Pregnancy Diet Plan with Type 1 Diabetes

No, I’m not pregnant. Although, I desperately wish I was, that ship may have sailed.

Regardless, I’ve been chatting with a lot of d-friends lately who are looking into the getting-pregnant-business, and they have been asking about pregnancy diet plans.

Below is what my endo’s nutritionist gave me, and it worked like a charm every day that I followed it. And by “charm” I mean: relatively reliable and consistent good blood sugars within a range I could handle at that point in my pregnancy. Blood sugars are ALWAYS a moving target, but pregnancy makes that even more of a challenge. It felt like I was changing basal rates and insulin-to-carb ratios almost every week.
As we all know, your body and diabetes may be different, but this is what I went by, and this worked for me. I am connecting this with Type 1 diabetes because that is what I know, however, I don’t see why it wouldn’t be applicable for a Type 2 or gestational diabetic as well – as always, you should consult with your doctor to discuss what is best for you as an individual.

Everything in ( ) is examples for that meal – you may obviously swap it out for things you like & different stuff each day – these examples are using the Diabetic Exchange lists. I was a little cavalier and didn’t quite stick to it 100% of the time. When you are pregnant and crave a chicken quesadilla, you must have a chicken quesadilla, though it may not mesh exactly into the options for food at dinnertime.

But to this diet’s credit – my HbA1c’s were fabulous throughout the 9-ish months of pregnancy – 5.2, 5.7, and 5.9 respectively. AND my daughter came out with no issues whatsoever (despite my fears throughout the entire 37 weeks that every high or low blood sugar was killing her. If I could do it all over again, I would do my best to NOT be so stressed out, and instead just relish in the ability to BE pregnant.)

Breakfast
– 1 protein (one egg)
– 1 starch (one slice of whole wheat toast)
– 1 milk (1 cup skim milk)
– 1 fat (1 tsp margarine or 1 piece bacon)

Morning Snack
– 1 protein (1 oz. cheese)
– 1 fruit (1 small apple)

Lunch
– 3 proteins (3 oz. lean turkey)
– 2 starches (2 slices whole wheat bread)
– 1 milk (or 1 fruit) (1 cup plain or lite yogurt)
– 1 fat (1 tbsp diet mayonnaise)
– 2 vegetables (1 tomato / 1 cup raw broccoli)

Afternoon Snack
– 1 protein (1 tbsp peanut butter)
– 1 starch (6 crackers)

Dinner
– 3 proteins (3 oz cooked chicken)
– 2 starches (1/2 cup pasta, 1 slice bread)
– 1 fruit (1/3 of cantaloupe)
– 1 fat (1 tsp margarine)
– 2 vegetables (tossed salad with tomato)

Bedtime Snack
– 1 protein (1 slice cheese)
– 1 starch (1/2 English muffin)
– 1 milk (1 cup milk)

Česky: Pizza

Pizza (Photo credit: Wikipedia)

Notes & info links:

  • I had terrible morning (really, all day) sickness throughout my pregnancy, up until the day I gave birth. The ONLY thing that kept me from retching all day was making sure I ate something every 3 hours. It was like clockwork, and I could almost biologically tell you when it had been exactly 3 hours because I would start getting nauseous.
  • Near the end of my 1st trimester, my husband and I went on a cruise. It was amazingly beautiful and relaxing, but my most favorite memory is eating a piece of PIZZA almost every night around 11pm so that my blood sugar would stay stable throughout the night. I AM NOT KIDDING. Pizza!! It was an historic event of perfect blood sugars with relation to that usually-nightmare-blood-sugar-causing food. (This only happened in 1st trimester and beginning of the 2nd. During the crazy-insulin-resistant-3rd trimester….pizza was off the table.)
  • There are tons of resources out there around pregnancy with Type 1 diabetes. Before I really engaged with the breadth of the DOC, I chatted a lot on the boards at  http://www.diabeticmommy.com/
    TuDiabetes also has forums and groups filled with women looking to get pregnant, currently pregnant, or post-pregnancy who can be great sounding boards for questions: http://www.tudiabetes.org/group/diabetesandwomen
  • And for those of us who face infertility (diabetic or not) and issues with just getting pregnant in the first place: http://www.resolve.org/

Period. Insulin Resistance. Period.

Attention men: You may want to stop reading now. We’re about to delve into one of those mysterious women-folk-things that might make you queasy, so don’t feel obligated to read this post in it’s entirety. But if you really want to, by all means, feel free! Maybe you’ll learn something. It’s really not THAT gross, I’m just going to say “period” a lot. You’ve been warned.

OK, back to this period thing. Being a woman of child-bearing age, I have a period every month. Having type 1 diabetes on top of that means, my body goes through weird cycles of hormones that connect both of those things. I’m sure other type 1 women have noticed this, but I finally paid close attention this month, and here’s my personal amazing discovery, always with the disclaimer that Your Diabetes May Vary (and I am in no way a doctor or medical professional):

On the first few days of my period, I CAN EAT CHINESE FOOD and NOT go high as a kite sugar-wise! I was curious as to why, hormonally, this might happen. Then I looked at a chart of the cycle of progesterone and estrogen hormones.

I learned many, many things about my body (some I wish I didn’t know) when we were undergoing fertility treatments trying to have our little girl. The main thing I learned, and saw in action very frequently, was that progesterone made my blood sugars run steadily higher the more of it I was taking. (This also supports why, in your 3rd trimester of pregnancy, you become the most insulin resistant as well – it’s when you have the most progesterone coursing through your body.)

