Ever the Teacher

Today's Prompt: Teach a class. What’s something that you’re uniquely great at and could teach a class on? Write the tutorial in a blog post. Bonus points for images, links to resources, and video.

There are a few things in which I'd consider myself qualified enough to teach a class, but I'm going to choose four.

Topic 1. I'm a bit of a grammar freak. I don't think it comes from being an English major; rather, I think it's the kind of quirk that may have driven me to it. It drives me crazy when people misspell. The root word of "definitely" is "finite" and has no "a" in it! (See this hilarious take on misspelling from theOatmeal.com. I have to chuckle at "If you put an A in "definitely," then you're definitely an A-hole.")

I will admit that I cringe when people use words incorrectly, and I try to catch the fabulous weekly radio show A Way With Words as often as possible in the hopes that I'll both ease up and learn something new to be more rigid about.

I hate when people mix words up like yea vs yeah vs yay. When I text someone that I got a promotion, "Yay. Good luck with that." is a lovely sentiment. "Yeah. Good luck with that." is sarcastic and dickish. It took me multiple instances of seeing this mix-up before I realized two people I know were celebrating whatever I'd messaged them and not just shrugging me off! LOL

I'm a stickler about the Oxford or serial comma (and most comma usage rules).

And I hate when people mispronounce words (it's especially, not expecially, familiar not furmiliar, February not Feb-u-ary).

I'm also one of the only people besides my favorite college English professor who prefers that "only" immediately precedes the noun, condition, or prepositional phrase it limits. I hate when I see it precede a verb. ("I only eat at that restaurant" indicates that you don't drink or talk there, while "I eat only at that restaurant" indicates that that's the only place where you eat.) I've been trying to ease up on this one.

That being said, there are rules that I flagrantly violate in blog writing for specific effect. I use incomplete sentences because they accommodate my flow. I play fast and loose with dashes and ellipses. I start sentences with And, But, and So when I like the way it sounds. I'm guilty of ___ and ___ constructions (see the sentence 2 sentences ago regarding dashes and ellipses!) as well as ____, ____, and _____ constructions.

So I think my grammar Nazi status is up for debate.

(See? That's an incomplete sentence AND it starts with So.)

Moving on... (incomplete sentence...with multiple ellipses....)

Topic 2. As a private voice lessons teacher by trade, there is much I could explain to you about how our vocal folds produce sound, how we employ breath, how our posture affects airflow, how projection works, how to improve your tone production...but it can't be taught in a blog post. There are people who claim to be able to train you vocally via expensive DVDs, CDs, and books, but to solve your vocal issues, you need a trained instructor listening to you and watching you sing. You need it tailored to you.

There's no one size fits all approach, which is partly why I love what I do for a living. I'm able to glean what afflicts them, diagnose and correct, and ultimately figure out how to make a concept click for someone on a case-by-case basis. Each student teaches me something new about teaching and singing and improves the quality of both in my life.

Topic 3. I could teach you about the attachment parenting and green parenting choices I've made: co-sleeping, babywearing, breastfeeding, cloth diapering, homemade baby food. But there are sites and spokespeople that are better resources for these strategies than I will ever be (and I've linked to those for you!).

I am hoping to blog about these choices more honestly with the birth of our next child. AP is not very supported where Hubster and I live. You're seen as a hippie freak for choosing any number of the options I mention, so you tend to stay a bit closeted. Even some friends who trust our judgment will tease me occasionally or tell us that our daughter shouldn't share our bed. Formula feeding is the norm here, the bare breast nurturing a child is an obscenity, wearing your child is seen as coddling, and babies are believed to sleep better in solitude. In leaving my blog open to discussing parenting though, I'm hoping I open myself to discussing what we have found works for our family, regardless of its popularity.

Topic 4. So I suppose that's why I've mainly tried to teach you about my life with diabetes. (Not to mention that I know a good portion of my audience is comprised of other diabetes bloggers and I'm inspired to continue in that vein.)

Because it's about me and what weighs on my mind. Sweetly Voiced is my story - a story of personal revelation, the surprises of motherhood, the reflections of a private teacher and public performer. Highs and lows - literally and figuratively.

