Pumping and pregnancy
Today I am so excited to introduce you to our newest guest blogger - the lovely Sarah Knotts from IGTS Blog! As a brand new first-time mom (of a perfectly precious little boy!) and new user of the MiniMed Paradigm® REAL-Time Revel™ insulin pump and continuous glucose monitor, she has a lot of interesting experience to share. The good news is, she'll be posting every month, right around this time. Please give her a warm welcome to The LOOP!
Pregnancy can be challenging, especially in the later months. Being a new mom also has greater challenges. You've heard all the stories. Like the ones about having to learn your baby's cries, or trying to keep a hard-sleeper awake during the day so they'll sleep at night, or if you're a breast-pumper, trying to schedule pumping times for when the baby is asleep that will still fall into your every 2-3 hour requirement so you'll make enough milk for the baby. All this while trying to get enough sleep yourself and keeping your house clean as much as possible the other times can seem overwhelming sometimes.
But what you don't hear about from others or read in magazines are the challenges that come with fitting all of these new mommy challenges in with the, what I call, "invisible child" that you already have - diabetes. Diabetes takes on a whole new phase when you become pregnant. I had to take everything I knew before pregnancy about diabetes and just throw it out of the window (except how to treat lows and keep a glucagon kit handy for the first few months!). And just as I got used to how the changes come in the pregnancy, I was suddenly at the end of it and my whole world changed again. I was not only holding my dear, beautiful child in my arms, but I was dealing with another world of changes that hormone fluctuations do to your mind, body, and diabetes control. So, once again, I had to forget everything I learned about myself over the years prior and the past nine months and throw it out of the window as well, with the same exception as before.
For me, being on an insulin pump made things so much easier than being on shot therapy. It made making changes to background (basal) insulin so easy and immediate, as well as changes to what was needed for food intake and correction amounts. Also, for those times in the beginning of the pregnancy when I was low a lot, I was able to suspend insulin delivery - something that can't be done on shot therapy. Sometimes, suspending the insulin delivery was the only thing that would help bring up a glucose number in the 20's even after my juice boxes and glucose tabs had been exhausted. For the later stages of pregnancy, I found it easy to temporarily increase my basal rate for persistent highs, especially when I was going high during a certain part of the day there for a while. And for after the baby arrived, using a pump made things easier to make the quick adjustments that come with the super-fast shift down to the "little-to-no-insulin-needed" stage. Of course, I still had to manage my diabetes closely throughout all these stages and do a minimum of 4-6 fingersticks per day as well as before making any therapy adjustments.
Certainly, having diabetes while pregnant does not necessarily warrant that you absolutely have to use an insulin pump to manage your diabetes and have a successful pregnancy. There have been many women who have been able to accomplish their pregnancies and have healthy babies while on shot therapy throughout the pregnancy. It's all in what you're comfortable with and what you and your doctor think would be the best plan for you and the baby. But if pumping is an option that you have and your doctor is on board with it as well, it would be a route worth considering. Not saying it's the only or best way to go, but as it was in my case, it may help make things a bit easier. And if anyone knows the value of needing things to be easy, that's me!