My Type 1 Diabetes and Pregnancy Journey

So, I’ve been MIA on here the past few months, but it’s been for a good reason…I’m pregnant! My plan was never to drop off the face of the earth entirely, but my first trimester was very rough and I had to cut everything back to the bare necessities to survive, so creating content sadly fell off the list. However, I’m back now and excited to share my T1D pregnancy so far! I’ve always been curious about what the journey was like for other women in an attempt to prepare myself, so I’m going to try to be an open book! Below is a quick hit list of some questions I imagine people might have, but please leave any additional questions in the comment section below and I will do my best to answer! I’m also going to do a few more detailed posts about the first trimester and specific weeks shortly, along with some non-pregnancy related posts as well. 

How far along are you?

I’m currently 19 weeks and due in September! 

When did you find out you were pregnant? 

I found out at about four weeks. I had no symptoms at that point, everything felt completely normal. 

How has pregnancy with type 1 diabetes been so far? 

This might surprise some people, but actually not as bad as I thought! In case you’re not familiar with pregnancy and diabetes, it’s well known that for most people the second half of pregnancy (about 18-40 weeks) is harder due to increased insulin resistance and the first half is a little bit easier due to increased insulin sensitivity. I’m into the second half now and starting to experience some of the insulin resistance so I’ll keep you updated on that, but the main struggles in the first half of pregnancy were increased lows and challenges eating my usual foods (more on that below). 

I will say that I’ve had to be more diligent about having my CGM and pump high and low alarms set at a tighter range (currently about 3.8-7.8), which means more alarms going off all the time. This has been hard physically (less sleep!) and also mentally, as each alarm can sometimes feel like a mini-failure, but I’m working hard not to think that way 🙂

I have also been able to continue using my stomach for pump sites so far, but I’ve noticed lately my skin is getting itchier in those areas around my sites so I plan to move towards my lower back as my bump continues to grow. 

How was the first trimester, and did you have any morning sickness/other symptoms?

As I alluded to above, my first trimester was a struggle and a half, and I was not prepared (haha). The first symptom I noticed was fatigue at around six weeks, and it was a tired I’ve never felt before. No matter what I did, I always felt exhausted—I could sleep 12 hours and take two naps and still feel like I could barely function. I had to cut out everything except for work and that was about it, all social activities, exercise (lol), and other commitments had to wait.

At around seven weeks I began to feel the nausea and food aversions. It wasn’t too bad at first, but by week eight I felt nauseous 24/7 and threw up almost daily, sometimes several times a day. I couldn’t stomach anything healthy, including my usual smoothies, salads, even things like pasta or meat or vegetables. I ate a ton of plain Eggo waffles, Pizza Pops, crackers, and granola bars, and even those I barely wanted to eat. It was rough to say the least, and it realllyyyy messed with my typical diabetes management. I couldn’t pre-bolus because I would often lose my appetite while waiting, or I would bolus and then eat less than I thought I would, so I learned to take my insulin in stages while eating. It did mean some spikes, especially because the food I was eating was pretty carb-heavy, but it was the best I could do. 

When did you start to feel better?

I started noticing less nausea around 14 weeks, although still a lot of food aversions. At 15 weeks I was able to slowly start integrating workouts back in and also things like smoothies and salads. Now, at 19 weeks, I’m largely back to pre-pregnancy energy and food habits, although I find I can’t meal plan much in advance like I used to, as something that sounds good a few days before (or even that morning) will sound revolting when it comes time to prepare and eat it. So still making minute-by-minute decisions on food, but they are generally healthier! 

I’m also still feeling tired, but it’s different than the first trimester. These days I have energy, but can’t do as much as I used to pre-pregnancy. If I do a morning workout and then go to work, that’s it - no grocery shopping, visiting with friends, or doing anything extra in the evening or else I’ll be super grumpy (haha). I also find the 3pm slump is worse than I’ve ever felt before, I wish I could nap daily!

Have you had any special healthcare team support?

Yes! I had my first diabetes and pregnancy endocrinology appointment at eight weeks, which I think is a tad earlier than usual but they made an exception because of the morning sickness and what that was doing to my blood sugars. Since that appointment, I now have bi-weekly phone check-ins with a diabetes nurse and a monthly in-person appointment with the endocrinologist, and can email someone anytime with concerns. The cadence of appointments will pick up as I get closer to my due date (which is likely going to be around 38 weeks). This team replaced my usual endocrinologist and is in a different hospital in the city, but I’ll go back to him after the baby is born. 

In addition to my diabetes pregnancy team, I also see a maternal fetal medicine doctor (a fancy OB) once a month, which started at 12 weeks. This will be the team that delivers my baby. These appointments will also increase in frequency as I get closer to delivery. They don’t work directly with the diabetes pregnancy department, but since they’re in the same hospital they can communicate when needed. It is a lot of appointments, but I’m happy to have access to everything!

What was your A1C when you got pregnant, and how has it been since?

With the BIG caveat that everyone’s numbers are different and to please not compare yourself to anyone, my A1C before getting pregnant was 5.2% with about 85% time in range. It has been below 6.0% for about the past two years. At 15 weeks pregnant, my last A1C was 5.0% and about 80% time in range, with the difference coming from the increase in lows during the first half of pregnancy. My doctors were and are happy with these numbers, but I know many people who had higher A1Cs and less time in range and they had perfectly healthy babies and pregnancies, so please don’t stress if your blood sugars don’t look the same. Years ago my blood sugars were not like this at all and I would have freaked out thinking they had to be this way before having a baby. Trust me, they don’t, it’s very individual!  

Do you have any pregnancy-related diabetes complications?

So far, no! Everything looks to be going very well, thankfully. I had my eyes checked shortly after discovering I was pregnant and they looked good, and also had a dental appointment recently (gum disease is common in T1D moms) and had no signs of complications there either. I will get screened for various possible issues (e.g., thyroid function, nerve damage, etc.) more often while pregnant, but so far so good.

Have you had any cravings?

Honestly, nothing like people talk about, so I’m going to have to say not yet! There are definitely things that sound appealing (like Dairy Queen ice cream cake) but nothing in an I-must-have-it-now kind of way. I’m sure it will come soon, though!

As mentioned, please leave any comments or questions below and I’ll be happy to answer them if I can! I have a few more posts coming soon specifically covering the first trimester, and I’m excited to bring you along with me on this T1D pregnancy journey 🙂 My hope is to start posting weekly or bi-weekly pregnancy updates here along with regular diabetes content, and resume my social media content as well. I have some fun things coming up soon (like an international babymoon trip!) which I plan to document for anyone curious about the experience, so stay tuned. I’m glad to be back!!