My T1D pregnancy plan

33 weeks pregnant on my maternity photo shoot. Was so much fun capturing my hard work being a T1D mum to be!

 
I’m 8 days away from giving birth!! I can’t believe it. I’m so excited. I feel like I’ve been pregnant for a long, long, long time.
 
One of the greatest things about being pregnant and diabetic is the sense of community I can find online, from the comfort of my own home. I love to meet people and have face to face interaction, but on the days when I don’t want to leave my couch, I can find “friends” online who know exactly what I’m going through and I’ve never met them. It’s truly a blessing. Whether it’s a fellow instagramer I’m stalking or a question posted on an Facebook group, someone is helping or inspiring me, just by being themselves. And that’s exactly what I aim to do. I share pictures of my life and my food and the response I’ve had fills me with joy. Having other type 1 diabetic women say that I’m inspiring them to get pregnant is the most rewarding feeling. There can be negative sentiment surrounding diabetes and pregnancy and I say DON’T LISTEN TO THE NAYSAYERS!
 
Arming yourself with information on how to have a successful pregnancy is the best thing you can do. Information and education will ease your mind - nothing beats knowing first hand that YOU CAN DO IT. You can teach those who preach negative sentiment by explaining you are perfectly capable of having a healthy pregnancy. We (diabetics) just put a whole lot more effort into every single second of every single day. I think it’s important to educate others when they are unaware of something related to diabetes. The extent to which I go into deep discussion is another blog altogether.
 
PLAN
My first piece of advice before getting pregnant is to plan (if you’re already pregnant stay tuned for the next blog). Planning to me meant eating better to achieve more stable sugar levels and getting off the roller coaster of highs and lows followed by highs and lows (you know what I mean!). It meant getting a team of professionals I trusted and felt supported me in my diabetic journey. And making the change to go on an insulin pump and continuous glucose monitor. That being said it’s perfectly possible to have an amazing pregnancy on injections.
 
Every article I read before conceiving said to plan 6 months or a year before ‘trying to conceive’ (TTC, I have since learnt is the online abbreviation). Originally I thought, a year?? that seems like forever to plan! However, in the end, that’s exactly how long I took. After 18 years of injections, it was time for a life changing decision. I resisted the pump for so long because I didn’t want to look different, but the prospect of having a baby overshadowed any embarrassment I might have felt.
 
April 2015 I travelled from Dubai (where we were living) to Melbourne to get the Medtronic 640G and Elite Sensor continuous glucose monitor (CGM). I cried in my appointment - a mixture of happiness that I was finally doing it and disbelief that I actually needed this medical device. I’d spent years putting diabetes on the bottom of my priority list and with injections, I felt like I could inject, test, eat and ignore. But with an insulin pump attached to me 24 hours a day, I felt like diabetes would play a prominent role I wasn’t sure I was ready for. But I was ready. I was ready to focus on my health in a way unknown to me. I’d consistently averaged an A1C in the 7’s – possibly the average of lots of high highs and waaaay too many low lows… either way it was time to get my A1C near a 5 or a low 6 to conceive.
 
My diabetes dream team consists of a managing director, that would be me! The other team members are endocrinologist, obstetrician, dietitian, local doctor and a psychologist or counselor if and when needed.
 
SEEKING HELP IS A SIGN OF STRENGTH
We all know what we should do to be a better diabetic, but putting it into action can seem like climbing Mt Everest. That’s where professional help can kick start your journey. And if professional help isn’t viable, that’s ok. Reach out to other inspirational diabetics on Instagram, Facebook or twitter who can provide positive advice.
 
As diabetics we know a little work goes a long way, the more effort we put in the more we can manage it (easier said than done). We control what we eat, when we exercise and how we choose to live our lives. We are the leader of the team we put together. It is essential we are honest with ourselves and with our support team. They will simply work with the information we give them. One of my favourite sayings is “you can’t manage what you can’t measure.” So a great start was recording what I was eating, my sugar levels, exercise and insulin doses.
 
Recording your data is a task no one wants to do. I tried writing my results on a notepad, using notes in my phone, using my memory (bad idea) and finally I settled on using an app called mySugr. Sometimes I’d wait until the end of the day and go through the data in my pump to put into the app. It was a draining and boring task so I only did it for a month. But if you just do it for at least two weeks, you’ll learn so much about your eating, the effect the carbs you eat have on your sugar levels and hopefully gleam where you can make changes. Even though I thought I was trying hard, something was still not right. I’d go too high and too low ALL the time.
 
I didn’t have much faith in dietitians due to past experience, but I just hadn’t found the right one. Ok, let’s be real. I was basing it on seeing one dietitian the year before I got pregnant and one 18 years ago when I was diagnosed! Then I met Rashi Chowdhary in Dubai. She was the angel I didn’t know I was looking for. She motivated me to prioritise eating at consistent times with similar carbohydrates for the corresponding time of day. I began to understand how my sugar levels reacted because consistency meant I could measure and see patterns with greater clarity.
 
We started with a paleo diet, which I did for two weeks and honestly I had the best sugar levels of my life. I actually thought it was impossible to stay between 4.4 and 7.7, however, it is possible. It just takes a WHOLE LOT OF WORK! Now the paleo diet only lasted me two weeks. But it changed my outlook on food and diabetes forever. Cutting out processed food (for two weeks) made me realise how much it was affecting my sugar levels. I learned how much carbohydrate in a carrot or an avocado affected me, something I never knew when it was wedged between two pieces of bread with chicken and mayo!
 
I continued to see Rashi every two weeks over a four month period. Seeing her was like therapy. She gave me great motivation to choose better foods and changed my meal plan every two weeks. We would discuss what was easy to prepare and I stuck with her meal plan most of the time (ok, maybe half the time). The greatest lesson learned was the importance of eating at approximately the same time each day and trying to limit my portion sizes!
 
Example of my eating schedule (give or take half an hour):
Breakfast between 7:30-8:30am
Snack 10am
Lunch 12-12:30pm
Snack 4pm
Dinner 7:30pm

Your food will always depend on what you like and what will fill you up. I was happy to go low carb to get really good sugar levels. Some people may get too hungry cutting out bread or pasta. But I found brown rice pasta to be amazing and a protein bread that only had 8g carb per slice and one slice was enough... when loaded with avocado, squeeze of fresh lime, cracked pepper, sliced cherry tomato and a sliced boiled egg.
 
Quick summary to planning for pregnancy:

• Start eating at consistent times and record everything (or try).
• Review your sugar levels at the end of each day and ask yourself questions (be really honest with yourself)
• If your sugar went high, did you eat too much or not give enough insulin?
• If your sugar went too low, did you eat less than you thought you would or give too much insulin?
• Did you do any exercise that day?
• Start building your team to support you
• Reach out to the diabetic online community on social media like Instagram, FB or Twitter, there’s so many people willing to help
• Trust yourself, believe in yourself and reflect on what you eat.

 
I know there are sooooo many factors that affect our sugar levels. But we have to start somewhere. You know your body better than anyone. You know what questions you need to ask yourself (write them down, all of them). I’ve had lots of highs and lows throughout this journey and the best thing you can do is speak kindly to yourself. Let yourself off the hook. Have an ice-cream on occasion or a white baguette with fries, burger meat and mayo (yes, I did that at Le Mans in France this year and it was delicious).
 
Energy flows where your attention grows. So keep at it. At 37 weeks and 4 days pregnant, I can say all the hard work is paying off.
 
(I am not a medical practitioner and the above is based on my experience only).