In everything I do, the teacher or the nurturer in me comes out - in the way I listen to you, engage with you, commiserate with you, comfort you, and share with you...

...and perhaps also in my use of the Oxford comma.

This post was written as part of NHBPM - 30 health posts in 30 days: http://bit.ly/vU0g9J.

Big Blue Friday

Today's Prompt: If it’s not broke, don’t fix it. What is working well in your community, healthcare, blogs, social media, or your work in particular? What do you like about it?

What works in my community is the UNITY part.

Yesterday, I wrote about the way that many of us come together to chat for an hour every Wednesday on the DSMA chat and I also posted a link to the Blue Circle Campaign that seeks to get diabetes organizations (particularly American ones) on board with the International Diabetes Federation's Blue Circle symbol.

Between Twitter, blogs, youtube, social networks, etc., this is a group of people who can affect change.

We've had a few really amazing initiatives take off recently.

Kim Vlasnik's "You Can Do This" Project

Similar in scope to the "It Gets Better" video campaign, many of us shared our stories on YouTube, letting people know that they are not alone in living with diabetes and facing its challenges. I did a personal video here and was included in a compilation video here when I attended Simonpalooza in Kansas City this last October.

Blue Fridays

If you're my Facebook friend, you already know about this one. Every Friday in November, we're asking people to wear blue in support of Diabetes Awareness.

This one has been pretty challenging for me as the weather has turned colder and all of my blue maternity shirts happen to be very thin t-shirts. So my lips are blue, too.

The Big Blue Test

This test just gets bigger and bigger! :)

In 2009, we encouraged people to test their blood sugar at 2pm (their local time), exercise for 14 minutes, test again, and post it.  Then we compiled the data to show how people's blood sugar levels were reduced when they exercised! We had done a similar test-in on July 14, 2009 on TuDiabetes and gotten about 1,000 people to participate.

In 2010, the Diabetes Hands Foundation secured donations from Roche (the makers of Accu-Check) to the IDF's Life for a Child program (which provides insulin to children in 10 impoverished nations) based on the number of views we received for this video.

THIS year, however, though getting the video views last year was a huge accomplishment, we want to encourage more people to actually participate in the testing and activity portion. Roche has earmarked a donation of up to $75,000 if we can get 8,000 entries into the test. The $75,000 will benefit Life for a Child again, as well as 5 US-based charities that provide diabetes supplies and medications to people here at home.

Please visit the website, watch the video (because it's stellar), and enter AS MANY TIMES AS POSSIBLE between the moment you read this and World Diabetes Day (Monday, November 14). We are about a third of the way to that goal.

For every single entry, whether you have diabetes or not (and you non-D folks don't even have to test your BG), $9.38 goes directly to help someone with diabetes live another day. 8,000 people benefit from these charities, which is why we are asking for 8,000 of the rest of us to offer their participation.

I've completed the Big Blue Test several times already and will do it several more this weekend before Monday's deadline. Here are screenshots from the first two entries I made:

As you can see, we aren't asking for your money. Just asking you to do what you already do - test your blood sugar if you have D (and don't test if you don't), and then do what we all should do - get active.

One of my 14min "walking" experiences started out as "Mommy takes the tot for a trike ride" and ended with "Pregnant lady, panting, running through the neighborhood, pushing an empty trike, chasing a barefoot toddler."

Hey, whatever gets your blood sugar plummeting, right?

This post was written as part of NHBPM - 30 health posts in 30 days: http://bit.ly/vU0g9J.

The Future, Some Math, and the Reality

Today’s Prompt: The future of online activism. Our favorite social media sites are constantly undergoing renovations to become quicker to navigate, easier to interact with, all encompassing, mobile, and everywhere. Imagine the same thing about your community – how will they evolve, improve, and grow?

I didn't get involved in the Diabetes Online Community in order to spread awareness. I NEVER imagined I'd become the advocate that I am. I just wanted to share my story - tips, tricks, funny anecdotes, annoyances.

The first time I tried to start a "diabetes blog" (in 2008), I didn't have anything to say and nobody stopped by to read me not saying it. Then I started Sweetly Voiced in September of 2010 and found that I suddenly had my angle. I knew what I wanted to say.

