Pregnancy, new diagnosis and needing family advice

Pregnancy
1

Hello,

This is kind of long, so bear with me. And maybe it would be better posted in a different group - I am not sure, it is more about family relationships and support, but I couldn't find a group that seemed to fit that. This seemed more like a mom-issue needing adult, female feedback. So I landed on posting here. This is not my first pregnancy. I have a 3.5 yr old son, but I was not diabetic during that pregnancy.

I was diagnosed T1 in July of this year, into my 6th month of pregnancy for my second son. They hospitalized me with DKA, after a routine visit to the midwife - where I told her I was worried about my weight loss, muscle loss and complete inability to stand for more than 2 minutes at a time. When I entered the hospital they said my blood sugar was over 600, my Ac1 was over 13 and even though the baby was growing I had lost 15 lbs (I am only 5'1"). At the time I had no idea what most of that meant. Now I get it - baby and I are lucky to be alive.

Since then, I have lowered my Ac1 to 7.5, that's still including my numbers from June when I was over 13, so I am really proud of that.

I have adjusted (as well as possible) to my diagnosis and have been able to keep things in pretty tight control, with the expected - occasional - unexplained highs and lows that they told me would just happen sometimes with pregnancy. Before the diagnosis I was pretty healthy - a runner, healthy eater, bike commuter - so the dietary changes weren't that much for me.

But because I was diagnosed mid-pregnancy, the parinatologist and endo won't give me insulin:carb ratios. They set a flat dose of insulin and I eat to match that, with occasional adjustments based on BG patterns as my needs change. It has actually worked really well, except that they want me to gain weight back, so they have me eating WAY too much and I am full all the time - I can't wait to be able to carb match after the baby is born and eat less in general.

The major problem I am coming to terms with, is that my family hasn't done anything to learn what I need to eat and how to make meals that fulfill my dietary needs. If someone else makes dinner, they make what they think sounds healthy and leave me to figure out if there are enough carbs. If there aren't, it's up to me to figure out something else to add to my plate that will make up the difference. Some nights I am in the kitchen figuring out carbs and scrounging for more or different food when some of the family is already done eating. 

I have made them really simple cheat-sheets and posted them on the fridge. I laid out my carb ranges for every meal, what defines a carb, what my meal plan is supposed to look like, my daily eating/testing/insulin schedules - and I have even given them log-in information for building recipes in myfitnesspal.com, so they can enter what they are making and the portions, and the website will tell them how many carbs it has per serving - so it could be really, really simple for them. They have done nothing with it.

I am going to give birth in the next 5 weeks. I have been a mom before - it is all consuming, taking care of a little infant, feeding them, diapering, sleep schedules, keeping up with the laundry. On top of that I will still be adjusting to insulin schedules, remembering to test regularly with a baby - and currently I am the only person who knows how to cook a meal that I can eat. Oh, and right before my diagnosis I quit my job and went back to school full-time, so I have that going on too. I am terrified I am going to be overdone; I can't do everything on my own and feel like I shouldn't have to. Am I wrong?  Do your families know how to track carbs and figure things out for the meals they cook - or do you all just cook everything for yourselves as I have been doing?

I don't want my family to sound like they don't care - they do - they just don't get it. They don't understand how much work this is for me to learn, while getting through my 3rd trimester - and classes - and how much more work it is going to be once the baby is born.

Has anyone else had experience with a later-in-life diagnosis, or even maybe starting a new relationship, and had to teach the other/new people in your life how to help out and be a participant in your diet, rather than leaving it all up to you?

If you read all of that thanks. :) If you have any ideas or sage advice, double thanks. :)

Best,

Rebecca

2

It sounds like you have done an amazing job. Congratulations! And it also sounds as if your family cook and try to make healthy meals, which is awesome. I am the cook in my family and have always been pretty independent with counting my own carbs but maybe this advice will help.

3

Oops, posted too soon!

4

Try discussing the day before what you will have for supper and how you can make it work for you. For example, my husband loves pizza but ordering take out is awful for my sugars. So he makes his pizza on a store bought crust and I make mine on a whole wheat tortilla. Or he can make it for me. Meals like chicken, salad and rice are also great as you can take as much rice as you need to carbs and the other items are free. (I only count carbs, not protein fats etc so maybe this is different for you).

5

Also, topping up meals with extra carbs is something I do all the time. Think of this as dessert. It’s a great time have fruit, yoghurt, milk etc. I would suggest investing in a nutritional scale. It is awesome for accurately weighing fruit and things like pasta, cereal etc. you can show your family how to use it so when you ask them for 30 carbs of grapes they can easily help. Good luck!

