We've been keeping a secret...
I’m so happy that I can finally talk pregnancy and diabetes with you all! It’s been so hard to keep quiet these last few months. You may have noticed; I haven’t been posting as much as usual. This page is so personal to me, it felt impossible to post anything without sharing my news. Thank you all for your incredible support since our announcement.
Let’s start with a little background on DM and pregnancy, shall we?
Glucose control has been directly linked to infant survival thanks to a study performed and published by Dr. Priscilla White in 1940. She observed that 18% of babies born to mothers with DM were stillborn or died shortly after birth. The risk of fetal demise, however, was significantly reduced with glucose control, diet, exercise, and the use of insulin. Though this seems obvious now, it was certainly not at the time. These treatments became the standard of care and are used today to give women with diabetes (T1, T2, and gestational) the best chance of a healthy and successful pregnancy.
Pregnancy with diabetes is HARD. The blood glucose and HbA1c goals are incredibly strict and insulin sensitivity is constantly changing. HbA1c goal pre-pregnancy is <6.5%. This is because all of baby’s organs are formed within the first 8 weeks of life (incredible, right?). We were able to hear our baby’s heart beats at just 6 weeks! Unfortunately, it takes some women that long to realize they are pregnant and poor control during this crucial time in baby’s development can lead to significant defects or spontaneous abortion.
After conception, the goals get even more stringent; HbA1c <6.0%, fasting glucose 60-90mg/dL, 1-hour post prandial <140mg/dL, and two-hour post prandial <120mg/dL. Sound exhausting? It is, but TOTALLY worth it.
In the second and third trimesters, poor glucose control can lead to premature delivery, delayed growth, and a large birth weight. Interestingly, baby’s weight gain occurs once they have a functioning pancreas. If mom’s blood glucose is elevated, baby’s pancreas tries to compensate. This causes the weight gain and can also cause severe hypoglycemia at birth. I do find it funny that at some point during this pregnancy I will have, not one, but TWO working pancreases!
If you have diabetes and want to become pregnant, this post is not by any means meant to deter you! All of this IS POSSIBLE with the right motivation and care team! My best advise is to set yourself up for success; get your glucose under control before you try to conceive, use birth control until you are completely ready both physically and mentally to take on this challenge. Lastly, give yourself grace. I’ve really struggled with guilt when my BGs aren’t exactly where I want them to be. I’m working on it. No one is perfect!