But I still don't blog that much.

Which is why these month-long challenges intrigue me so. I wonder what I'd have the impulse or the courage to say about my life if I just sat down to write more often. Then, when the month is over, I feel a mixture of both loss and relief.

The focus of my post today is on the future of this online advocacy I've been unwittingly absorbed into.

Last night, during our hour-long weekly Twitter chat called DSMA (Diabetes Social Media Advocacy), the topic was Diabetes Awareness. We talked about what we're doing that works, what isn't effective, if the message is loud enough, clear enough, unified enough.

Two things struck me.

1. Whether or not we risk saturating our communities, our friends, and our families with this non-stop talk of diabetes - whether just in November or year-round.

2. And the fact that we were celebrating that we had over 100 people participating in the discussion.

We in the D-community often compare our message, funding, unity, etc to that of the cancer survivors community. When you think breast cancer, you think pink. You think ribbons. You think walks through the city centers. You also sometimes think about too much marketing and message saturation.

I don't give money to the Susan G. Komen walk for the same reasons I don't give money to the ADA walk. If most of the money (70% or more) goes to the overhead of organizing and marketing a walk, then the money isn't going anywhere constructive. If an organization gives most of its money to research or to making life better for patients, they are far more likely to get my dollar.

If you know or love someone who is a breast cancer survivor though, you just want that message out there. You want people thinking pink, getting regular mammograms, understanding the heartache and trial that living through it entails.

Diabetes is like that. I KNOW I have saturated my friends and family and colleagues and students with dtalk, dtalk, dtalk. They think we must live and breathe this stuff.

Well, newsflash. WE DO. One of my D-friends brought up last night that we deal with this every minute of every day 365 days a year and that it's not asking too much to have others listen. It's not that we want any of YOU to suffer what we endure. But it's nice to think we've educated you about what our days are like. How, in people who are really living healthily with diabetes, it can potentially affect every decision we make throughout the day.

But that's the weird thing. People often think that if you're talking about it a lot, you must be one of the "bad" ones. One of my best friends is a PPD survivor and laments this same conundrum. If you're talking about what you go through, it must be because you have it worse than others. It couldn't possibly be because you're empowered by the knowledge you've gained and want to make it better for the people who aren't talking about it.

Which brings me to point #2. Over 100 people participated in DSMA last night. 100 of us chatting back and forth (which is incredibly fast-paced and hard to follow). And new people join us every week!

TuDiabetes.org has 21,688 members (as I type this post) and we'll approve at least 10 new members in the next 24 hours (and sadly decline 3 times that number in spammers and marketers!).

But over 26 MILLION Americans have diabetes. 7 MILLION of them are undiagnosed or misdiagnosed. Over 8 PERCENT of the population in the US lives with this condition everyday. You or your loved ones will face this.

And unless you're on our side of the fence, and sometimes even when you are, there's a lot you don't know about living with it. There's so much misinformation and snake oil and so much your doctors and nurses will tell you that is inaccurate.

One of my relative's general practitioners told her that it's normal for non-diabetic's blood sugars to go up over 200 after a meal. (Oh My God). There are doctors threatening diet/med-controlled type 2s with "going on insulin" as if it's their fault.

We ALL are on insulin. You and I both need it. We just get it in different ways. You cannot (and I repeat CANNOT) live without insulin. Either your body produces it or you inject it. And if you're a type 2, it's highly likely that at some future point, your body may no longer be able to produce the amount you need due to insulin resistance.

And your blood sugar shouldn't ever go over 140 (where cell damage begins to occur). It should rest around a comfortable 90 most of the time. You and me both, actually. It's just not possible for me 24 hours a day. I'm lucky to be in range 50% of any given day. Never in my life have I had 24 hours of in-range numbers. Not a single day. And yet, my A1c (which is like an average) is a full percentage point lower than the ADA recommended level for healthy people with diabetes. I'm one of the ones doing it particularly WELL.

