrated – of course I do. But there is no judgement or ‘fault’ in place. Instead of getting pissed off with myself, I get pissed at diabetes!

I think that the language we use when talking about diabetes is a real issue. Words have the ability to really sting and using positive language can have a positive effect on how we see ourselves as people with diabetes. It’s difficult though, because even though I feel that (most of the time) I use language that is completely not judgemental, this isn’t necessarily reflected in the big bad world! The media is terrible (very judgemental and stigmatising) and some healthcare professionals use really damaging language.

Miss T1D:

misst1dI am still in my honeymoon phase of Diabetes, and I very rarely get a high BG result that I can’t explain – “Oh I had a feeling I didn’t count the carbs right”, “That meal was pretty high in saturated fat” “It must be that time-of-the-month coming up” – so when I do get a result I don’t like, I often feel the need to compensate and get a few ‘perfect’ results in the coming days. I don’t believe I should blame myself, I should blame the diabetes, but I can’t help but get disappointed when I realise I can’t control many aspect of my diabetes.

There is a Facebook group dedicated to people with Diabetes posting pictures when they get the ‘perfect’ 5.5 or 99 (depending on where you live). So at first, I assumed that that 5.5 was hard to achieve and must mean you are doing things right. After getting a number of perfect scores and seeing the many members post their pictures I realised it isn’t about getting the good result because you worked for it, but because you can do it all right, and still miss the mark it’s about celebrating the rare times when outcomes reflect the hard work (or by contrast, getting the perfect score despite having cake for breakfast). This group just highlights to me that feeling bad about getting a ‘bad’ result is pointless, because you can’t always help it.

How do you feel when you see advertising for food with high sugar content (e.g. frozen coke, specialty sweets)?

Renza:

RenzaI don’t even think about it. I wouldn’t eat or drink it, but then, I probably wouldn’t have before I was diagnosed (at 24) either. Having said that, there are days – usually in Summer when it is sweltering – that a slurpie is the only thing I feel like. And when that’s the case, I buy one and bolus accordingly.

I am a real foodie – I spend a lot of time preparing, thinking about and eating food. A meal or a coffee or an afternoon tea cake is one of the most lovely ways to bring friends and family together and nothing is nicer than being able to feed people. I go through periods where I bake every day and then deliver the goodies to the neighbours. It is lovely!

What we choose to eat is an incredibly personal decision. If people choose to NOT eat foods that have a high sugar content, that’s fine. Equally, if people do want to, that’s fine too. I very much subscribe to that belief, which is I believe why food ‘movements’ are so awful. They judge people and stigmatise those who don’t follow their ‘rules’.

I am also a big believer that there is no such thing as the ‘diabetic diet’. I am all about moderation. And if I want to eat a doughnut, I will. But probably not for breakfast, lunch and dinner every day. (But…but….but…if YOU want to eat a doughnut every day for breakfast, lunch and dinner, that’s okay!)

Miss T1D:

misst1dI am still very new to managing my diabetes, and when I think about eating and drinking food high in sugar, I get a bit nervous. Intellectually I know that I can have a Frozen Coke if I wanted to, I would just need to make sure I bolus right for it, but I am still learning to turn down the feelings of worry when I see such items. One by one, cake by cake I am reaching outside my comfort zone and just eating things that I thought I had to say good bye to when I was first diagnosed. And the more the world doesn’t end, the more I end up balancing sugary treats or realise that I won’t go into a Diabetic coma should I not balance, the more confident I am becoming.

However I still deprive myself of certain things, and feel very much left out when I do so. Especially now I am pregnant and extremely susceptible to food advertising. I see a soft drink such as Coke as my Mt. Everest. I am climbing and one day I will reach that bubbly sugary peak, insulin in hand.

What activities or situations make you nervous that wouldn’t, if you did not have T1D?

Renza:

RenzaI really don’t think that T1D makes me feel nervous about any situation. Of course, I consider my diabetes (ALL THE BLOODY TIME!), but that’s the nature of the beast. I went sky diving a couple of weeks ago for my birthday and diabetes was so insignificant in the overall activity. I thought about it, did what I needed, and then jumped out of a plane. But there certainly was never a thought of ‘Oh, maybe I shouldn’t do this – I have diabetes.’ In fact, I don’t think I’ve ever thought that about any situation.

Of course, I am fortunate enough to be living complication-free. This may be a very different scenario for people who have diabetes complications.

The way I think about it is this: Diabetes adds an extra degree of difficult (sometimes SEVERAL extra degrees!) to many situations. A wonderful man I met who had lived with diabetes for 75 years said to me that he doesn’t think of diabetes as an illness; he considers it an inconvenience. I have tried to live by that ever since I had the privilege of meeting him.

