My pregnancy was without doubt the hardest thing I've ever done, but worth every minute to have baby James safe in my arms.
My control wasn't as good as it should have been when we started trying for a baby, and I hadn't seen a diabetes consultant for years. Instead I just attended check ups at my GP surgery. To be honest I didn't fully realise the risks involved with having a baby as a diabetic, although I did know that diabetics have a tendency to have larger babies.
It was during one of these check ups that I mentioned that my husband and I wanted to start a family, and the practice nurse told me I should see a diabetes consultant urgently. At that point I was already a few days' pregnant - although I didn't know it yet.
I was worried about miscarriage
Thankfully we found that I was pregnant very early on, and I was seen by a consultant the following week. I'd read up on what effects diabetes can have on pregnancy and I felt quite stupid and irresponsible for not having taken better care of my sugar levels before. I wanted this baby so much but was really worried that I would have a miscarriage, or that the baby would have some kind of abnormality.
I was determined to get my blood sugar levels to the lowest levels I could, and started testing at least 10 times a day.
I was really struggling to get the balance right, giving myself corrective injections to bring the levels down, and having hypos every single day.
Hormones during pregnancy interfere with blood sugar levels. That coupled with losing hypo awareness meant I had a lot of severe hypos and we had to call an ambulance out on a couple of occasions.
Ten weeks into my pregnancy I had a hypo at work where I ended up fitting at my desk.
I hadn't wanted to tell my colleagues that I was pregnant until after my 12-week scan. I told that I was making some 'significant changes' to my diabetes regime that might mean I had bad hypos and not realise it was happening. I also told them what to look out for.
My diabetes consultant suggested that I switch to an insulin pump to help me get better control, as I'd be able to fine tune insulin doses and correct more quickly if I was out-of-target range. I wasn't keen at first as I hated the idea of having a pump attached to me all the time, but I decided to give it a go as I was desperate to get better control.
Getting a pump was a life-changing decision
It turned out to be a life-changing decision. I would never go back to injections now. I was put under the care of the diabetes team at King's College Hospital, who specialise in insulin pumps and diabetes care in pregnancy.
With the insulin pump and some amazing support from the consultants and diabetes nurses at King's, I was able to get fantastic HbA1c levels that were simply not possible for me when using injections.
My pregnancy progressed without any major complications and although I was busy at work, my bosses were very supportive and understood that my hospital appointments would mean I was out of the office for half a day each week. Being diabetic felt like a full-time job in itself during pregnancy!
As well as obsessive testing, I counted carbs meticulously and tried to work out exactly what kind of foods worked at what time of day to avoid any big blood sugar peaks. It turns out a cheese croissant for breakfast worked perfectly, while an evening pizza was absolutely impossible to manage. Having a target for post-meal blood sugar levels is one of the big differences during pregnancy, as well as having lower targets overall.
The other tricky thing with pregnancy is the huge increase in the amount of insulin required, and it keeps on going up throughout. By the end of my pregnancy I needed more than twice the amount of insulin I do now.
I went on a DAFNE course when I was around five months' pregnant and the other participants were a bit shocked at what huge doses I was taking, and that I was happily walking around with blood glucose levels between 3.5 and 4!
Being diabetic had its advantages
The plan with most Type 1 diabetics is to induce labour at about 38 weeks as there is a risk that the placenta can deteriorate if pregnancy continues to 40 weeks.
A few weeks before I was due to go in for induction I was getting high blood pressure readings at clinic. I was admitted to the antenatal ward for overnight monitoring because the doctors were concerned that I may have pre-eclampsia (as with so many other things, more likely if you're diabetic).
I realised then that being diabetic did have its advantages: it meant I was getting much more care throughout my pregnancy so if anything were to go wrong it would be picked up quickly.
At 38 weeks pregnant I went into hospital for my induction. The first dose of hormones didn't have any effect, so the next day I was given a second dose. I still thought nothing much was happening so sent my husband home late in the evening to get some rest.
Of course as soon as he'd gone I started experiencing labour pain and when I got to 2cm dilated I had my waters broken. However, something was amiss with the baby's heart rate so the decision was made to go for an emergency Caesarean. I was prepared that I might need a Caesarean as it's quite common for diabetics, but the fact that the baby might be in danger was pretty scary. Fortunately my husband just got back in time – five minutes more and I think he'd have missed me going into theatre.
The Caesarean went to plan, but with the concern over the baby's heart he was taken to the Special Care Baby Unit (SCBU) to be monitored. When he was born he needed resuscitation, and I only got to see him for a couple of seconds before he was taken away, which was extremely distressing.
I didn't get to meet my son properly until he was about seven hours old because I was in the recovery room following the C-section. I'd so looked forward to the first few hours with him.
The paediatricians quickly established that the baby's heart was fine, but he ended up staying in the neonatal unit for five days. Despite all my best efforts to get good glucose levels during pregnancy, baby James was born with hypoglycaemia, which is very common with diabetic mothers.
Unfortunately treating hypoglycaemia in a newborn is not as simple as giving them glucose so their sugar levels get back to normal levels quickly, because their body continues to produce too much insulin for a few days. To get baby James's glucose levels up, he had to be tube fed every hour and his heel pricked to test his blood.
It was upsetting having him in the SCBU and I struggled to get breastfeeding established as he was being tube fed. At the same time I had to keep going back to the postnatal ward as there were concerns over my high blood pressure.
However, slowly but surely things got better. After five days, baby James was discharged to join me on the postnatal ward and I got to enjoy spending time bonding with him and getting to know him properly. And then a few days later I was discharged myself to begin our new life in the family home.
Without a doubt my pregnancy was the hardest thing I have ever done. But it was so incredibly worth it.
