Pregnancy Tracker: 17 weeks
Size of the Baby: The size of a large avocado!
Biggest Obstacle: Making my insulin last until my new vials arrive tomorrow!
For a woman with preexisting diabetes, pregnancy requires a lot of planning. To have the healthiest and most joyful experience, special steps should be taken to get your diabetes in excellent control, and prepare yourself for the stresses of a diabetic pregnancy. Each woman will go through a personal process of preparation for pregnancy -- this was my journey:
For at least 18 months, I thought of myself as being in the process of "preparing my body for baby," and that's exactly how I described it! My first phase began in the summer of 2005. I knew I needed to step up my diabetes care, so I began seeing my very first endocrinologist and had an A1c drawn for the first time in over a year! My result came back at 7.3. Not great, but not as terrible as I had feared. Nonetheless, I had some work to do.
Through a lot of logging and more intensive diabetes management, I lowered my blood sugars pretty substantially, so that my next A1c reading, three months later, was down to 6.4.
While paying much closer attention to my blood sugars, I also began taking folic acid over a year prior to conceiving. All pregnant women require higher doses of folic acid, but it is a particularly important vitamin for diabetics.
Also, I continued to work out and watch my caloric intake during these months. I figured that I wanted to be in good shape physically before conceiving, and also maybe lose a few pounds, so that I could maintain a healthy weight throughout my pregnancy.
Other aspects of a woman's health that might be overlooked while she's preparing for pregnancy include a dilated eye exam and routine dental care, both of which are critical for diabetic women.
Although I achieved an A1c result under 6.5 (many doctors' threshold for conceiving) for several months, I was doing so with injections of Humalog and Lantus. Numerous injections, including correction doses, were required each day, and I split my Lantus dose into a morning and bedtime injection. In effect, I was mimicking the work of an insulin pump with my shots! While I had proven to myself that tight control was possible without the pump, many of my fears of the pump had subsided. I decided to give the pump a shot (pun intended).
On September 22, 2006, I began using an insulin pump. I chose the Deltec Cozmo, in part because it comes with a 300-unit reservoir, which I knew I would utilize during my pregnancy (insulin requirements can triple by the end of the third trimester!)
Insulin pumping was the missing key to my diabetes management. Now I could cater my basal rates and boluses to different times of day and particular situations. I simply love pumping now, and cannot imagine doing all the work of a diabetic pregnancy without one. That being said, it is possible to achieve excellent control with injections, it is just a whole lot more work!