If you’ve ever watched South Park, you might remember this:
And I don’t want you to kick the baby, I want you to Kickstarter this baby.
We Need Real Resources for Type 1 Diabetes Pregnancy
Even with one of the top endocrinologists familiar with Type 1s, pumps, and pregnancy, I felt alone in my care. That whole “What to Expect When You’re Expecting” doesn’t discuss the hypos in the first trimester, the fears of high blood glucose, or the psychosocial aspects of a pregnancy that has diabetes in the mix.
Know what I had? The Medical Management of Pregnancy Complicated by Diabetes by a well-known physician that was geared towards medical professionals and not people with diabetes. (And I bristled at the very title… “Complicated” – yep.) It gave information, but when you are awake at 3am and freaking out, this tiny book just didn’t cut it. I knew very few individuals who had Type 1 and had recently given birth (In fact, I knew one.) and longed for real resources.
Enter The Solution
I’ve said before that I’m not the person to turn to for information about Type 1 diabetes and pregnancy, as my pregnancy was not about my diabetes. But I know plenty of women now who have shared their experiences and insight since The Kid was born, and I’m thrilled that one of them (Who also happens to be a dear friend with an adorable baby, Lucy!) is providing a solution for a patient-focused real resource.
Along with Jenny Smith<CDE, RD (who is also a PWD!), they’ve created: Pregnancy with Type 1 Diabetes: Your Month-to-Month Guide – and there’s a problem.
No publisher will touch it, because the market is too small. That means those of us Type 1s who want to have healthy pregnancies are not worth publishing for, because we don’t make up a profitable segment of the population. So, Ginger and Jenny have gone out to the community to help get this book published through Kickstarter.
Why? Because all women with Type 1 diabetes deserve to have real world resources to help them get through one of the most rewarding (and management intensive) times of their lives. This is one of them.
Ginger was kind enough to share this video with my readers (It has Lucy in it!) why this is important and how you can support the work they’ve done.
What’s better than Lucy?
That’s a trick question. Nothing. But if there was, it would be an excerpt from their book, which is what Ginger has graciously offered to you as an exclusive to this blog.! Take a read, then head to Kickstarter and give what you can… and share this within our community.
EXCLUSIVE FROM PREGNANCY WITH TYPE 1 DIABETES
(THANK YOU GINGER AND JENNY FOR GIVING US A SNEAK PEEK!)
Preparing for Pregnancy: Part 3
New Standards for High & Low Blood Sugars
There’s been a longtime assumption that anyone with an A1C in the 5s or low 6s must be experiencing a tremendous number of low blood sugars every day or every week, but the truth is that that is not an essential ingredient to achieving an A1C at or near non-diabetic levels.
What it really comes down to is different goals, different standards for the day, different ways of dosing insulin, of choosing what to eat, when to take insulin and how much longer after that before eating…it’s a variety of habits that lead to an A1C in the 5s or low 6s. Those habits require a tremendous amount of practice, discipline, and always being open to learning and making adjustments.
If you are aiming for an A1C in the 5s and low 6s and you’re constantly experiencing low blood sugars then that is a sign that you’re due for a little help and fine-tuning on how you’re approaching your diabetes management. Frequent hypoglycemia is not an essential part of achieving a low A1C.
This entire book is designed to help you achieve a low A1C without experiencing frequent hypoglycemia! It’s all about blood sugar management, fine-tuning your insulin doses, and learning as much as possible about diabetes management during pregnancy and everyday regular life!
Okay, now that we’ve gotten that part out of the way, let’s talk about the A1C you’re aiming for and the blood sugar goals you’ve set for yourself.
What do you currently consider a “high” blood sugar?
We’re going to keep this straight-forward, cutting right to the chase: if you’re trying to achieve an A1C of 6.0 but your blood sugar between meals and during most of the day is usually sitting around 150 mg/dL or higher, you’ll be as likely to reach an A1C of 6.0 as someone driving north when they’re trying to get to Florida. It just doesn’t make any sense. Your target blood sugar ranges and your A1C goals don’t match.
