Pregnancy Peace of Mind by Patti B. Geil and Laura B. Hieronymous
by Patti B. Geil, MS, RD, LD, FADA, CDE, and Laura Hieronymous, MSEd, APRN, BC-ADM, CDE.
Copyright © 2003 by The American Diabetes Association.
Excerpted with permission of the publisher, The American Diabetes Association.
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NOTE: Excerpts are provided on dLife.com for informational purposes only. The information contained within will not be updated by dLife and may be outdated. Please consult your doctor before acting on anything described here.
Chapter 7 – Pregnancy Peace of Mind
I have always had excellent control of my diabetes, but this pregnancy has turned my life – and diabetes management – upside down. What can I do to get back in control?
TIP (Type 1 & Type 2): That depends. Diabetes is a complex condition and the physical and hormonal changes of pregnancy can provide even more challenges to your management plan. It's important to accept the fact that your diabetes may not always respond the way you'd like, even though you are doing everything "by the book." You may find yourself feeling especially anxious when your diabetes control is less than perfect during your pregnancy, or if you have to begin taking insulin or increase your previous insulin dosage. Rest assured that your diabetes has not grown worse; actually, your blood glucose is responding as expected to the contrainsulin hormones released by your growing placenta.
To preserve your sense of well-being and control, be sure to stay actively involved in your medical care. Ask your health care team questions when needed and communicate your concerns clearly. Realize that your body will respond differently now that you're pregnant and pat yourself on the back every day for your hard work and your efforts to give birth to a healthy baby!
Trying to take care of a two-year-old and keep my diabetes under control while I'm pregnant seems impossible. Is it?
TIP (Type 1, Type 2 & GDM): Raising a small child while you are pregnant is very demanding – to say nothing of the added challenge of keeping your diabetes under control. It's understandable that you may feel overwhelmed at times. Rather than trying to manage everything yourself, this is the time to practice what mental health professional call "positive selfishness." Accept offers of help from others whenever they're made. If your child's friend invites him over for a play date, accept happily and use the time to relax and regroup. Don't be reluctant to ask others for help. Perhaps your mother can help by cooking a meal every once in a while, or your husband can help more often with the household chores and shopping. If you can't afford to hire a babysitter, try trading childcare duties with a neighbor or friend. This will free up some time for you to enjoy a nap or a break at the movies. If you take care of yourself first, you'll be more likely to have energy left to take care of the other important things in your life, including your diabetes.
I'm constantly worried about how my blood glucose is affecting the baby. What can I do to relieve this?
TIP (Type 1, Type 2 & GDM): Keep in mind that pregnancy is s time of apprehension – and excitement – for women, whether they have diabetes or not. AS a woman with diabetes, all the decision you make regarding your health and diabetes care have an impact on the health of your baby as well. It's no surprise that your anxiety level is high! Remember that advances in diabetes and neonatal care mean that the odds are greatly in your favor for having a healthy baby, as long as you work to keep your blood glucose levels as near normal as possible during your pregnancy. An out of range blood glucose reading every once in a while isn't likely to be a disaster. Checking your blood glucose levels often will help you make the necessary adjustments in your management plan.
Share your anxiety over your baby's health with your medical team. The frequent medical tests you undergo during your pregnancy (ultrasounds, fetal stress tests, etc.) can go a long way toward reassuring you that your baby is developing as he or she should. If you find that your worries are just too much to handle, it may be helpful to seek professional help so you'll be better able to cope with the stress – and joy – of pregnancy.
I would love to talk with another woman who has managed a pregnancy with diabetes. How can I get in touch with someone to share experiences?
TIP (Type 1, Type 2 & GDM): Talking with other women who have experiences pregnancy with diabetes can help you gain perspective and valuable information, as well as peace of mind. Often, just talking about concerns, ranging from the challenges of frequent blood glucose monitoring to the misery of morning sickness, can reassure you that things are going as they should. Internet chat rooms are one way to get in touch with others in your situation. Support groups can also provide lots of practical advice. Check with your physician, midwife, or diabetes care team. While they probably won't be able to share actual patient names and phone numbers with you because of privacy issues, they will be able to point you in the right direction. It may be as simple as taking the initiative to post a sign in the office of your obstetrician. You may also want to contact the maternity service of the hospital in which you plan to deliver for information on their support groups. If you enjoy sharing your experiences with other women, think about helping others after you deliver your baby by coming back and sharing your success!
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...