Meet T1D Momma, Kacy B.

It is absolutely possible to have a healthy pregnancy and healthy babies with T1D

I was diagnosed with T1D when I was 11 years old— about 15 years ago. When I was diagnosed, the medical staff told my parents I should never have kids because of the risk involved — thank goodness we now know with good control and a healthy lifestyle, it is absolutely possible to have a healthy pregnancy and healthy babies with T1D.

When my husband and I started thinking about having kids, I made an appointment with my doctor to ask questions and find out what would be expected as far as diabetes control to ensure as healthy of a pregnancy as possible. My doctor told me I should achieve and maintain an A1c of 6.4 or less without excessive low blood sugars. This seemed impossible to me— my A1c was pretty much always in the 7s and achieving an A1c that low really seemed impossible to me. I felt defeated after that visit, but I started working towards that goal and was quickly able to achieve it— largely thanks to being diligent about pre-bolusing and tracking my sugars with my Dexcom CGM. I was ecstatic!  I manage my T1D with multiple daily injections, as I have personally never been a big fan of insulin pumps. However I know several people who have had healthy pregnancies using a pump for insulin administration! Soon after I found out I was pregnant I started dealing with morning sickness (which was more like all day sickness). I dealt with a lot of lows because I was not able to eat much for the first few months and I would get sick often. It was rough. I was always able to get my sugar back up by sipping on Gatorade or apple juice slowly and I would keep an eye on my CGM and try to treat as soon as I noticed my blood sugar was starting to get low.

Shocked to find out we were having identical twins!

At my first ultrasound around 8 weeks, my husband and I were shocked to find out we were having TWINS (no wonder I was so sick so early and so often)! We found out my twins were sharing a placenta (which presented risks for a bunch of other scary things that could happen if they didn’t share the placenta equally). We also found out that meant they would be identical!

I read the book Pregnancy and Type One Diabetes (which I highly recommend) and felt pretty prepared about what to expect as far as insulin needs and blood sugar management during each month of my pregnancy. It was actually much easier to control my blood sugars while I was pregnant than I expected! My A1c stayed between 5.4 and 6.4 the entire time.

I was very blessed to have a pretty non-eventful pregnancy considering it was double high risk with T1D and twins sharing a placenta! At about 33 weeks I developed some symptoms of pre-eclampsia and was hospitalized for monitoring (standard care for twin pregnancies). I had to be induced at 34 weeks due to elevated blood pressure. I delivered my beautiful baby girls at 34 weeks and 2 days. Having T1D did put me at a higher risk for pre-eclampsia and carrying twins added to that risk as well, so we were watching out for it!

One of the things I was most nervous about was managing my blood sugars during labor and delivery. Again, it was easier than I expected. My sugars stayed on the lower side and I was able to sip on Gatorade and water as needed, which was very nice. I also had some dextrose mixed in with my IV fluids to help keep my blood sugars at a good level. I had a separate IV for insulin administration if I needed it, but I ended up not needing extra insulin during labor! My basal insulin was doing it’s job and was enough for me during labor. Immediately after birth my insulin needs plummeted— I even ate a few meals and didn’t require any bolus insulin for the day or two after I delivered. SO crazy! But my insulin needs did start going back up to my pre-pregnancy numbers within a few weeks after delivery.

Juggling it all and learning every day

Once my babies came home, diabetes management was definitely more challenging! Since I have twins, someone always needs something and it is easy for diabetes to get put on the back-burner. Sometimes I’ll start eating, get interrupted by a crying baby, and totally forget to take insulin until my CGM goes off telling me my blood sugar is high. Lows will happen at inconvenient times as well— I have found it helpful to keep snacks in pretty much every room in case I’m nursing or rocking a baby and start to get low.

I am still figuring out how to juggle it all, but it’s getting easier and I feel like I’m learning more every day! I was so overwhelmed and nervous about having a healthy pregnancy and delivery while managing T1D— but if you prepare ahead of time and take it one day at a time, it is absolutely possible!!