Most newly-married women my age (that would be 26) spend the first year basking in the glow of newlywed life: snuggling up on the couch watching movies, traveling and exploring far-off places, establishing new routines and merging two lifestyles, and lots and lots of late nights (wink, wink).
And me? On top of all that, I'm thinking about a baby.
Even before we were married, I started plotting out a timeline for children. Many of our friends and family, contrary to popular belief, actually balked at the idea of planning for kids. "You're so young!" "You have so much time!" "Enjoy married life!"
While my husband and I aren't spring chickens, we also aren't rushing to beat the fertility clock either. So why am I so wrapped up in pregnancy just three months into marriage? Well, it's because of my diabetes.
Let me put all the cards on the table: while I'm a well-educated PWD and have zero complications, my last A1c was 8.3%. Ideal A1c percents aside, I realize that number might be extraordinarily high for some, yet a dream-of goal for others. We're all at a different spot on this journey we call diabetes, and A1cs means different things to different people.
But not so much when it comes to a baby. I've done a lot of research on the topic — and even reviewed a book about the subject — and although there doesn't seem to be a hard-and-fast consensus on the subject, in general, a woman's A1c needs to be as low as humanly possible without excessive hypoglycemic episodes in order to get pregnant. Although Dr. Lois Jovanovic advocates an A1c of 6% or less for her female patients, that kinda freaks the crap out of me. So I tend to lean toward something a bit more moderate, like the ADA recommendation of under 7%. My own endocrinologist sets the bar at 6.5%. Which is a loooong way from where I'm at, but it's do-able. Well, under 6% might also be do-able but I'm not sure I could handle that much cookie deprivation.
The thing with pregnancy and diabetes is there really shouldn't be any surprises. There's a whole host of problems that can happen to the baby if the mother's A1c is elevated prior to conception and during pregnancy, so prep work starts early. My husband and I haven't decided when we want to have kids. Most likely, it will be around two to three years into our marriage. But I also know that it could take that long to get my A1c where it needs to be. Breaking the 7% A1c threshold is something I have never been able to do in 18 years of having diabetes.
So what's my plan of action?
Get on a CGM. This seems like the most obvious first step, right? You might even wonder why I'm not already on one. Well, I'll tell you. When I was on a Medtronic Minimed CGM, I had a terrible reaction to the sensors. It wasn't that the CGM was inaccurate (it actually worked OK for me most of the time). But my body rejected the sensors after a couple of days. Itchy redness and irritation. It was gross and painful. It just didn't do me enough good to suffer! Now that I'm in baby-planning mode, it's time to suck up the expenses and I'll be joining the ranks of DexCom users. I'm very excited — and will most likely be filled with questions, so stay tuned!
Exercise! Easier said than done, of course. But exercise is one of the best ways to lower blood sugar. Plus, starting pregnancy with a few less pounds decreases the same complications that arise in overweight women without diabetes, like high blood pressure, risk of birth defects, and the risk of needing a cesarean. It's a win-win for mommy and baby!
Eat clean. I'm not on the low-carb bandwagon by any means, but I also know that less carbs = less blood sugar fluctuations. It's the rule of small numbers and as much as it pains me to say it, it's true. Earlier this year, I hopped on the clean eating bandwagon, which emphasizes eating only whole, natural foods and cutting out artificial sweeteners and preservatives. Between clean eating and exercise, I managed to lower my A1c by almost a full percentage point, and I lost 15 lbs. Some of that has crept back on in recent weeks, but I'm a girl on a mission now!
I'm excited to start this journey and to share it with you all, and although I won't have any announcements for awhile, I appreciate any and all advice in preparing and planning!