Tommy's PregnancyHub

My experience of pregnancy with type 1 diabetes

Karen is mum to 4-year-old Evan and 2-year-old Zoe. In this blog, she talks about going through pregnancy after being diagnosed with type 1 diabetes.

I had my first baby in 2015, when I was 34. I’d been diagnosed with type 1 diabetes when I was 26, so had always known that there’d need to be more of a plan around any pregnancy, rather than a 'lets see what happens' approach! So when the time was right, my husband, John, and I met with my consultant to discuss trying for a baby. I was prescribed a higher dose of folic acid, but my HbA1c was good and I had no complications to worry about, so we were given the green light.

A full-time job

Diabetes can feel like a full-time job, but pregnancy and diabetes can feel like a full-time job with an excessive amount of unpaid overtime. I saw my specialist diabetic team in the clinic every two weeks, then every week during my third trimester. I also saw the specialist midwife at the clinic too, so it was a bit of a one-stop shop. I went from testing my blood sugars four times a day to at least double that and then deciding if I needed to correct a result. It was full-on. 

During my first trimester, my blood sugars were good, but I eventually needed some fine-tuning that injections couldn’t offer. I was about four months pregnant when my consultant suggested I go onto an insulin pump. It was a total gamechanger and I’m still on it today. As the months went by, my insulin needs increased steadily from a 1:1 ratio for short-acting insulin before getting pregnant, to triple that by the end. The numbers seemed crazy, but was actually very normal.

Physically, I sailed through my pregnancy, but mentally, it was more challenging. I’d read a lot about diabetes and pregnancy before we conceived, so I was very aware that being diabetic and pregnant carries more risk of complications and I was convinced something would go wrong at any point. I ended up spending nine months imagining I was in a computer game and that each day, month, clinic appointment or scan was another level of the game to complete. Looking back, that sounds a bit mad, but I suppose it helped to break things down into manageable chunks. 

I can’t speak highly enough about the care I received throughout my pregnancy. The boredom of sitting in the clinic waiting room was always offset by the guidance, advice, support and reassurance I received during the appointment. Another massive benefit was the continuity of care – I saw the same consultant, specialist nurse and midwife throughout my pregnancy and it felt like we were working in a proper partnership. I left appointments feeling just a little bit more confident that everything was going to plan.   

Inducing labour

I always knew I would be induced around 38 weeks. I stupidly used to read a lot of other women’s stories of inductions and almost universally, the verdict was “it’s horrendous”, so I was very nervous about what was to come. But in reality, I had a couple of boring days in hospital on medication to try and get labour going, that never really worked. I was eventually hooked up to a hormone drip to establish labour and I always remember the consultant coming in and saying, she would come back and examine me in 12 hours. But after just three and a half hours in labour, I was the proud mum to a healthy baby boy!

After the birth

Evan’s blood sugars were tested almost as soon as he arrived and then twice more – he passed them all with flying colours, so that was a big relief. For the first day or so though, he was very sleepy and a midwife was a bit concerned. His sugars were tested a fourth time then, but everything was normal – I think it was just the first indication of his laid-back attitude!

I ended up breastfeeding for nine months, but getting it established was tough. I don’t think that had anything to do with diabetes really, but because I was diabetic, I was offered donated breastmilk while we were in hospital, to make sure Evan was getting something. That definitely took the initial pressure off and I was very grateful to whoever had an excess supply at a time when I didn’t.

After the birth, my insulin requirements steadily dropped back to pre-pregnancy levels and I got into the swing of being a new mum. My baby weight fell away but after six months or so, I’d lost all of it and a lot more besides without changing my diet or activity levels – I knew breastfeeding helped with weight loss, but this seemed pretty spectacular. Around the same time, I’d also been getting increasingly ratty with everyone around me, but as I was finding it very difficult to sleep at night, I just put it down to tiredness. My GP diagnosed me with postpartum thyroiditis, and all my symptoms fell into place.

It meant my immune system had attacked my thyroid and although it’s rare, it is more common in women with type 1 diabetes. My GP expected my thyroid function to normal within a year, but in my case, my low thyroid hormone levels became permanent and I now have to take medication each day to manage that.

The second time around

Just over two years later, John and I welcomed our daughter Zoe into the world. My thyroid issues meant there was another plate to spin in this pregnancy, but thankfully they caused no major issues. Overall though, I found this pregnancy so different to my first and nowhere near as stressful. Looking after a boisterous toddler meant that I hadn’t had time to worry so much, but I also think I’d learnt that while there are lots of things you can’t control about pregnancy, there is a lot you can and those are the things to focus on.

Here's my advice

One thing you are never short on when you are pregnant is advice! But if anyone is reading this who has diabetes and is planning on having a baby, then my advice is to think about what you can do, not the what ifs. Talk to your diabetes team before you get pregnant, if you can. Make sure your HbA1c is good and take folic acid. Keep taking your blood sugars (even when your fingers start to resemble pin cushions!) and be proactive in tackling the inevitable highs and lows that will crop up. Don’t beat yourself up if things don’t always go to plan. Avoid reading horror stories on the internet. Trust the team around you and don’t keep feelings bottled up (my husband John was definitely the voice of reason I needed by my side). But maybe most importantly, be kind to yourself – growing a human, especially with diabetes, is no small undertaking!