What do you do when you see a blood sugar of 150 mg/dL on your glucose meter two hours after eating? Do you take a correction dose of insulin or do you say, “Eh, that’s fine”?
Take a look at the following A1C translation chart from the American Diabetes Association explaining what the average blood sugar level and overall range is for each A1C result:
- 12% = 298 mg/dL (240 – 347)
- 11% = 269 mg/dL (217 – 314)
- 10% = 240 mg/dL (193 – 282)
- 9% = 212 mg/dL (170 –249)
- 8% = 183 mg/dL (147 – 217)
- 7% = 154 mg/dL (123 – 185)
- 6% = 126 mg/dL (100 – 152)
- 5% = 97 mg/dL (70 – 125)
What is your A1C right now? If you’re at 7.5 percent and you’re extremely frustrated, ask yourself, “How often is my blood sugar sitting around 150 mg/dL?”
Now, where do you want your A1C to be either prior to pregnancy or during?
Take a look at what your goal A1C translates to as an average blood sugar and blood sugar range.
For example, an A1C of 6.0 percent: That means your blood sugar is rarely over 150 mg/dL, and very often sitting around 120 mg/dL. That 30-point difference matters. If you’ve been telling yourself that a 150 mg/dL isn’t a big deal and isn’t much different than a blood sugar of 120 mg/dL, then you now know exactly why your A1C hasn’t budged from 7.5 percent.
Want to get your A1C in the 5s? That means you’re aiming for non-diabetic blood sugar levels. It means you’re spending the entire night near 90 mg/dL. You’re waking up near 90 mg/dL. (Why consider the overnight? That 8 hour window of time that you are hanging out at a value, weights about 33% into what your A1C value is going to look like). An A1C in the 5s means You are pre-bolusing your insulin before meals so that your blood sugar does not rise too much past 130 to 140 mg/dL for very long, or very often. It means when you correct a low blood sugar, you only consume enough carbs to bring yourself back up to 90 mg/dL rather than 130 mg/dL. It means when you see a blood sugar level sitting steadily at 140 mg/dL, you take a tiny correction dose of insulin to bring it down to 90 mg/dL.
An A1C in the 5s means you’re always aiming for non-diabetic blood sugar levels, but that doesn’t necessarily mean that’s where you should aim.
Non-diabetic blood sugars?! That’s crazy!
We know, it sounds crazy! But here’s the thing: you don’t have to do it perfectly. (And frankly, you don’t have to do it all–that’s a personal decision that you’re going to make for yourself. It can’t be made for you!)
Instead of perfection, it’s just the aim. The target.
Instead of telling yourself that it’s impossible to manage your blood sugars that tightly, you’re telling yourself that you can do the very best that you can do to achieve the tightest blood sugar levels that you personally can achieve for the sake of both your health and your baby.
You don’t have to be perfect. You don’t have to get your A1C in the 5s. It’s okay if you never see your A1C in the 5s while you’re pregnant–but the intent is what matters. The intent and the belief in your ability to do the best you can do is what’s going to help you achieve blood sugar levels you’ve never thought you could achieve. Learning how to manage your diabetes is a non-stop, life-long learning process and if you believe in your ability to learn and improve, you could learn more about diabetes management during your pregnancy than you even realized there was to learn!
You just have to believe in your ability. Not the ability to be perfect, but the ability to improve, to achieve things you’ve possibly never achieved. That is all.
(And if you have a healthcare team that doesn’t understand the aspect of “perfect blood sugars during pregnancy isn’t possible” thing…you show them this chapter and you tell them what’s up!)
And it’s really about creating your own personal standards and goals.
For all of us that didn’t have this resource when we were going through our own pregnancies with Type 1 diabetes (not COMPLICATED BY DIABETES), don’t you wish we had this? That’s why I’m sharing this and asking for your help with their project, because I know that it’s not about being a profitable market… we are not a “market” – we are women who want healthy pregnancies and real-world resources.