In the little chart above, you can see progesterone levels come crashing down at the end of your monthly cycle, thus, triggering your period. For me this past week, these hormone changes equated to one visit to Red Bowl, with me eating “flower chicken” (no breading on the chicken, and a light sauce low in sugar), veggies, a small portion of fried rice AND half an eggroll, and actually going LOW afterwards. It was so unbelievable, I had to try it again a couple days later. The next time, I got a little more brave, ate some wonderfully evil-and-carb-filled Spicy Chicken, bolused appropriately for it in a dual-wave, and peaked at a high of only 165 about an hour and a half later. It was truly magical.

The one thing I didn’t get the test over the last few days was pizza. Next month, I will! Now, I’m not saying we all should go out and eat vats of Chinese food and pizza when we are all on our periods, but if you’re going to do it, may as well do it when it will affect ye olde blood sugars the least, right?  (Oh, and speaking of monthly reminders – you might want to change out the lancet in your checker 🙂 )

Kindness of Strangers

It was a tough morning. I had to go to my yearly OB/Gyn visit, and see all those lovely pregnant bellies flaunting themselves in front of me. I could almost hear them ridiculing me….. “ha, ha, your belly will never look like THIS again.” I have all but given up on the idea of even trying to get pregnant and have a second baby. I’m 40. I have type 1 diabetes. I’m overweight. I have infertility. I have all manner of aches and pains. I’m tired of the emotional roller coaster. I don’t want to waste away the joy of my one and only daughter’s childhood on the unrequited hope for another baby.

There are a multitude of reasons I believe pregnancy will never happen for me again….and maybe it shouldn’t. I’m even higher risk now than I was when I got pregnant with our daughter, 3 years ago this month. And we only got pregnant with her after thousands and thousands of dollars of fertility treatments, IVF, and years of hope and disappointment. That took a huge emotional and physical toll on me, on my husband, on my family and friends who had to deal with me….and I’m not sure I want to go through that again.

I also see how hard pregnancy is on women my age – with or without diabetes. Just because I got through my one pregnancy OK, my body wasn’t damaged beyond repair, and my little girl came out perfectly healthy through it all…..that doesn’t mean the 2nd time around would be the same, and that scares the bajeezus out of me.

As a treat to myself, I went to Starbuck’s after my appointment. I was starting to edge on the side of low blood sugar, which makes me strangely emotional, and was already a little weepy remembering my conversations with the doctor. (She was all sickly-sweet and upbeat, “you had a miracle once, it could happen again!” referring to the ONE and only time I ever got pregnant on my own and had a miscarriage. Yeah, let’s remember that heartbreak.)

I ordered my Grande Skinny Mocha with 1.5 pumps, and an Asiago-cheddar pretzel. (They are evilly delicious, by  the way.) When I pulled up to pay, my friendly neighborhood barista said, “The gentleman in front of you paid for your order already, and hopes you have a fabulous day.” I think I started openly crying at that point, and replied, “That was so sweet of him. Thank you.” And I went on to pay for the lady’s order behind me. I really needed that pick-me-up, and maybe she did, too. My barista gave me a super warm smile (he kind of reminds me of an Italian Santa Claus, so it was even warmer-feeling) and said he hoped my day was wonderful from here on out.

I pulled away, still weeping, but feeling better and more hopeful than I have in some time. Maybe I will get pregnant again, and it will be OK. Maybe we will adopt, and that will be OK. Maybe my daughter will end up as an only child, and that will be OK, too. That man in front of me had no idea how I was feeling, or what a rotten emotional day I was having, but he showed me a kindness that I must have desperately needed right at that exact moment. My barista shared just a few kinds words with me that were unsolicited and not necessarily part of his job description, but he did it anyway. Today, even moreso than usual, I truly appreciate and admire the kindness of strangers.

Pay It Forward

Thank you, thank you, thank you to the man in front of me in line.

D-blog week Day 4: Accomplishments Big and Small

Diabetes Blog Week topic: So today let’s share the greatest accomplishment you’ve made in terms of dealing with your (or your loved one’s) diabetes.

I saw the movie Steel Magnolias when I was 16….I was healthy and active, with not a care in the world (except, would my friends and I go cruising that night and scope out the cute guys who were also cruising in their cars along the downtown strip? Sigh.) Imagine my surprise when, 5 years later, I was diagnosed with type 1 diabetes. When I asked my doctor how this would affect my life – outside of having to take shots, monitor sugar, etc – she said, “well, you can probably expect to live 10 years less than you would have without diabetes, and depending on when you decide to have children, it may or may not be a good idea.” Ugh, that didn’t sound hopeful or inspiring at all.
Of course, my thoughts went back to Steel Magnolias and how complications caused by diabetes post-child-birth led to Shelby’s untimely death. The movie is so old, I hope that wasn’t a spoiler for anyone. Also, many of us diabetic women sort of hate that movie. It’s a downer, and shows one of the absolute worst possible outcomes of a woman not in control of her diabetes having a baby.

Long before my diabetes diagnosis, there was one thing that was a constant desire in my life – I wanted to have a family and be a Mom. I always loved children, loved spending time with my friends who had babies, and could never get over the joy of teaching a young child something new, and seeing that sparkle of wonder in their eyes. I longed to share that with my own child, and experience parenthood with a loving partner. I hoped and prayed every day that having diabetes now would not steal that joy away from me.

I was 35 years old before I married my husband, and we started working on having a family. As a woman of “advanced maternal age” (the doctor’s words, not mine), I faced many hardships and risks because of that, never mind the silly little body-debilitating disease of diabetes. Through close to 3 years of fertility treatments, IVF, and a roller coaster of emotions and hope and pain and everything you can imagine…the light at the end of the tunnel became my wonderful, perfect and amazing little girl. Screw you, diabetes. I did it. Joy