I have some exciting news (at least to me and my family)...in January there will be another human being in our household. The last few months have been quite a whirlwind. From learning the news, to figuring out how shift my diabetes management, to making sure I am doing all I can to protect the little one growing inside me. Pregnancy is a marvel to begin with, but I had no idea what the duo of diabetes and pregnancy would bring. To say the least, I am amazed and a little scared.
My blood sugars have never been so fantastic. An A1c of 5.7% and dropping. I thought that was a fairytale I would never experience. Pregnancy lows bring on a whole new set of meanings. Most striking is the hypoglycemic unawareness. I used to feel shaky at 70, now it is 45. From what I have learned, the baby likes lows better than highs, and at delivery I will be glad to have a normal instead of glucose super-sized babe. The good news, things are going well and this is doable. At least the first 6 months have been.
Of course I have been paying more attention to the research on diabetes and pregnancy. I've been struck by how little there is! Think about it, when else do we have women with existing diabetes put into a natural immunosupressed state? It looks a little like the immunosuppression that is being studied for islet cell transplants and other "cure" related therapies.
I am fortunate to be working with the best of the best in diabetes and pregnancy, Dr. Lois Jovanovic. Recently, she told me of fascinating research that could hold potential keys to the mystery of diabetes in general. Amazingly, 25% of pregnant women with type 1 diabetes begin to re-create their own insulin during the pregnancy period. It is speculated that these women thrive off of that mild immunosuppression and the growth hormones being produced by the placenta.
Specifically, these women show a rise in their C-peptide levels and a drop in their insulin requirements. So far, the C-peptide rise has been parallel to a rise in pregnancy-related growth factors (prolactin and placental lactogen), and the pregnancy-related immunosuppressive hormones (cortisol and progesterone).
These results suggest that administration of certain hormones in people at the early onset of diabetes may be able to stop the destruction of Beta cells, and perhaps increase their numbers back to normal levels.
This is just the tip of the iceberg. There is so much to learn about the pregnancy state and diabetes. Really, there is not enough information out there.
As we think about diabetes research and our combined hope for a cure, let me suggest that we keep our eyes and ears open to the myriad of possibilities.
For those thinking about pregnancy, know that it is possible, but the key is good glucose control before conception. The most crucial time in the baby's development is the first few weeks when you don't even know you are pregnant.