So, anyway, back to my point. If less than 1 per 1,000 of Americans with diabetes are part of the social network where I volunteer and less than 1 per 200,000 of Americans with diabetes are chatting with me on DSMA, are we reaching enough people through social media? Do people have enough information? Enough support?

I feel a little less bad about saturating you with this message now.

Until every health care professional in this country is better educated about a condition that will affect 8% of their patient base...

Until every insurance company has stopped placing restrictive limits on how often a person may test their blood sugar or on whether they may purchase a device/meter/pump/continuous monitor their doctor feels they need...

Until people with misconceptions about their own diabetes stop saying things to me like "Oh, 300s won't hurt you. I stay up over 300 and I feel fine." (said to me by the man who installed my wood flooring 2 years ago)...

Until people stop believing that insulin is a cure for Type 1, that you can outgrow it because it's referred to as "juvenile," that "all you have to do" is test your blood sugar and take your medications, that it goes away if you change your lifestyle, that Type 2 can be cured or reversed, that Type 2 happens because you're obese...

I will continue to raise my sweet voice along with the 1 in 200,000 committed enough to tell it like it is.

Click here to read more about the Blue Circle Campaign.

In the meantime, if you feel you just can't take any more dtalk, ask me about something else over a cup of coffee and I'll enjoy the breather, too.

But know that in the back of my mind, I still have to be thinking about my blood sugar and how much insulin to take for that coffee and how many tablespoons of creamer I had to eyeball as I poured it and whether I feel shaky because of the caffeine or if I feel a low coming on and whether the tape around my insulin pump is starting to peel and whether or not this is going to push me higher by dinnertime and...and...and...


This post was written as part of NHBPM - 30 health posts in 30 days: http://bit.ly/vU0g9J.

My Personal Brand

Today's prompt: My Personal Brand. As a Health Activist, you are a front-facing leader. What do you imagine you look like to your readers? What qualities do you possess? It's okay to toot your own horn today - you have full permission to indulge. Don't hold back. (Heh. Me? Hold back?)

I have to branch out a bit for today's blog post because, not only is it day 9 of WEGO Health's National Health Blog Post Month, but Nov 9, 2011 also marks the 7th annual D Blog Day, hosted by Gina Capone at Diabetes TalkFest.

The challenge for D Blog Day was something I didn't take the time to accomplish this year - which was to create a 12x12 scrapbook page. I had three reasons I didn't do it.

1. Shopping for scrapbook materials when you have no idea what you're doing can be overwhelming and is especially hard with a toddler in tow.

2. Putting together my first scrapbook page with Sweetie running around with my tape and scissors would prove exhausting.

And the real reason...

3. We were supposed to include the words "I want a cure."

I don't talk that way.

I don't believe this disease will ever be cured.

At least not for those of us who've already been diagnosed.

And so I don't ask for one.

For me to lament that there is no cure, I feel, is to waste the time that I could be living, doing, singing, writing, playing with my daughter. To beg the cosmos to cure me of something is to assume that there is a reason I have it and that if we just follow some rules and wait patiently, the cure will be revealed to some scientist finally. Nobody asked for this. We've all got to go on. We have to deal.

It's not that I wouldn't get in line for one if it were found, and I know there are talented researchers working hard toward understanding diabetes, but I'm not going to hope for something I can't see on the horizon. That's not how my mind works. I don't sink money into it - I'd rather spend my money on my own diabetes management than on cure research. I don't usually ever even think about a "cure."

When the human race cures anything, I'll be impressed. But we haven't yet. And there is a lot more we understand about the illnesses we can at least vaccinate against or send into remission. Diabetes' genesis is still so misunderstood that I think it's ludicrous to suggest we're "five years away," as they've been saying since the 70s.

Which brings me back to my personal brand and the niche I fill in my community.

I believe I stand for those that need to know what to do right now. How to live with diabetes. You and I both have to wake up every morning and deal with the reality of this. And I think I get that across. So I think I know how I'm viewed.

My hundreds of friends in the Diabetes Online Community - 40 or so of whom I've had the joy of meeting in person by now - see me in much the same way that my close friends and students have always seen me, I think: maternal, creative, compassionate, empathetic, occasionally wise, occasionally funny.

