Pregnancy, Twins and Type 1 Diabetes

Two years ago, after leaving the clinic for my pre-conception visit I decided I did not want to ever get pregnant.

Not because I did not want a baby; I wanted one more than anything. But after sitting in the doctor’s office for an hour-and-a-half so he could lecture me about the do’s and don’ts, all while graphically describing every possible scenario that could go wrong, all I could think of was that I couldn’t put my baby in jeopardy like that. I would never be able to forgive myself if anything went wrong. I was supposed to have blood sugar levels between 70-100??!! Seriously?! (Spoiler alert: it was pretty doable.)

My husband was just as taken aback, but he had more faith in me than I had. With him by my side, and personally knowing many amazingly strong women with type 1 diabetes (T1D) who have had healthy babies, I felt like I had the strength to take on the challenge.

I knew it would be first-thing’s-first: my HbA1c needed to be below 6. For the next couple of months, I watched things like a hawk and at the time of conception it was 5.9.

We found out I was pregnant and the ecstatic feeling of bliss was out of this world, but that didn’t last very long. My “diabetic brain” took over, and worry hijacked the moment.[sectionbreak]

After more than two years of trying to get pregnant, finding out I was pregnant was a shocker but nothing could have prepared us for what came next. At our first ultrasound we found out we were having twins! TWO babies! The challenge had doubled. I had di/di twins meaning two placentas, which would double my insulin resistance but at that point I didn’t care. All I knew was my motherly duties had begun and I needed to kick diabetes’ butt for these babies.

The next few weeks were nerve wracking. Every time I went above 100 I would visualize large sugar molecules with angry faces attacking my babies. I had to make a paradigm shift to keep my sanity because the stress was making my blood sugar control worse.
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After multiple conversations with my doctors, nurses and multiple moms with T1D, I felt reassured that occasional highs would not hurt my babies. As long as I corrected and took action, I needed to brush it off and move on because the stress might actually do more damage than the occasional highs.

I quickly learnt a few tricks that helped make everything doable. I switched out my regular insets to contact detach so the cannula wouldn’t kink, and so I would always get the insulin dose I bolused for. I also pre-bolused at least 15 minutes in advance, sometimes as much as 30 minutes in advance depending on how high I was, especially in the mornings and towards the end of my pregnancy. I would take a brisk 10-15 minute walk after every meal. I ALWAYS had my Dexcom on and would check using my meter at least five times a day to make sure it was on track.

If there’s anything pregnancy with T1D taught me, it’s to trust my body, do my own research and advocate for what I believed was right for me.

My doctor wanted me to limit my carb intake and go on the same meal plan everyday, but I refused. I was working 24/7 to maintain my target blood sugars—at least give me the joy of enjoying my meals. He reluctantly agreed when he saw my numbers and my Hba1c was 4.1!! I always joke that pregnancy cured my diabetes.

Throughout my 21 years living with T1D I learnt to find the silver lining in every scenario. One silver lining during pregnancy was that the burden of going in for weekly checkups was lighter because I got a weekly ultrasound. I got to see my babies grow and heard their heartbeats every week. That sound gave me the power to push through and work harder every week until I got to hold my beautiful boys in my arms. Knowing that my babies depended on me made the impossible possible.

A week before my induction date I was admitted to the hospital for preeclampsia, but I didn’t let that distract me or get me down. I used this downtime to relax and regain my energy before the boys arrived—the room-service massages in the hospital were a definite plus! On January 26, I was induced and two days later we welcomed Rakan (6.6 pounds, BG 89) and Kareem (5.5 pounds, BG 76).  All the stress and hard work throughout the pregnancy is only a vague memory when I see the smiles and hear the laughter of my healthy little munchkins. They were definitely the shining light at the end of the tunnel.