My journey with family planning and type 1 diabetes

Growing up, I always pictured myself as a mother. In my fantasies, I had two kids, a caring spouse, and a steady job.

One detail I never pictured was that I’d have diabetes.

I was diagnosed with type 1 diabetes when I was 16 – And it felt like the apocalypse.

I needed to figure out how to deal with my glucose, change my diet, and make insulin injections part of my regular routine. It was a staggering moment, far from the lighthearted time of my younger years that I’d imagined.

But as time passed, I got used to it. I figured out how to live with the disease, even if it never completely moved out of my mind.

Fast forward to my mid-20s. I was recently married and thinking about starting a family. It was exciting and nerve-wracking – Till then diabetes had always felt like something I could manage alone. But suddenly I had to work out how to bring a youngster through it as well. This was a complication I didn’t know how to prepare for.

Coming face-to-face with reality

The first time my partner and I sat down with my endocrinologist to discuss pregnancy and diabetes, I felt like I was hit by a tsunami of data.

Glucose targets, likely challenges, and dangers to me and the child – There was a huge amount to contemplate. It felt less like family planning and more like taking off on a high-stakes mission, where the risk of mistake was razor-thin.

My primary care physician made me feel better. “I’ve seen many women with diabetes carry solid pregnancies and deliver healthy infants,” she told me. “Everything revolves around cautious preparation and tight control of your glucose level.”

However, while her words were encouraging, the obligation still weighed heavily on me. I’d consistently dealt fairly well with my diabetes, but pregnancy required a considerably stricter degree of control. My HbA1c needed to be in a specific target range, and I would have to screen my glucose more regularly than at any other time.

The reality of this hit me hard. I began second-guessing myself – Could I handle this? Can I give my child the best chance of a sound beginning?

These considerations kept me up at night.

My partner was unimaginably steady, constantly advising me that we were in the same boat. Even so, there were times I felt absolutely alone in my battle.

Planning for pregnancy

Before getting started, I knew I needed to get my glucose under control. To do this, I worked closely with my endocrinologist to change my insulin dosages, monitored my glucose level more regularly, and followed an even stricter diet plan. Every meal, every bite, every temptation needed checking – It was exhausting.

It also joined an online group for local women with diabetes who’d gone through pregnancy. Hearing their stories and experiences gave me faith. Some had experienced challenges, but many had gone through fruitful pregnancies and delivered healthy children. They shared tips on the best way to manage glucose changes, manage temptations, and handle the mental ups and downs. When I really needed consoling, it was a lifesaver.

No matter how prepared I was though, regardless of how strictly I stuck to my script,  there were still days when my glucose would spike suddenly. These times were the most testing – I’d question if I was really equipped to handle this, or if I was just setting myself up for disappointment.

I kept having to remind myself that being perfect wasn’t the goal. It was to commit and see it through.

Getting started

After quite a while of planning, my HbA1c was finally in the target range and my primary care physician gave us the go-ahead to start trying.

It was an exciting milestone, but brought a new feeling of uneasiness – What would happen if my glucose spiked during early pregnancy? What if I couldn’t keep up the degree of control I was aiming for?

As the weeks passed, I checked my glucose regularly and changed my insulin doses on a case-by-case basis. Each day began with a finger prick, and I tried my best to avoid significant glucose spikes with every meal.

It was a difficult task that sometimes felt impossible, but I kept going, knowing that every effort I made was for the strength of my future child.

And when at long last a positive pregnancy test returned a positive result, my feelings were out of control. I was filled with bliss, obviously, and a sense of overpowering satisfaction. But I also had a shiver of dread – I knew that this was just the beginning and that with pregnancy, and the expected hormonal changes, my glucose levels would almost certainly get thrown into chaos.

Managing diabetes during pregnancy

As expected, pregnancy brought an entirely new set of challenges. My insulin needs changed practically day to day, and I had to watch everything I ate.

I worked with a group of medical service suppliers (my endocrinologist, obstetrician, and dietitian) to make sure my child and I were in top condition.

And again, despite everything I did to prepare, there were moments of disappointment where my glucose would spike for no reason, leaving me feeling like a failure and terrified I’d caused harm to my child – One time I enjoyed a small piece of cake at a family gathering, thinking I’d dosed my insulin accurately, only to see my glucose soar. I felt so crushed, like I’d just bombed myself and my child.

Over time, I learned to be kinder to myself. Diabetes can be unpredictable, even with the best management. And I recognised that I didn’t have complete control over everything, and that was okay – What mattered was that I was doing my best.

Looking to the future

Right now, I’m in my third trimester of pregnancy, and I’m finally beginning to feel a sense of harmony.

It’s been a long journey, with lots of ups and downs (both physically and mentally), but I’ve made it this far. The road ahead isn’t clear, and I know that managing diabetes as a mother will bring yet another new set of challenges, but I feel ready.

The biggest thing I’ve learned during my pregnancy, not just in terms of diabetes management but also regarding life in general, is that being perfect doesn’t matter. Being steady and tolerant, and giving yourself a break, is what truly matters.

There will be days when things don’t work out as expected, and that’s fine. The key thing is that I continue to move forward, slowly and deliberately.

I’m eager to meet my child and begin the next stage of my life, regardless of diabetes. It’s not what I pictured when I was growing up, but it’s my way, and I’m happy and grateful for how I got here, and how far I’ve come.