Pregnancy Week 15 with Type 1 Diabetes- Perfectionism vs. Sanity
By: Grace Wall
Follow: Type 1 Pace Blog
There have been studies that show girls and women with type 1 diabetes have a stronger chance of developing an eating disorder. Type 1 diabetics are constantly counting and measuring food, and measuring their level of success at managing diabetes (which is impossible to get right all the time) multiple times a day through a number on their blood glucose meter. Constant cognizance of being evaluated and judged on how vigilant we are with food, with exercise and with diabetes management is not always best.
I think it was around the time I was diagnosed that I developed perfectionist tendencies and the need to control any situation. I was ten years-old and diabetes honestly didn’t seem like a big deal to me. Adults were always telling me new things I had to do: you need to brush your teeth, you need to set the table, you need to go to summer running camp, you need to come home when the streetlights come on, and now you need to check your blood sugars and take insulin through a syringe. It didn’t phase me.
That is, until I saw when my blood sugars were out of range, worry would appear on my parents faces. When my blood sugars were good, they would proudly pat me on the back. I saw what grief I caused them when my blood sugars were out of range and I made it my goal to get as close to range as I could.
But how could I? I didn’t have the technology we have now. It took my meter 45 seconds to register a blood sugar! I began to feel lots of shame when my parents would look at my sugar log and ask about different patterns. They were only concerned and I took it as something I had done wrong. But I did nothing wrong. I did not cause my diabetes. As an adult, nineteen years later, that sentence feels cathartic to type.
Fast forward to present day. I am in my 15th week of pregnancy with my first child and I have never tried so hard to manage my diabetes. In the beginning every time my blood sugar would go over 140 I would feel guilty, but I have learned to use the reading as a tool that indicates I need to adjust my insulin needs for tomorrow. I have found it helpful to take a walk when my blood sugar is high and have already given insulin to correct it. It speeds up the absorption rate, and my dog doesn’t mind all the extra walks he’s getting!
I did have one scary day last week where I was 240 for 4 hours and I could not figure out why. The day before I had spoke with my High Risk OB/GYN about some high blood sugars which he believed just meant the placenta was doing it’s job and (here’s the fun part) starting to work against me by creating insulin resistance.
But this particular high event was not coming down with insulin or walking. I was freaking out to say the least and feeling more guilty I was hurting the baby with each passing minute. Of course it was a busy work day too so that did not help. I had a pounding headache, had to go to the bathroom close to every 5 minutes and felt nauseous.
Finally I realized my insulin pump infusion site had disconnected. Not fallen out, just unhooked the quarter of a turn it took for me to get none of the insulin I had been pumping the last few hours. I immediately reconnected and bolused for 7 units. I felt more guilty for being so stupid. In my 17 years of using an insulin pump, I hadn’t had this happen once. I have had my site completely rip out, but this was inexcusable in my perfectionist book.
As I began to reframe the situation, my guilt and anxiety tapered. I rarely wear my site on my stomach, which is where it was at the time, and as my stomach has gotten larger with a growing baby the last few weeks, it has created a variable I have not encountered before. I am getting used to my new body and I may have accidentally bumped my site.
I have also been wearing maternity pants and the waistband on those are great for growing bellies, bad for holding up pumps. Going to the bathroom throughout the day creates multiple opportunities while pulling down and pulling up those pants, where I could have knocked something loose.
The guilt of that high day registered through the roof for me. I remember feeling so defeated. However, I also recognize that I am only human and I am doing my absolute best for this baby. I think it’s truly impossible for me to try any harder (I have given up chips and salsa, pizza, diet Coke and beer for God’s sake!), and that is why I am letting it go. My husband calls it “clearing the mechanism” and it’s what we do when we come home and need to just forget about what happened at work that day. I am “clearing the mechanism” on this hyperglycemic episode and starting fresh tomorrow.
My team of High Risk OB/GYN’s have told me that I don’t need to see my regular OB/GYN any more. I ignored that and have kept seeing her. I like her - A LOT. She helped me through my first and second miscarriages and always has great things to say. She is a realist, which I appreciate.
On my last visit with her she told me I’m doing a great job with the pregnancy, the diabetes, running while pregnant, and everything and told me I need to stress less and start enjoying the pregnancy, because it’s going to be over before I know it.
I will continue to be diligent with my blood sugars but she’s right, I plan to start enjoying the pregnancy more. I plan to be value my sanity over my guilt and stop being so hard on myself. I’ve lasted almost 19 years with diabetes and if this baby is anything like it’s parents, it’s a fighter and it will be healthy and happy.
This post hits so close to home for me, thanks for sharing. I was diagnosed at 12, and went through the same adolescent guilt you describe when my results weren’t perfect. And at 36, I still feel that way frequently, except that now I understand that there are factors beyond my control at play as well. It’s just a hard cycle to break. I had my first child last year and adding the layer of ‘mom guilt’ took this tendency to a whole new level. I think the advice your OB has given you is right - try to give yourself a break because you’re doing a great job. Easier said than done (trust me I know). I nearly melted down at 31 weeks when I learned her normal growth rate had accelerated and she was measuring big, but I eventually delivered healthy baby and she’s just perfect now at almost 14 months old. Enjoy this wonderful time - your diligence will be worth it!
Hi Grace, Keep up the good work. Having Type one and being pregnant is very tough. My daughter is now 6 months going on 7 months she is beautiful and happy baby. My pregnancy was very tough for me . I would beat myself up if my blood sugars were not perfect and that it was affecting the baby. I realized just like you I’m doing the best I can do and can’t do any better and it will be ok. Insulin resistance is a real thing. Once you get later into your second trimester the amount of insulin you need to take is insane. I remember taking 30- 35 units of insulin just for meals and even then my blood sugar would be around 140 after meals. (I’m not a pump user I use the flex pens.) Also you are doing the right thing by sticking with OB that you like. I was in a very similar situation where my family wanted me to use a high risk doc but I said no because I loved the midwife that i was seeing and she knew my situation and she had my back 100% during my delivery. Stick with your gut everyone is going to have an opinion wither you want to hear it or not. It is important to have an ob that you trust it will make the delivery comfortable. Blood Sugars and regular insulin intake will go back to normal once you deliver. It’s very weird. Anyways, try not to stress the time goes fast and you will have a wonderful bundle of joy soon. 🙂