The members of TuDiabetes have twice honored me with member-voted awards - the "Life Coach" award in 2008 and the "Uncertified Diabetes Educator" award in 2009. I know that people trust that I will give my experience honestly, that I'm not afraid to share personal info, and that I genuinely want to help.

People who nominated me said things about me like:

-Her advice is always reliable, dependable, and on-target. She is so smart! I appreciate all the time she spends with us.

-Melissa's contributions are chockful of information. They are "meaty" and objective. She has contributed a lot to this community by sharing her experience, advice given to her over the years from her valued educators and her general knowledge of diabetes. There is no question she has done a lot of homework over the years and she knows her stuff!

-Melissa shares valuable information almost daily:) Her practical tips on pumps, CGMS, etc. provided w/ kindness and support...have made living w/ my diabetes so much easier.

I spent eighteen years doing diabetes all alone, thinking wrongly that I must be doing a horrible job because my blood sugars were not that of a normal non-diabetic person's. Once I discovered the D-OC, I realized that everyone felt that way. Everyone was overwhelmed, occasionally burnt out, thinking they were the odd man out.

And I realized that I had this HUGE wealth of experience stored up that I could share. I was a veteran in the trenches. And thanks to my husband's support and a good medical team, I'd started to turn some things around. I was working on my Happily Ever After. But I'd been down, I'd felt sick, and I had been motivated to find answers.

One of the things I love about this community of people is that we all know how scary, lonely, tedious, and thankless this condition can be. And we get out here and we say, "hey, I need someone to hold me up today." And suddenly the troops are rallied, advice is offered, hands are held, and we soldier forward.

Finding support online ultimately changed how I viewed myself, my struggles, and this condition.

In most areas of my life, I barge in and assume I'm wanted. Assume everyone appreciates my perspective. Assume I have a right to share it. I'm the girl in the elevator eavesdropping on your conversation and itching to give you my take on it, and probably my life story. I've got an anecdote and an analogy for just about every situation (ask my students).

In the Diabetic Online Community, I've been lovingly accepted for those quirks. Instant family. Blood sugar is thicker than water.

And to take one final turn in this post, I want to address the conversation I've been eavesdropping on this week concerning JDRF's controversial ad stating that "1 in 20" of us "will die of a low blood sugar." Because it directly relates to the hope for the cure I gave up on.

I applauded the JDRF for the first time when, last year, they addressed issues of living with type 1 diabetes as part of their mission statement rather than narrowly focusing their efforts on cure research and fundraising. People like me who live in the now, in the disease - we were so thankful to have this media powerhouse working toward technologies that would make our management easier. Many parents of young children felt it was a distraction from JDRF's stated mission over the last few decades. Veterans like me breathed a little easier.

This new ad, based on research that says that 5% of us will die of low blood sugars, aims to encourage the FDA to act more quickly in approving insulin pumping systems already available abroad that include LGS (low glucose suspend) - a feature that will shut off insulin infusion during a low blood sugar episode.

But strangely enough, this ad focusing on what I've been wishing they would focus on, made me think about the fact that I don't want it to be a single "1" of the way more than "20" people I know who fear those lows on a daily basis. Hell, I have two to three low blood sugar episodes EVERY DAY OF MY LIFE. It could be me. I've largely come to terms with that over the years. But when you make it about my friends...my family...and now the family I'm building....

I still can't bring myself to say "I want a cure," let alone immortalize it on fancy square paper. I think it makes me feel too vulnerable. But I have no trouble saying, yes, WE need a cure. Because I have to stop thinking about what I can handle myself and start thinking about how there's no one in that community I'm ready to say goodbye to.

I would love to get together with them on Wednesday nights someday and reminisce about the condition we all vaguely remember having.

1 in 20. We've lit too many blue candles already.


This post was written as part of NHBPM - 30 health posts in 30 days: http://bit.ly/vU0g9J.

Tell Me Sweet Little Lies

Today's Prompt: 3 Truths and 1 Lie. Tell us three truths about your condition. Now tell us 1 lie. Do you think we'll be able to tell the difference?

