Blogabetes - Family Planning
Today's Blogabetes post comes from Rebecca Abma, who is a woman with type 2 diabetes experiencing her first pregnancy.
As a type 2 diabetic woman, I was shocked to discover how little information is available about pregnancy and diabetes. At first glance, it looks as if there’s a ton on the topic. Google “pregnancy and diabetes” and several million pages come up. But dig a little closer and you’ll see the majority of those pages are about diabetes of pregnancy, or gestational diabetes.Search “pregnancy and type 2 diabetes” and a million or more pages come up, but still most of them are about gestational diabetes, which is often a precursor to type 2 diabetes. Once I hit upon the magic search words “pregnancy and preexisting diabetes” the content wasn’t reassuring. Words like high-risk, complications, birth defects and macrosomia jumped off the screen.
According to the March of Dimes, “Pregnancy is considered risky for the 1.85 million U.S. women of childbearing age who have diabetes.” After detailing the numerous problems pregnant diabetic women can encounter—miscarriage, still birth, microvascular damage to the mother—and with visions of “Steel Magnolias” in my head, I found the reassuring words, “with good preconceptional care and careful monitoring of their blood sugar, most women with preexisting diabetes can look forward to healthy pregnancies and healthy babies.”
Not satisfied with my web searches, I went to the book store and bought every book I could find on pregnancy and diabetes, except for a textbook that looked rather scary. I devoured all three books that afternoon and felt gypped. There wasn’t anything in these books that I hadn’t already read on the web.
After I got over all the scary stuff—and believe me, there was a lot of scary stuff—it almost sounds like a piece of cake. Plan your pregnancy, achieve a healthy a1c, maintain tight blood sugar control throughout the pregnancy and work closely with your doctor, and you will be rewarded with a healthy baby.
Sounds easy enough, right? My a1c is well within range, and my fasting and post-meal numbers are good too. A few doctor’s appointments to go and some tweaks to my meds and meal plan, and let the baby dancing begin!
Comments
- At 06:35 PM on Thu, Aug 30, 2007 Tired Type 1 wrote:
One of the questions I faced, as a woman with Type 1 diabetes, was whether or not I wanted to inflict my condition upon another genertion of my family. My father has it, and while my sister does not, there are enough nasty conditions in my family (asthma, Chron's disease, IBS, psoriasis) that I had to sit and take stock of my family's medical history and consider what flavor of autoimmune nightmare might show up in my child. It is interesting, having a conversation with oneself about whether or not to roll the genetic dice and spend a good portion of a pregnancy terrified and stressed out that I was responsible for passing something incurable to my kid. At least my father had an excuse - I was unfortunately already on the way when he manifested. I don't have the luxury of saying that if my child ended up with this that I knew nothing about it and could not have prevented it. Sadly, the only way I can make sure that I am the last of my family to have to deal with this is to forego having biological kids.
Steel Magnolias aside, this is a debate that diabetic women have gone round and round with over the years and there are no easy answers. I also deeply resent the fact that many diabetic men seem to have excused themselves from the parenthood discussion. Some women are willing to take the chance and have kids and are capable of maintaing a very strict diet and have the luxury to be able not to have to work during the majority of their pregnancy. I am not one of those women and I think the majority of Type 1 women are in the same boat. It's difficult enough delaing with this disease on a daily basis without adding a high-risk pregnancy to the pot, yet another reason to forgow children. Personally, I feel it is selfish to have child when you know there is a chance you could be giving them a genetic road map that leads to an incurable lifelong illness. There are also other overarching philisophical questions as to whether or not we as a society should encourage the chronically ill to have children, given that we do so little support later in life. Given the tremendous financial and personal cost of getting sick in our society and how poorly the chronically ill are treated by insurers, employers, doctors, HMO's and other governing entities and given the discrimination Type 1 diabetics face, I personally cannot bring myself to introduce a potentially Type 1 diabetic child into this kind of environment.
Call it self-selection or self-imposed eugenics. or what have you. I wish I could get pregnant and have a child, since my husband is the kind of good man that would make a great father. But that wish is more about what I want than what would ultimately be the best thing for a child. I'm sure there are plenty of diabetic women who have gone on to have perfectly healthy children that show no sign of Type 1 diabetes. Their dice roll came up 7's. I know my usual luck at gambling and quite frankly, it stinks.
After talking about it with the hubby, I decided that the best thing for any biological child of mine would be to simply not have them. I am making a judgement call regarding my own reproductive capability and in my mind, it's the right one and the moral one.
If you have a diabetic child, then your first step to prevent your child from the complications of diabetes is planning a health and proper diabetic diet for your child. Planning a diabetic diet for your child will play a significant role in maintaining his/her diabetes and ideal body weight.
You can do some of the tips like: Avoid foods that greatly affect your child’s blood glucose level.