PHOTOS BY Lindsey Freitas

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.

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.

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.

WRITTEN BY Noor Al Ramahi, POSTED 09/06/15, UPDATED 08/04/23

Noor has been living the fullest, finest life with type 1 diabetes (T1D) for the past 22 years after being diagnosed at age 5. Born and raised in Abu Dhabi, UAE, she spent her time volunteering at local hospitals helping newly diagnosed kids realize that nothing can get in the way of their dreams. Noor studied marketing in Dubai and worked in the products marketing department for Etihad Airways before getting married and moving to the Bay Area three years ago, where she quickly realized her passion wasn't in the corporate world. She wanted to be involved in the T1D community and help give people opportunities that come from having a community, something she didn't have growing up. Noor is now an active volunteer with the Children With Diabetes organization (and has been for eight years!), a member of the Sugar Mommas group and she works as the community manager for CarbDM. Besides helping people, she has a deep love for equestrianism, cooking, the beach, Diet Coke, her furry babies Bella the dog and Berkeley the cat, traveling and exploring the world with her family, party planning, tiramisu, black clothes and Justin Timberlake.