I'm going to take a slightly different take on the prompt today and discuss my health condition in relation to pregnancy. I meet women online everyday who have been told something scary or inaccurate about becoming pregnant with pre-existing diabetes. Their doctors throw around frightening terms like "congenital malformations" and "stillborn." Their mothers tell them they shouldn't "risk it." That's just not the reality for most women and it hasn't been the reality for me. I'd like to set the record straight. Here are my 3 truths and 1 lie.

Women with type 1 diabetes can have perfectly healthy pregnancies with minimal interventions.

A woman with diabetes can need as much as 300-400% of their normal insulin intake per day during pregnancy or as much as a whole unit for every gram of carbohydrate.

Type 1 and gestational diabetes are essentially the same thing during a pregnancy.

The baby's blood sugar is generally about 80% of the value of the mother's during pregnancy and newborns have lower target ranges than adults.

Do you know which one isn't true? Let's take a closer look at each statement.

Women with type 1 diabetes can have perfectly healthy pregnancies with minimal interventions. True! Women with Type 1 all over the world - of every size, shape, race, and age - have perfectly healthy pregnancies everyday. I've been really grateful to have the resources of the Oh! Baby!!! group on TuDiabetes, the Positive Diabetic Pregnancies Yahoo group, and the book Balancing Pregnancy and Pre-Existing Diabetes to see the truth in this. Some women deliver naturally, some have VBACs and VBA2Cs, while others (like me) schedule caesarians. Some women have higher A1cs (7s and 8s), while others keep the recommended range of below 6.5% during pregnancy. Some women have fertility issues, while others don't. Some have children with perfect health, and others don't. Really very similar to the basic concerns and risks of the general population.

This isn't a melodramatic Julia Roberts movie from the 1980s. It's the 21st century. What stands in the way of type 1s having kids (should they want them) is a lot of out-of-date misinformation and fear-mongering - often from their parents, grandparents, physicians, and friends. If you manage your numbers as closely as you can (which most women are incredibly motivated to do during pregnancy), your risks of problems are essentially EQUAL to anyone else's. The scary truth we have to accept is that, yes, sustained poor control (sustained highs, not testing BG, A1c's over 9) in the first trimester can disrupt the development of the baby's spine, brain, and heart during a period when many women might not yet know they are pregnant - which is why women with T1D are encouraged to be in tight control before trying to conceive.

If you manage the first trimester to the best of your ability, your biggest concern as a type 1 is that the baby may put on weight in your final trimester if high BGs continue to fuel too much glucose to the baby. A large baby could have trouble passing through the birth canal and may need to come out early via induction or c-section to avoid birth injuries. And sometimes the condition of a diabetic woman's placenta results in the need for an early delivery. Another reason for tight control is that your glucose passes through the placenta, but your insulin does not (molecules are too large), so the baby's pancreas is sometimes having to take up the slack, which can also cause lows for the baby in the first 12 hrs after birth as the baby's pancreas adjusts to a less "sweet" environment.

Most type 1 pregnancies do include aggressive monitoring from your medical team as a safety precaution against these concerns, with lots of extra ultrasounds (I had 12 with Sweetie) and non-stress tests and visits to measure the baby's weight and organ development, but the end result is peace of mind and the healthiest outcome possible.

I am SICK of people - mainly older family members and older acquaintances - perpetuating myth and fear about my health condition and my family planning choices. I feel constantly on the defense of my choice to have biological children. It's my right and it's my diabetes management. I guarantee I know more about this than you do, so calm down. I am offended that people think my efforts at good health indicate that there were "problems."

A woman with diabetes can need as much as 300-400% of their normal insulin intake per day during pregnancy or as much as a whole unit for every gram of carbohydrate. True! As my perinatalogist told me once, "Your placenta doesn't know you have diabetes. It's just doing its job." And one of its jobs in the last half of the pregnancy (20ish weeks onward) is to produce HPL (human placental lactogen). In a woman without diabetes, this hormone causes insulin resistance in the mother so that plenty of nutrients are siphoned off to the baby in case the mother is malnourished. It's evolutionarily advantageous for our species!

