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/

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.

Being a Type 1 with Just One Child

I’ve been warring with myself for months now over having one child and wondering if I was going to be OK with that or not. (Like, I have a choice about it? Sometimes the universe tends to make it’s choice for us. Or do we try to balk against it anyway?? Grrr. Too philosophical –  I digress.) I’ve talked to tons of friends about it – ironically, mostly friends who have siblings. I just realized that I have very few friends that are also only children. (Is that a function of being born in the 70s or something else?)  Being an only child myself, I always thought I wanted a brother or sister growing up, and with the loss of my father a couple of years ago, I felt a sudden overwhelming responsibility for my Mom, and realized I had no one to share in that with me. (I also have no one to share stories with about my parents. “Remember when Mom/Dad did this??!!” Only I remember. And sometimes I even question my own memory….not sure if something really happened, if it was a dream, or some fantasy I created as an imaginative kid.) Being an only child has meant that I form friendships that are, to me, like my family. And I have some fabulous friends, so I’m certainly not lacking in that regard.

My husband and I, in the early days of our relationship, always said we wanted to have two children. We struggled for 3 years before we finally had Penelope. Because of my fertility issues, it took thousands and thousands of dollars, a ridiculous number of doctor visits and procedures, and more nights of crying myself to sleep than I can remember. The hope, the waiting, the disappointment, utter despair, but finally the joy – it was a wonderful and exhausting ride. Since then, we have certainly tried to have another baby. I miraculously got pregnant on my own in 2011 and had a heart-wrenching miscarriage.  Earlier this year, we went back to the fertility clinic that helped us have our daughter, and started the process of attempting to get pregnant with the last of our frozen embryos. We jumped back on the roller coaster of emotions and fertility drugs, and unfortunately, we were not successful.  We have no more embryos, and decided we didn’t want to spend exorbitant amounts of money, time, and toll on our emotions trying to do IVF again, especially now that I’m 40 and the chances for success are even slimmer than they were before.

We could try on our own….I got pregnant naturally once, it could happen again, right? But with my “advanced” maternal age,  there’s always more risks of birth defects, of the toll it would take on my body, on the possibilities of complications with the baby – you name it, we’ve thought about it.  I am finally  losing the weight I put on while pregnant and trying to get pregnant, and still have more to go. I am on a very long road to getting into shape and in better health (so that I can BE active with our daughter and have fun), and getting pregnant again would halt that for the time being. And let’s not even talk about how difficult it is having type 1 diabetes in all that bucket of concerns.

We feel so lucky and blessed to have our wonderful little Penelope. She and I both came through the pregnancy with flying colors (more or less – some high blood pressure for me near the end, but in the grand scheme of pregnancies, it was really good.)  Should we throw the dice and risk something happening to me with another pregnancy? Is my personal health and well-being, and the possibility of it affecting how I can take care of my child/children worth that? Do we risk the emotional pain of another miscarriage, or of something being wrong with a baby and affecting our family life forever?

We could adopt – it’s certainly an option we’ve considered at great length. I was adopted, and I turned out OK, even as an only child who was adopted. Yes, I had some emotional angst to overcome in my younger years, but it wasn’t all just because I was adopted or because I was an only child. (Those pesky teenage years are trying on everyone, trust me.)  Adoption is wonderful option that I feel I am more than qualified to understand….but, again, how would that affect our family dynamic? Do we want to engage in *that* emotional roller coaster of trying to adopt? And if we succeed, how will it affect Penny, being our biological child paired with a child we adopt? How would our adopted child feel? Assuming it’s an open adoption, how would interactions be with a birth-family? Do we want to pile on even more emotional responsibility for ourselves?

So many questions, and so few answers.

Here are a couple of articles I read that spurred me into writing about this topic:

Only Children: Being One and Raising One
Only Children – Lonely and Selfish?