6

Hi Rebecca, first would like to send you lots of positive vibes to you and your baby! I can somewhat empathize, as I was diagnosed T1 in June 2012 when I was 29, and got pregnant in Feb of 2013. My original A1c was 14 and by the time I found out I was pregnant it was a 6.3. All that being said, I think being a spouse/ family member of a newly diagnosed loved one can be confusing for them too. My husband has tried (and succeeds) in helping me plan healthy meals, but I don’t think he fully grasps how difficult it can be, especially while pregnant and our hormones raging. Since it seems you know what meals work for you, I would suggest trying to plan and freeze your meals for post pregnancy. Also, if your health insurance covers it, I would suggest trying to see a nutritionist. Since I have so many prenatal appointments and endo appointments, mine is fine with just communicating over the phone or by email, and she’s really helped me learn what options there are to eat and quick meals to plan. Good luck with the rest of your pregnancy! I’ve also got 5 weeks left, so we’ll have to share our delivery stories :slight_smile:

7

Thanks, ladies. I do have a food scale and a nutritionist. My nutritionist says I need to be ok with eating a tiny bit less healthy and start adding in a few carbs of honey, brown sugar, dressings, etc, when I am short.

Planning meals in advance is something we definitely need to get better about doing. It's tough, but we could definitely do better. We do a lot of simple meals, which they do great at. I run into trouble when they make things like a casserole or an apple crisp - with lots of carb ingredients and they don't quite remember what or exactly how much they put in it, it is all mixed together so I can't really weight things out. I suppose I just need to talk to them again and ask them to plan earlier in advance and write down what they are putting in things, in advance. It's especially hard for my mom, who is used to rich farm cooking.

Thanks again for the ideas. It was good to get it out and off my chest too.

8

Rebecca,

Wow that is tough to deal with. I was diagnosed with T1D at age 25, in November 2000 and I know what it is like to deal with it later in life. It sounds like your family is "trying" to make healthy meals for you. But, unless you tell them what you need, or they go to appointments with you how are they supposed to know what to do for you? Ya know what I mean? Personally, I have always counted my own carbs and my mom always made things in the house that everyone could eat. Nothing special just for me.

I am assuming that you are currently on either Lantus/humalog or NPH/humalog sliding scale right? Have you thought about preparing your own meals ahead of time with correct amounts of carbs and foods this way you know exactly what to eat and how much insulin to take? I used to have some prepackaged healthy snacks to take with me for lunch or if I was on the go and needed something when I was on multiple daily injections. Maybe if you have those things with you or in the house already if you need lets say an extra 15 carbs or so you can just grab a 100 calorie pack of something and eat that to compensate for the lost carbs? or have things in the fridge like greek yogurt/regular yogurt etc so you can just eat it for a snack.

You technically can eat everything that they are eating in moderation. What kinds of foods are they having that are troubling you? You have a lot going on at the moment and its very overwhelming.... I am sure. I just had a baby 10 months ago so trust me I know first hand how hard a diabetic pregnancy is. With proper planning now, you won't feel so overwhelmed once the baby comes.

I am currently on a workout/eating schedule where I have meal prep mondays or sundays. I have a bunch of tupperware that I use for 3-4 days worth of meals. I measure out my carbs, protein, veggies and snacks and when I am hungry I just heat it up and eat. Its a healthy meal that I have prepared for myself and it is exactly the right amount of everything.

If your family can't do what you need, only you can do what you need to do to take care of yourself. Hopefully, these tips helped a little?

9

Try not to be disappointed with your family.  They will never understand what it's like to be diabetic.  

Also take a tough look at yourself and your expectations; if there's a chance you're being high maintenance then try to correct.  

Diabetic perfection isn't possible.  Sometimes doctors act like their advice is easy or leads to good control. The reality is that managing blood sugar has a lot of factors, some you can control and others you can't.  With experience you will learn what works for you.  

Do you have the app or book of "The Calorie King Guide to Calories, Fat and Carbohydrates"?  It's the best carb counter.  Since your doctor gave you a target carb total for each meal, you can look up what your family has cooked and add additional carbs to reach the target.  Know that fatty or high carb meals will sometimes raise your blood sugar higher than the listed carb amounts.  

Since you're too full consider using measured amounts of juice or milk, which have high carbs with little bulk.  

I hope you and the baby do great in your last month of pregnancy.  It sounds like you're a really good mom and I'm sure everything is going to be just fine.  Take care.

-Jenna