Miss T1D:

misst1dAnything I haven’t done yet since being diagnosed. I was nervous the first time I ate out at a restaurant, the first time I had to guess how many carbs were in my meal, rather than measuring, the first time I went overseas, had a coffee, slept alone etc. Even after nothing went wrong after doing all those first, I still feel nervous when I have to enter a situation that requires me to be prepared because of my Diabetes. I havn’t yet gone camping, and although I am nervous (how will I keep my insulin cool, what if something happens and I need a hospital?) I am also keen to give it a try (wow just realised I have not been camping in 12 months!).

I know that being diabetic means I have to be prepared, that it makes certain things more difficult, but I am also aware it does not mean I have to exclude myself from situations, or not do things because of it, I just have to consider more and be better prepared (my hand bag is and will always be massive).

Are you more likely to follow the advice of your Endocrinologist, or take it under advisement and trust what you have learnt about your Diabetes?

Renza:

RenzaI feel I have a really wonderful and consultative relationship with my endocrinologist. Whenever there is something new to consider or try, it is a decision we make very much together. She knows I will always speak with other people with diabetes to hear about their experiences and thoughts and this is part of my decision making process. She also knows that it is me who is living with diabetes and that whatever management strategy we try has to be sustainable. There is no point in saying something like ‘We need to fix your basals – you need to check your BGLs every two hours, including overnight, for the next six weeks. And write them down in this book; turn them into a spreadsheet and analyse all the results daily, providing me with a written report every couple of days’ because I’ll do it for 24 hours and give up.

Miss T1D:

misst1dWhen I was first diagnosed I was terrified and knew very little about diabetes. I saw my endocrinologist as the person with the key to survival. I took her word as law, and followed everything she said to the letter.

Now I am more confident and understand more not only about diabetes, but about my diabetes. I rely less on Dr. O when I it comes to navigating something I am unsure of. By this I mean, I don’t need to call her up and ask what I should do, but rather I will make a decision about what I will do and then probably consult Dr. O on it at a later appointment.

However there is still so much I have to learn about diabetes management and the best treatments or methods my body responds too, so for this reason still I see my appointments with Dr. O as learning opportunities rather than consulting with each other on best management practices (somewhere I hope to find our relationship down the track).

How worried are you about developing Diabetic complications?

Renza:

RenzaAbsolutely. Terrified. And this seems to be increasing the longer I have diabetes. But as terrified as I am, I need to keep it in perspective. I know that there is far better treatment these days for complications. I get my eyes screened regularly and if there are any changes they will be picked up early and dealt with.

Talk about diabetes complications is an absolute minefield. We are told that if we ‘look after ourselves’ we won’t get complications. If only it were that easy. Of course we know that we can reduce the risk of complications with a lower, in-range HbA1c, regular complications screening and by keeping in touch with our healthcare team. But that’s no guarantee. I know people who have never had an A1c above 7, have never ‘dropped out of care’ and are meticulous about their diabetes management who still have developed complications.   

There can be this really nasty assumption that if you have retinopathy or neuropathy or nephropathy (all the opathys…) you did something to bring it on yourself. This is a really damaging attitude and incredibly unsupportive.

Miss T1D:

misst1dI am pretty dang worried. So far and thanks to my honeymoon period, I have had great control, but from what I have read and heard from other more experienced type 1 diabetics great control isn’t the be all and end all of diabetic complication avoidance. I was lucky my diabetes was found extremely early on before my levels had a chance to go above 12mmol/ml, so I haven’t yet had any hospital stays, or any complications recorded… yet.

I asked my Obstetrician about what he predicts the end of my pregnancy will hold, seeing as I very easily control my sugars and still have a fair bit of pancreatic function. His answer has me thinking. He said that there is still much about Diabetes and the effects it has on the body, especially, the developing body of a foetus, that we don’t know, and that there could be other factors in it that cause complications. I believe this is true for diabetic complications, having perfect control 100% of the time won’t guarantee a life free from them. So I guess I will just have to accept what comes my way and be thankful for medical advances to treat and prevent such conditions.

How does T1D have an effect on the daily running of your family’s life?

Renza:

RenzaI try to make the impact of diabetes on my husband and daughter as small as possible, but I know that there are times that it is far more significant than I would like. I hate it when diabetes intrudes in my family time and I hate it when my diabetes becomes something they have to deal with. I really hate that my daughter even knows about diabetes in the detail that she does.

Miss T1D:

misst1dThere are many people who believe diabetes is a family disease. Not because it can run in families, but because even if only one person has it, it regularly impacts the rest of the family. My husband can count the carbs in my meals as well as I can, and often I trust him to do so. He is always wants to know what my BG is and if I am acting dopy and tired, requests I check to make sure I am not going hypo. It is on his mind almost as much as it is on mine.