Those articles were certainly enlightening and thought-provoking for me, but I’m still no closer to understanding how I truly feel, or knowing what I want. My husband would be fine just having our one, but if I asked for another, he would happily try to oblige – whether it meant more fertility treatments, adoption, whatever.  And my sweet, sweet Penny-girl. She’s so amazing and so vibrant and full of life and growing and learning every day….I don’t want to miss out on this part of her life because I’m too busy chasing after the hope/thought/want/need of having another baby. I love Penny with my whole heart. I have never felt a greater love for any other human being, although my husband runs a very close second. But is my heart wanting/needing to feel even more love with another child? Am I prepared to feel even more worry over their health, their existence, their happiness? Am I up to the task? Is that what I truly desire? Should I just be happy with what a wonderful family I have, and that be “enough?” Not sure if I will be answering these questions anytime soon. We’ll see what the universe has to offer up, and if the choice(?!?) actually ends up being made, or just made by default.

She runs like the wind

Friends can be as good as sisters/brothers, right?

Trust Me, I’m a Type 1

Since I broached the topic of weight issues yesterday, it’s only fair that I set the stage now for many blog posts to come. It’s been almost 19 years since my diagnosis as Type 1, and I’ve gone from a healthy and comfortable weight in my roaring 20s, to being an honestly overweight 40 year old. I accept that true lack of diligence on my part has added extra pounds. For those of you who have not yet made this transition – our lives and our bodies change dramatically in those 2 decades between 20 and 40. Consider yourself warned.

I don’t want to point the blame at anything but myself for this steady weight gain that I’ve had over the years, but let’s be rational and look at what has changed for me in 20 years, and what has helped contribute to my current state of unacceptable BMI:

…at age 20, I took Accutane to get rid of the awful cystic acne that plagued me since the beginning of puberty. You are required to go on birth control pills while taking it (because it WILL cause birth defects), and my ob/gyn recommended I stay on them to help retain my fertility (I’m sure I will tell more jokes about this later. Looking at the side effects, did accutane cause my diabetes?? A question  to ponder in another post….)

That horse was HUGE!

Ahh, the roaring 20s!

…I took said birth control pills for 15 years. There is conflicting information about whether or not birth control pills make you gain weight. I personally believe that anything that synthetically whacks out your normal hormonal system is bound to have some adverse systemic effect.  Most women report an average of 5 pounds gained each year on birth control. You do the math.

…once I got out of college, I got a job. Sitting down in front of a computer all day. It took more effort to exercise than ever before, and thus, exercise fell by the wayside in lieu of making money to pay off college loans, and spending time outside of work socializing with friends and dating.

…over the years, I’ve become more insulin-resistant, very much like a Type 2. I have taken Metformin since having a baby to help with some crazy sugar spikes, and slightly reduce my insulin requirements. As we all know, more insulin = more weight gain. (more thoughts on Metformin in future posts…)

…I got married at last when I was 35. I was happy and eating out a lot more than ever before. (But yay, I have an awesome husband! He loves me no matter what I look like, and has supported me more than I ever dreamed was possible.)

…and we started trying to have a baby. I had fertility issues. I took crazy amounts of fertility drugs for 3 years, went through several rounds of IVF. Stress. Emotional roller coasters. More weight.

…after much heartbreak and hope, I had a baby! Add on baby weight. (This weight I carry as a badge of honor. I freaking had a BABY!! I will gladly gain that weight again if I can ever have another. )

The good news is, I love my life, and I love all the people in it. I wouldn’t trade the years of struggle with my weight if it meant I wouldn’t have my friends and family that I have now in my life.

I recognize that there are lots of factors that led me to the place I am today – having to work hard to get back to some semblance of that healthy and comfortable weight of my roaring 20s. Most of the people who meet me today and who never knew me in the olden days are a little surprised, and probably think I am lying when I say I’m a Type 1 diabetic. They think that because I’m overweight now, I must be Type 2, right? But I know plenty of thin Type 2’s. And through my ever-growing circle of diabetic friends, I’m meeting more and more overweight Type 1’s. I wish people weren’t so quick to judge. I wish more people were educated about diabetes in general. I wish they would trust me when I say, “I’m a Type 1.”

I tend to crop pics now so you don't see as much of my body. But here, you can certainly see my happiness :)

I tend to crop pics now so you don’t see as much of my currently overweight body. But here, you can certainly see all  my joy and happiness 🙂