T1D and Pregnancy: A Firsthand Account

Capone

For women with type 1 diabetes (T1D), becoming pregnant and having a healthy pregnancy raise many questions. But planning a pregnancy or adjusting to pregnant life as a person with T1D doesn’t have to be stressful. We asked Gina Capone, JDRF’s community manager for TypeOneNation and first-time mother with T1D, to share her pregnancy story with us. Gina was diagnosed with T1D at the age of 25, and has been living with the disease for 12 years. She recently gave birth to a healthy son.

What were your initial thoughts of being pregnant AND having T1D?

I was reading a lot of blogs about people with T1D that were or had already been pregnant and honestly, they scared me. So I stopped reading ANYTHING related to diabetes and pregnancy and decided to just live it out for myself.

There were times in the early stages of pregnancy when I was extremely scared because of my higher A1c level at conception, combined with my age (36). I was afraid that it would affect the baby, but after a couple of sonograms and blood tests, my mind was put at ease.

I also had a serious bout of morning sickness in the first trimester which was nerve wrenching because it was causing a bunch of scary lows all day long and I wasn’t able to keep anything in my stomach until I was put on an anti-nausea medicine. I couldn’t even eat a glucose tab!

Did you have to take any planning steps when getting pregnant? Were there any issues you had to be aware of as a person with T1D?

The main thing my doctors kept telling me when I first started asking about becoming pregnant was to get my A1c into “baby range,” which to them meant 6.5 or lower and to me seemed impossible!

I first started my journey for the perfect “baby range” A1c shortly after I was married—but I failed at it miserably. No matter how hard I tried I just couldn’t get it to where I needed to be and that started taking a huge toll on me, mentally.

My endocrinologist advised me to check my blood-glucose every two hours, make sure I bolused 15 minutes before a meal, and to exercise at least 30 minutes a day. I also tried to shoot for a pre-meal blood sugar number of 60-90 mg/dL and 120 mg/dL two hours after eating.

I did come close to reaching those levels a couple of times, although not enough for a go-ahead from my endocrinologist. But after 4 years of frustrating A1c numbers coming up short, I actually ended up becoming pregnant with an out of range A1c.

It was very challenging to keep my A1c in a healthy range during the entire pregnancy, but I am living proof that you can do it. There were times when I would have a crazy blood sugar in the 300s but I would try not to beat myself up about it, correct it, and move on. ‘Correct and move on’ was the motto I had during my pregnancy, and it worked because my A1c was in the 6s the entire time.

Did your T1D treatment differ during your pregnancy?

Things are very strict during a T1D pregnancy. It is a lot of work but has the best pay off! I checked my blood sugars every hour and at 2 hours I would make a correction if I was above a 90 mg/dL blood sugar.

I also sent my blood-sugar log to my endocrinologist every Friday and shortly after emailing, my doctor would call with new basal rates and carbohydrate ratios. The rates varied throughout the entire pregnancy. I saw the endocrinologist every month and they took an A1c, checked me from head to toe, and we would change rates again! If I didn’t send my logs on time, I got a phone call from the endocrinologist. Now if they only did that all of the time, I would never have a high A1c!

What was the most challenging part of being pregnant with T1D?

The hardest thing was the constant worry that I was going to harm my baby with high blood sugars. I had to talk to myself a lot to stay calm follow my ‘correct and move on’ motto.

Did you have any T1D-related issues in the delivery room or after pregnancy?

During labor my numbers were on the lower side— in the 60s-70s mg/dL range. So I had to correct a couple of times with glucose to bring those numbers up. I ended up with a c-section, so I had to take my pump off for surgery, but I was in the 90-100 mg/dL range during the delivery. When they removed the placenta, however, my blood sugars quickly dropped and I needed glucose through the IV. For the next three days after birth I was low A LOT. I couldn’t keep my blood sugars up past 60 even after eating!

Do you have any advice for ladies that are trying to conceive or soon-to-be mothers?

Do the best that you can and try not to stress! Have someone help you even if it is to check your blood sugars while you are sleeping or in the middle of the night—it helps tremendously. Remember to enjoy your pregnancy!

If you are pregnant or are planning a pregnancy, JDRF’s Pregnancy Toolkit can be an invaluable guide. Available electronically and in print, the toolkit is a free resource that helps prepare people with T1D for pregnancy and childbirth, and offers a host of tools and information to support them at every stage.