As we are about to have a baby I am very anxious about how life will be different for my baby compared to others. I listen to my young mother friends and family talk about how they didn’t even realise they skipped a meal, or how they only get to eat half of a meal because they are sharing it with their toddler, and I know these things just can’t happen for me. I worry my baby will have to stay in his cot crying for a few extra minutes while I treat a hypo; I worry about my toddler having a tantrum because Mummy gets to eat Jelly Beans in the car, but he can’t or even worse, I worry about what effect sleep deprivation will have on my blood sugars. I just hope that Diabetes won’t alter the way I am able to care for my children too much.

Thanks again to Renza for participating in this blog post, if you would like to hear more from Renza you can Subscribe to Diabetogenic.

Happy Diaversary to Me: 1 year with Type 1 Diabetes

20 January

Today marks one year since I was diagnosed as a Type 1 diabetic. Wow. Twelve months! 365 days keeping myself alive. On average, I have given myself 1,825 injections and 2,920 finger pricks (150 of which were in the wee hours of the morning), I have taken somewhere between 15 – 20 blood tests, counted the carbs in 2,190 meals/ snacks, according to my meter data have had approximately 115 hypoglycaemic blood glucose results, I wore a pump for two weeks, and have left the house without my meter bag twice. That’s a lot of ouch, and a lot of inconvenience.

To make myself feel better, I should look at the bright side of the past twelve months, or the good things relating to my diagnosis. I have lost a total of 15 kilograms (before pregnancy), have never been over 10.9 mmol/L (196 mg/dl), have (up until the last couple of weeks) had meticulous control, have remained within my honeymoon period, never once been to the emergency room for a diabetes related issue, met new friends who I share a common life experience with, and started one very fulfilling blog. And to top it off, treating my diabetes has finally allowed me to get pregnant!

I owe a lot to my early diagnosis, as I have been able to gain control of my diabetes while still having a fair amount of pancreatic function – kind of like using insulin therapy with training wheels on. However, these past two weeks have been a real challenge for me. Heading into the third trimester of pregnancy means my insulin resistance is starting to pick up (as it does for all expectant mothers, not just diabetic ones), and so I have been finding it difficult to know where my sweet spot sits in regards to my carb-to-insulin ratio. Some days it seems to be double my usual ratio, other days that repeatedly sends me hypo. I will be working closely with Dr O to work out how best to navigate this new stage of pregnancy.

On the whole, I am very positive about my diabetes and its treatment, but I am finding myself feeling rather down about not having as good a level of control as I did. My previous HbA1c was 4.4 and stable (meaning low, but no hypos), which is apparently “unheard of” in the words of Dr O. So basically I have been doing fantastically. My OB and Endo have both said “it’s like you are not even diabetic” about my pregnancy: which, it turns out, is the biggest compliment you can give a Type 1 diabetic. So even though I was well warned about this stage, and I know it is only my pregnancy causing me to have less than perfect blood glucose, I still feel very frustrated. The main factor I find that is bringing me down is that I am concerned the higher blood glucose will have an adverse effect on my baby. I am afraid that he (yes, he is a ‘he’!) will have too much body fat by the time he is born. I just need to keep telling myself that once I have given birth my excellent control will come back, and my baby will be healthy regardless of how he comes into the world (natural, or caesarean).

On the bright side, this increased resistance to insulin will probably mean I finally get to go back on my insulin pump! What an upside! Instead of having to set up and inject at every meal, I will just whip out my pump, press a few buttons and off I go… And I will need only one injection (of the pump cannula) every 2–3 days! See – there is always a silver lining!

So let’s hope that by my next “Diaversary” I will still be in my honeymoon period, be complication-free, Emergency-room-visit free, and very happy with my blood glucose control. For now, I am going to celebrate with a bowl of Ben and Jerry’s Sweet Cream and Cookies Ice-cream, because yes – I can eat that.

Ice Cream Top

Controlling the Things Beyond Your Control

Hypo 7

Summer is closing in on us here in Australia, and things are certainly heating up. So far we have had a few days in the high 30s centigrade, with one or two days breaking into the 40s for sure. Seeking the places with air-con is always mission number 1 for most days (especially when baby hormones take away your usual amount of tolerance for uncomfortable situations). Unfortunately, a lot of the time, with high temperatures comes low blood glucose readings (BG) for Type 1 Diabetics.

These past couple of weeks I had been experiencing a sudden increase in the amount of hypoglycaemic episodes that I usually have, and to be honest I didn’t even think about the increasing temperatures – I assumed it was just a new phase of the crazy ride for pregnant T1Ds. I have been getting my below-4mmol/ml BG results late in the afternoons, after I had my lunch and afternoon snack. There really isn’t much I can do about this except for keep a close eye on my BG levels, staying aware of how I feel, and treating the hypos when then happen.