In a woman with diabetes, however, it means that you're pouring insulin in by the buckets to try to counteract the effects of this hormone. Some women need as much as a unit of insulin for every 1, 2, or 3g of carb coming in. With Sweetie, I went from 50u per day pre-pregnancy to over 150u. I'd have meal doses that would exceed the max dosage allowed by the manufacturer of my insulin pump. My insulin to carb ratio was down to 1:3. That means I was taking 5u for a single slice of bread!

It's challenging to avoid highs when your body seems so resistant to staying in range, but it just takes lots of persistent checking and correcting. As my doctor reminded me, "Feed the baby and don't be afraid to take enough insulin to cover it."

I've had people assume that diabetes goes into remission during pregnancy. Ha. More like goes into hyperdrive.

Type 1 and gestational diabetes are essentially the same thing during a pregnancy. False! There are some distinct differences. Notably, Gestational diabetes usually shows up after week 20 (so no concerns about that first trimester development or first trimester lows) and these women generally do not suffer from low blood sugars. They do not suffer the volatility of type 1 blood sugar management. Most never need to take insulin. GD comes on in the last months of pregnancy as a response to those hormonal changes I mentioned above. It's still unknown why it affects some women and not others (and unfortunately many women who develop GD during a pregnancy have an increased risk of developing Type 2 diabetes later in life). Women with GD can often control the insulin resistance with diet, exercise, and sometimes also with insulin. According to my endo, the big difference in how doctors have to treat this condition is that you can aggressively increase their insulin with almost no risk of lows. Their bodies can still self-regulate to a degree.

In a type 1 pregnancy, however, it's a balancing act to keep the standard deviation and range as tight as possible, with the A1c as low as possible, while avoiding the severe lows that we experience doing it all manually (artificially) without a pancreas. While lows do not particularly affect the baby, no fetus needs its host mama to be unconscious or seizing from a debilitating low. In many (but not all) women, excessive lows are extremely common during the first trimester. Others of us - the weirdos - experience insulin resistance from the get-go and enjoy both extremes. Guess which one I am. I don't experience first trimester lows that others talk about, though occasionally I rebound down into the 40s from aggressively treating the highs I see.

Anyway, this distinct difference between pre-existing D and GD has me going round and round with my perinatalogist. He insists that my BG never be over 120. Both my endocrinologist and Dr. Steve Edelman (the well-known endocrinologist affiliated with TCOYD) rolled their eyes at my perinatalogist's suggestion and called it unreasonable when I relayed it to them. My insulin is in my system for 4 hours after I take it. If it peaked so fast that my BG never crossed 120 at the 1 hour post-meal mark, I'd be "on the floor" (as my endo said) at the 3 hour mark.

So if your doctor is treating you the way he or she would treat someone with GD, educate yourself enough that you can be your own advocate (as I do) or find a new doc! My CDE's suggestion is that I just lie to the man and tell him my blood sugar is 100 mg/dL all of the time. I'm seriously debating doing this. Yup, 100. All the time.

The baby's blood sugar is generally about 80% of the value of the mother's during pregnancy and newborns have lower target ranges than an adult. True. Well, according to my perinatalogist. I haven't been able to confirm it in an online source yet. That certainly makes me feel better when I'm over 140 though.

And yes, the normal range for a newborn, though currently debated in some medical circles, is between 40 (or some say 45) and 60. When Sweetie was born, my first question was to ask about her blood glucose level. It was 54 and she was declared perfectly normal. If the blood sugar is lower than that at birth from Baby's pancreas overcompensating for Mommy's high glucose, Baby is generally given glucose water or encouraged to nurse until the BG stabilizes (within first 12hrs of life). From that point on, your diabetes is no longer their body's concern. Unless they swallow one of your test strips, of course.

If you want to have kids, there are many options available to you. Don't discount the old-fashioned way as one of them.


Additional Resources on Pregnancy and Type 1 Diabetes:
JDRF: Type 1 Diabetes and Pregnancy
Diabetic Mommy
Diabetes Forecast Magazine (ADA): A Guide to Pregnancy with Diabetes

This post was written as part of NHBPM - 30 health posts in 30 days: http://bit.ly/vU0g9J.