One of the greatest technological advancements in diabetes care has been the insulin pump. For one, it gives you the illusion of being "normal" because you no longer have to inject insulin throughout the day. Instead, you "bolus" by pushing a button on the pump itself or using a remote control. It allows better glucose management because you can adjust your basal rate (the "background" insulin dose) by increments of one thousandth of a unit every hour. Especially when you're moving from the peaks and valleys of NPH or the restraints and hazards of Lantus, the freedom of living with an insulin pump is incredible. But pumps do not come without their kinks.
I've had type 1 diabetes for nearly 14 years. I have fallen off the wagon a few times, battled diabulimia, survived numerous insulin shock comas and ketoacidosis episodes, and struggled with acceptance: I have my scars. Despite these mistakes, I've picked myself up countless times and have prevailed. I've persevered with a disease that doesn't take vacations for even a minute, and I've come out on top. I'm alive and healthy, with a full life and a child of my own.
Last year, I gave birth to my daughter and shared my pregnancy and birthing experiences with you. The pregnancy was a very difficult but extremely rewarding experience. A few months after our daughter was born, my husband and I discussed whether we'd have another child. On one hand, I went through several insulin shock comas, severe insulin resistance, and pre-eclampsia, ending in an emergency cesarean section. Because my first pregnancy was so tough, we weren't sure if we wanted to risk another one. On the other hand, if we did have two children, we wanted them to be very close in age so that they could bond well. We figured that if the two children were around fifteen months apart, then my daughter would be too young to feel any tension about having another baby in the house. We hoped they'd be close enough in age that they would always have one another as a companion.
Two years ago, I was a different woman. I was just beginning to come out of my diabetes shell, assessing my confidence with strangers by testing in public and telling friends about my disease. I can still feel the panic rising in my throat as I told people that I have diabetes and need to take injections multiple times per day. I was afraid of rejection, afraid that they would treat me like a sick person. But after eleven years of fighting for my life with type 1 diabetes, I was tired of being afraid. The more people I told, the easier it got.
I wake in the morning with the taste of sour milk on my tongue. I'm sweating, extremely weak and disoriented. My muscles ache at the thought of moving. I have a sick feeling in my stomach, and it's threatening to come up my throat. I'm not sure what day it is. Nausea hits in a wave, sending chills down my spine.
A couple of factors lead to increased risk of insulin shock comas during the first trimester. For many, insulin sensitivity increases and the pancreas isn't yet producing the hormones associated with insulin resistance. In addition, many type 1s will be taken off of their current basal insulin if it is not yet approved for use during pregnancy.
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