The “skinny” on what? The only thing skinny on me these days
is perhaps my pinky, on a good day. J
As promised, this blog is intended to present a very honest
portrayal of pregnancy with type 1 diabetes, which has involved many Doctors,
many finger sticks, many sonograms, many increases/ deceases in insulin and
many growth and learning opportunities.
A brief background: mothers with type-1 diabetes often have
pregnancies characterized by abnormally large babies with prematurely developed
lungs and most often deliver between 37-39 weeks. Ironically, and thankfully,
the risk of Finley getting diabetes from me is only 4%- you can tell how lucky
I was to inherit this disease from my father. I kid, but I really think my
parents should have played the lottery the day they discovered this.
So here goes, a brief summary of my pregnancy (to date) with
type-1 diabetes:
1st trimester
During the 1st trimester the baby is growing
tremendously and the mommy is not often feeling up to optimal eating in
quantity or quality. That being said, this trimester is characterized by
decreasing insulin needs and very LOW blood sugars. Like so many lows that you
wonder why you’re even bothered to take insulin. During this trimester every
calorie I was putting into my body was being sucked away by Finley so I lived a
lot off of juice and frequent snacking to keep my blood sugar levels constant.
Prior to this I was more of a breakfast, morning snack, lunch, dinner and
bedtime snack person and learning to break these meals into smaller more
frequent sittings was a bit challenging and a shift in the way that I knew
eating.
At this point in my pregnancy I was seeing a perinatologist
for monthly 3 and 4D bio-physical sonograms where they would check the heart
beat and heart development. I was also seeing the OB monthly to measure my
growing belly, weight and double check for the heartbeat. Finally, I was seeing
an endocrinologist every 3 weeks to monitor my glucose control, adjust my
insulin levels and discuss how things were going.
2nd trimester
Once I hit the 20-week point of my 2nd trimester
the insulin demands of my body shifted drastically. As the baby continued to
grow in size and in functional need, Finley demanded more insulin (a growth
hormone in fetuses) from me to develop as she needed. Whereas I was mostly
insulin sensitive during the 1st tri, I became more insulin
resistant as fat stores accumulated in my body. This resulted in a huge shift
of insulin (an increase of about 30 units/ day) to continue to maintain my
blood glucose levels while eating small, frequent meals to keep my glucose
levels more stabilized.
At this point in my pregnancy I continued to see the
perinatologist monthly for sonograms, bio-physical profiles, a 20-week fetal
EKG and the usual OB things. Because babies do not begin to differentiate in
size until the 25th week, much focus remained on the development of
Finley’s vital organs and heart.
3rd trimester
About midway through the final trimester my body once again
shifted from insulin resistance back to sensitivity- I’ve been lowering my
insulin in 2 unit increments/ week ever since. As I understand, the baby is
done growing and no longer demanding as much insulin from me. This has once again
brought many low blood sugars, leaving me some days to struggle to get above 75
(post-meal.) As I’ve just hit 37 weeks (full term- woo hoo!), much of the focus
has shifted on making sure that Finley continues to grow at a stable rate and
that her lungs are maturing.
Throughout the 3rd tri I’ve been seeing the
perinatologist and OB bi-weekly for bio-physical sonograms and having a growth scan
every month. At 34 weeks I began seeing both specialists weekly. The endocrinologist
and I met weekly at the top of the 3rd tri then tapered off to
bi-weekly as insulin levels began to stabilize.
Finley had her final growth scan last week at 36.5 weeks and
weighed 6lb. 15oz. (+/- 1lb.), measuring on time= great control of my diabetes!
In her bio-physicals she’s been showing good practice breaths and my medical
team feels that she will have mature enough lungs at birth to avoid the NICU on
this basis.
The birth plan:
There are a lot of mixed reviews about type-1 mothers
carrying their infants to full term so Finley will be greeting us at 38.5 weeks
via a scheduled induction (date to be released in a later blog entry). I have
chosen (against my wishes) to not argue with the Drs. and try for a vaginal
delivery because her size appears on track. For those that haven’t gathered, I’m
a huge control freak and I’m trying to be “zen” about the entire labor and
delivery experience. More details on our birth plan will be coming in a future
post. For now know that life with Finley is right around the corner, and to get
her as a prize at the end of the journey has been worth every finger prick
(avg. 15/ day), needle stick (avg. 4/ day) and Drs. appointments (avg. 1/ week)
in the world!