That’s one of the kickers about living with T1D. The truth is that you are rarely in total control of the things that affect your BG levels. You can measure your carbohydrates and match your insulin accordingly, but you just never know if there is an extra concentration of carbs in your food: maybe your apple is a little bit riper than you thought, and so has more sugar in it; maybe that type of pasta contains more flour than most. Even if you do get this right, you can’t control the temperature all the time, or even how active you need to be from hour to hour. Hormones play a HUGE role in levelling out your BG (after all, insulin is a hormone), good luck controlling those!

This is why so many T1Ds suffer from Diabetes Burnout, and end up not properly looking after themselves. We can feel like the efforts we make towards good control are useless and don’t really matter anyway. I like the memes I see on Facebook that say things like, “Be nice to T1Ds, we deal with enough pricks”, or “No, I wasn’t drinking last night, but yes, I am hung over” (referring to a “hypo-hangover”, when someone is up all night attempting to treat a persistent hypo). I like these because they give other people a little bit of insight into the difficulties of controlling T1D. With T1D, putting in more effort won’t always yield better results, and you can imagine how frustrating that could be, especially when you are not feeling well to start with. But to our credit we plod on anyway, keep checking, keep injecting, keep balancing… after all – “you don’t know how strong you are, until being strong is the only option you have” – Unknown.

Type 1 Diabetes and Morning Sickness

Tiny Bump

Life as a Type 1 Diabetic is challenging. That’s because there are many parts of our days and weeks and years that are made difficult by the Diabetes. Getting a good night’s sleep can be hard, eating out at a restaurant can cause stress… and then there is Christmas. I haven’t been through my first Diabetic Christmas season yet, but I am bracing myself for disappointment over not being able to graze on treats I have always loved – for a whole month!

So I should have been prepared when at five and a half weeks pregnant and my first taste of morning sickness sent me to research methods for coping, I found 101 very useful tips that are completely useless to a Type 1 Diabetic: eat smaller more frequent meals (too bad I have to wait at least two hours in between eating); keep your stomach a little bit full at all times (again, no help there); eat lots of complex carbohydrates (I admit this one wasn’t the hardest to deal with, but when you are trying to eat lower carb and low GI it doesn’t help).

So for six weeks I had a daily struggle with an eating cycle. I would wake up feeling sick, eventually eat, feel a bit better for an hour, spend the next hour feeling terrible (and I mean terrible), check my post-meal blood glucose results, then make a decision about eating again, or simply waiting to throw up, before starting the cycle again.

I have been on B6 and ginger, Maxalon and varying dosages of Zofran. They have helped, but I have been in bed pretty much for a month and a half. At one visit to the doctor to refresh my prescriptions the doctor officially labelled my morning sickness as ‘Hyperemesis Gravidarum’ (Really Bad Morning Sickness) because of my weight loss. Not enough to land me in hospital being pumped with fluids and food, but enough to get me more sympathy and better prescriptions from my doctors.

Luckily I have a really awesome husband, who has for the most part been my full-time carer. I was too sick to stand, so he had taken over all the household duties, including bringing me my food and lemon water (if you suffer from morning sickness I fully recommend trying lemon water!)

How has my diabetes been affected by my Hyperemesis?

Not a great deal – being in my honeymoon phase still means I can get away with a lot more as a T1D. I have had to increase my night time Levemir (slow acting insulin), from 2 to 3 units. I have been having more frequent higher post-meal BG results such as in the 6s and 7s, but I think this may be more to do with the fact that I am having higher carb meals at these times due to my lack of appetite, and aversions to my usual meals. I figured, and Dr. O agrees, that as long as I am eating something, the occasional high carb meal isn’t going to affect me or the baby badly. On the flip side of this, when I have been feeling so ill I cannot eat, my sugars tend to drop, and when this happens I feel even worse (as you can imagine). Often I have had to force myself to eat something when it was against everything my body was telling me to do. For a few weeks, a good 80% of my diet was made up of crackers with avocado and tomato, something I was able to stomach.

Really there wasn’t much relief for me, so I just had to suck it up and deal with my symptoms, and try my best to keep my Diabetes under control (I said my best).

Now that I have reached my second trimester I am gaining better control of my BGLs again and am trying to eat healthier meals (still have many food aversions, which does not help). I am also starting to step down my anti-nausea medication, which some days makes me feel like I am taking a step backwards.

So even though the first trimester of my pregnancy was miserable, I am improving and am able to look forward to the fun side of this time, including watching my bump grow, and shopping for all the essential baby gear, all the while keeping a very close eye on those BG levels.

Happy Diabetes Awareness Week!