Postpartum Diabetes Challenges

There is something to be said about the hoops T1s jump through to maintain a healthy pregnancy.

The countless doctor appointments and tests.

Scrutiny to what you ate 3 days ago that made your blood sugars spike and drop uncharacteristically (while suffering from pregnancy brain)

The assumptions and misinformed medical staffers.

All of those ultrasounds that measure your peanut larger than he’ll actually be born. (Not a unique problem to PWDs.)

And then you have baby and all is right in the world because all of your hard work has paid off and you have this awesome little nugget in your arms who will unconditionally love you. YAY! Time to leave the hospital.

Wait…

Oh, no one told you that you actually are coming home with TWO children? A real-live newborn and a cranky chronic condition which just spent the last 10+ months being micromanaged and now wants to party like a college freshman on spring break? Welcome to the next stage of your pregnancy with diabetes care: the postpartum period.

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In addition to “normal” bits of new parenthood, like sleep deprivation, baby blues, and healing from childbirth, we have a whole set of unique challenges to consider.

Your blood sugars will be shit. 

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Thank those postpartum hormones and the fact that you no longer are sporting a placenta. Sometimes it comes as welcomed relief to those who were burned out by the constant testing and dosing. (Meh – #BGnow 180, #zerofucksgiven #sleepneeded) For others, it means downing a juice box every hour while 70 mg/dl seems to be your weekly average. But suddenly, a rebound of 320 shows up.

Tip: Write down your pre-pregnancy insulin doses and keep them in a safe, but easy to find, location. Once the placenta goes, so does your need to take 150% more insulin than usual. (Usually.) Having these doses handy will at least give you a starting point. And if it’s still too much, you can adjust with your medical pro from there.

Remember that these WTF blood sugars are temporary. I know it’s probably hard to go from super mega control to… not in a matter of 12 hours. But in the grand scheme of life with D, this is a small blip on your A1C’s radar.

Keep a basket of goodies near you at all times.

There are a ton of Pinterest posts about “nursing baskets” to keep handy if you are breastfeeding your baby. (Also applies if baby likes to nap on you after a bottle, etc.) These baskets generally have burp rags, a bottle of water, something to read, the TV remote, your phone, breast pads, lanolin, a blanket for baby, snacks… pretty much anything you would want in arms reach if stuck under a sleeping/nursing baby for several hours.

I would add for us PWDs: a glucose monitor with an extra vial of test strips, a full bottle of glucose tabs or your low treatment of choice, snacks you can eat with one hand and have a ton of protein (because oh, God, you will be hungry all the damn time), your continuous glucose monitor, if applicable.

For snacks, I liked anything with peanut butter, almonds, cheese and crackers, high protein granola bars, and my lactation cookies.

Refill your supplies before baby comes – or set up Auto-refill.

It’s one thing to have a screaming newborn and surviving on no sleep. It’s another to have to make an emergency stop at CVS with said screaming newborn because you don’t have any test strips. Of the three companies I have for refills, all of them have some sort of automatic refill option when your insurance says you can reorder. Medtronic automatically sends me my supplies and then invoices me, for example. Make this one less thing you need to think about.

Double check that all of your scripts are current as well. I went through a long process with Medtronic at year-end because my prescription authorization expired and no one could get a hold of my endocrinologist.

The Baby will still be there if you need to treat a low.

The baby will also probably be crying. And that’s okay. This was probably the hardest thing to do during postpartum – remembering to take care of me, even if Bean was screaming. Because I am no good at parenting and picking up a screaming child if my blood sugars are under 50 mg/dl. I was home alone with Bean quite a bit before returning to work. There were plenty of low alarms and times that I had to set her down for 2 minutes while I found a juice box. It’s fine. You are responding to baby’s needs by being able to actually respond to her needs in about 3-5 minutes. (And not drop her/fall with her.)

Disclaimer: Nope, still not a doctor. Consult one if you have more specific questions.

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4 thoughts on “Postpartum Diabetes Challenges

  1. Christina says:

    Your blog is so great! Currently pregnant with our third! Ha! And everything you’ve said is spot on. With our first, I had NO idea how quickly I would bottom out while nursing. It’s insane! Great tips and even better jokes!! Good job!!

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