Managing Diabetes After Pregnancy

Kelsey Bonilla Health Guide
  • I have a first "date" on Monday....


    My husband doesn't have to worry however since my "date" on Monday morning is actually my first appointment with a new endocrinologist. 


    Those same feelings of anticipation, curiosity, and anxiety accompany the inception of a new relationship, whether it's with a new physician or a romantic interest.  I'm pondering questions like: "What will he be like?"  "Can I be open about my thoughts and feelings?"  "Will we hit it off?"


    If you've had diabetes for any length of time, you undoubtedly know that not all endocrinologists are created equal.  Before I met my beloved doctor who helped me achieve a healthy diabetic pregnancy (read about Kelsey's pregnancy here!), my last endo relationship left much to be desired.  His bedside manner lacked warmth and friendliness.  Also, it's never a good sign when you're telling the doctor about new diabetes technologies on the horizon.  His hesitancy to adopt new medical tools and techniques was quite disconcerting.  I was thrilled to change doctors when I decided to have a baby. 

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    Now that I'm no longer with child I needed to have an endocrinologist that did not specialize in diabetes during pregnancy.  (I'm looking forward to working with the Diabetes and Pregnancy Group when I get pregnant again in a couple years!)   


    Diabetes is such a unique disease.  A fair amount of preparation is required of diabetics before the actual appointment.  Since logging my blood sugars and insulin doses has dropped significantly on my list of priorities over the past few months, I've got my work cut out for me.  Hopefully a week of records will suffice.


    The lack of logging is a symptom of a larger issue... how much energy am I currently putting toward my diabetes management? 


    I test 8-10 times per day, bolus faithfully for all meals and snacks, change my sets on time, and fit in exercise as much as possible.  While this is probably an average to above-average care regimen for a type 1 diabetic, compared to my level of management during pregnancy it feels like I'm slacking.   I'm finding it difficult to be enthusiastic about my diabetes care without sustaining the level of discipline I exercised during my pregnancy. 


    As a new mom, my energy is largely focused on Sienna's needs.  In the midst of pumping breast milk, prepping bottles, laundering diapers, making meals, oh yes, and working full time, it's hard to summon the concern over whether my blood glucose is 100 mg/dl or 150 mg/dl.  While I do not enjoy having blood sugars over 250 mg/dl or so, the degree to which I work to avoid those occasional highs has dropped significantly.  There's just no way to duplicate the intense motivation that carrying a child instilled in me.


    However, when I take a long range view of my diabetes management, I can see how the level of care I achieved during pregnancy continues to benefit my health today.  Once you experience the kind of control necessary during pregnancy, you realize how good it feels to have normal blood sugars.  Also, just knowing that a high level of control is possible does motivate me to make the effort at tighter diabetes management.

Published On: May 20, 2008