An Extra “Sweet” Pregnancy

Written by Rachael Butterworth.

I’ve always known I’ve wanted children, and as my 30th was approaching last year, I started thinking about plans for the future. Little did I know at the time, my pregnancy would be far from straightforward.

In April last year, I was diagnosed with type 1 diabetes. I’d been losing weight without trying, felt constantly thirsty and needed the toilet more frequently. Ironically, it came at a time when I felt my fittest. I was eating pretty healthily and going to the gym five times a week, so the diagnosis came as a huge shock. There’s no history of diabetes in my family, and I remember wondering what I could have possibly done to cause it. Turns out I hadn’t done anything wrong, it was simply something that had developed and was completely out of my control.

For anyone reading who may not be aware, type 1 diabetes is an autoimmune condition that stops the pancreas from producing insulin. Insulin is the hormone needed to regulate blood sugar levels, particularly when eating or drinking carbohydrates which the body breaks down into sugar. As the body can no longer produce insulin, it has to be replaced throughout the day with injections or an insulin pump, and those with it have to carb count for the food and drink they consume. Blood sugar levels are monitored 24/7 using finger pricks or a CGM (continuous glucose monitor) to try and avoid hypoglycaemia (dangerously low blood sugar) and hyperglycaemia (dangerously high blood sugar) which is affected by everything from food and exercise to stress and illness.

Unfortunately, there’s no cure, so it’s something I’ll have to manage every day for the rest of my life. 

The timing of my diagnosis was really difficult. I was suddenly learning how to manage a condition I had very little understanding of, while also feeling anxious about whether it would impact my chances of becoming a mum. I’d heard about women experiencing gestational diabetes during pregnancy, but had no idea what being diagnosed with type 1 would mean for having a baby.

I was referred for care with the Diabetes Clinic (who are absolutely incredible!) and told them about my desire to become a mum almost immediately. They couldn’t have reassured me more and explained that while pregnancy with diabetes, whether type 1, type 2 or gestational, involves a lot of checkups and monitoring, it was absolutely possible to have a healthy baby. I was so relieved, but knew I had some work to do first.

My HbA1c (a blood test which measures your average sugar levels over the previous few months) was 90 mmol/mol when I was diagnosed, which is extremely high. It was recommended I bring it down to at least 48 mmol/mol before being considered safe enough to fall pregnant (for comparison, a non-diabetic may sit between 20-38 mmol/mol). This wasn’t something that would fix itself overnight and I needed to be strict with myself to bring my levels back into a healthy range.

I started wearing a CGM on the back of my arm and was prescribed insulin injections.  From that moment onwards, I spent the next six months doing everything in my power to bring down my sugar levels. It was a really difficult time for me, but I was lucky to have the brilliant diabetes nurses at the clinic on hand, and also my partner and family who were so incredibly supportive and checked in on me every single day. I couldn’t have got through the first few months without them.

As my levels started to decrease, and to prepare in the hopes of getting pregnant, it was planned for me to start using an insulin pump to allow me to control my blood sugars more closely. It’s another device I now wear which links up to my phone and delivers insulin without the need for constant injections. I was lucky to get one in September.

The following month I found out I was pregnant. I was absolutely over the moon, but also feeling super anxious. I’d only been diabetic for six months at this point and was still trying to figure it all out, so the thought of managing it through pregnancy with all the added hormones was quite daunting.

From week six of my pregnancy, I went to appointments every two weeks at Nobles hospital to see both the antenatal and diabetes clinic, who monitored the baby and my blood sugars to make sure everything was going smoothly. I also had to go for regular eye screenings to check for diabetic retinopathy, which affects the small blood vessels in the eyes. You have to keep your levels in such a tight range during pregnancy, as consistently high blood sugars can increase the risk of complications for both mum and baby, including problems with the baby’s development. There is also an increased chance of having a larger baby, so I had extra growth scans in the last few weeks. I genuinely lost count of how many checkups I had. It was reassuring but relentless!

As my pregnancy progressed, my insulin resistance increased massively. I found myself dealing with lots of highs and would immediately worry about whether they were going to affect the baby. I spent my whole time carb counting, correcting insulin doses and walking to keep my sugars stable. I even bought a treadmill to have in the house so I could walk in the middle of the night if I needed to. Looking back it sounds extreme, but I was prepared to do anything to keep my baby safe.

Thankfully whenever I was worried, the nurses at the Diabetes Clinic were always there to reassure me and help me work out what I needed to do, especially Jan, Laura and Bethan who couldn’t do enough for me! Diabetes can feel extremely isolating and invisible to those around you, but somehow during this period I never felt alone.

Despite all of this, the rest of my pregnancy was very smooth. I was lucky that I didn’t have any other complications and the additional scans gave me lots of reassurance that the baby was growing well.

As delivery was getting closer, it was decided that I would have a planned c-section at 38 weeks to avoid any potential complications. I was able to continue using my insulin pump throughout the birth, with my partner keeping an eye on it for me while I concentrated on the birth itself. My blood sugars stayed very stable throughout and there were no unexpected issues, and our beautiful baby boy Ayden arrived in June. The relief I felt was like nothing I had experienced before! All of the appointments, monitoring, carb counting and worrying was worth it. He was finally here and he was healthy.

His blood sugar was checked after his first two feeds, which is something the midwives do as babies born to mums with diabetes can sometimes have low blood sugar after birth. Thankfully his levels were absolutely fine. Ayden does have a slightly increased risk of developing diabetes in the future because I have type 1, but it’s only a small risk and is something we’ll be mindful of as he grows up.

Since giving birth, my insulin needs have dropped massively which has been another learning curve in itself. Navigating diabetes alongside having a newborn comes with its own challenges, and sometimes it upsets me that I can’t just switch off and enjoy this time without having to think about it, but I genuinely wouldn’t change it for the world.

If there’s one thing I’d want another woman with diabetes to take from my experience, whether that’s type 1, type 2 or gestational, is that having diabetes doesn’t mean you can’t become a mum. I won’t sit here and say it’s easy, because unfortunately it isn’t. There’s a lot of monitoring involved, a lot of appointments and a lot of worrying about whether you’re doing enough. But with the right management and support around you, it is absolutely possible to have a healthy pregnancy and I would do it again in a heartbeat. Being diabetic was something I never expected in a million years, but I’m so happy it didn’t stop me from starting the family I’ve always wanted.