Type 1 diabetes and pregnancy: Technology helps Ros cope

Ros felt she knew her diabetes well and has lived with it for as long as she can remember. Diagnosed at 13 months old, she always wanted to learn as much as possible about diabetes, keeping up to date with the latest research and embracing technology advances as they come along.

As a diabetes educator, blogger and active social media presence in the diabetes community, Ros wanted to share her story and experience of going through pregnancy with type 1 diabetes.

She said: “Treatment of type 1 diabetes has improved massively since I was a child. I always accepted my diabetes although I do have early memories of hiding behind the curtains when it was time for my injections. I was lucky that my parents were so good at managing my diabetes and that they also instilled in me that I shouldn’t feel ashamed or try to hide my diabetes. They always encouraged me to engage with my diabetes and I can remember being really happy to give my own injection aged 6. During childhood the main issue for me was not being able to go on some school trips, residentials and sleepovers. That was were diabetes affected me most”

In her late twenties, Ros became insulin sensitive and started to need 10 to 15 injections a day to try and avoid erratic blood glucose readings. “Wearing a glucose sensor was a revelation, because I had a lot of insights into my erratic patterns and I used that to show my doctor how I could benefit from an insulin pump, and finally got one in 2015. Initially it was a battle to get approval for an insulin pump, but I received a lot of support and advice from Diabetes UK, as well as from the type 1 diabetes online community and from INPUT”, she explained.

Ros feels very passionate about technology and previously was the Lead Volunteer for Insulin Pumps Wales, sharing her knowledge and raising awareness of the uses of insulin pumps to both Health Care Professional and Patients.

When she became pregnant, Ros knew there would be many changes to her diabetes management but says that it helped that she had her diabetes relatively under control beforehand: “I started closed looping before I was pregnant and have always had a lot of support from my husband and family to do this. There are so many changes that your body goes through during pregnancy (without the diabetes), but it's still staggering the amount of insulin I needed in the third trimester and also how your body's insulin needs change instantly after giving birth. The good thing is that I learnt so much through using technology and researching that I felt empowered and that I’m the one making the decisions. I discussed those decisions with my Consultant, but I’m confident in how I manage my diabetes and tools such as an insulin pump made this so much easier. I also have Coeliac Disease and an underactive thyroid, and likewise, all of that impacts on the body during pregnancy and has to be taken into account.”

Ros tried to keep fit during the pregnancy and lockdown by going for regular long walks and eating healthy: "Initially this was a lot of bland food to try and keep the nausea at bay". She joined online antenatal classes and received extra medical support and diabetes screenings because she was pregnant.

“It has been a strange year to be pregnant what with Covid and the lockdown. I had to shield most of the time as pregnant women were not advised to receive the vaccine and having diabetes made me more vulnerable. Again, the technology to stay on top of it, to share my readings/ settings with my Diabetes Team and to stay connected with others in the type 1 community through social media, online groups and other platforms has been really positive and invaluable.”

Ros’s top 5 tips for pregnancy and type 1:

• Planning really does help: I know that people aren't always in a position to plan their pregnancy but being able to work on your diabetes management in advance of falling pregnant can have huge benefits.
• Exercise is key: if you were active before, then try and keep up the exercise where you can. For those who may not be particularly active, taking daily walks and getting outdoors can really help with the insulin sensitivity and for a healthy pregnancy. 
• Don't do it alone: Peer support is always important, but I really found that speaking to other pregnant ladies with Type 1 diabetes was beneficial in terms of gaining insights into the next stage of the pregnancy journey. Equally, I couldn't have done this without the love and support of my husband, family and friends. During the pandemic, this meant a lot of video calls with family and friends, but this didn't make the virtual baby showers or online chats any less effective or important.
• Keep talking to your HCP team: Speak to your team about any worries or concerns that you may have and speak to them about advice needed. I found that I needed to change my hypo treatments in the first trimester as the ones I'd been using for years beforehand suddenly weren't as effective. Having spoken to my team, the Consultant was able to make some suggestions and to help me approach things in a new way. We also spoke about what to expect over the coming weeks of pregnancy so that I felt prepared for the changes that were about to happen.
• Don't beat yourself up: When pregnant you're regularly told about the benefits of keeping your blood glucose readings in range for both yourself and the baby's development. Although this is really important, please don't feel guilty about the odd higher or lower readings! The key thing is to respond to what is happening and to try and stabilise things as soon as possible. Your body is amazing and adapts to your baby's growing needs, so just remember that there's a lot of adapting needed on the diabetes front along the way too.

Ros also recommends Ginger Vieira’s book “Pregnancy with Type 1 Diabetes: Your Month-to-Month Guide to Blood Sugar Management."

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