Skip to main content

The Technology Behind a T1D Pregnancy

The bags under my eyes and the formula stains on my shirt are proof that I am a new mom, again. And the sweet chubby cheeks, striking eyes, and uncoordinated hand movements of the babe in my arms? Well, those are proof that Type 1 Diabetics can, absolutely, have successful pregnancies, no matter what Steel Magnolias depicts. Today I have decided to highlight the tech that made my two T1 Diabetic pregnancies (and subsequent, adorable children) possible!

1) Tandem t:slim X2 insulin pump

During my last pregnancy I used the Animas ping exclusively, but have since switched over to the Tandem t:slim X2. There are many-a-T1-diabetics who can pull off the multiple daily injections (MDI) course of treatment, but for me, an insulin pump is a gift from the heavens, especially during a T1D pregnancy. My insulin needs change dramatically from those first few weeks after conception, to the last few weeks of omg-am-I-ever-going-to-have-this-baby. The Tandem pump allows me to fine tune my basal rate requirements, down to the 0.001 units per hour. I can also set difference carb ratios and insulin sensitivity factors throughout the day. In a perfect world you may not need this much flexibility, but, for me, the changes are so significant and happen so rapidly that it is freeing to have complete control over all of these individual settings.

The Tandem t:slim X2 also integrates with the Dexcom G5 (and now G6!) sensor which allows me to see a real-time graph of my blood sugars right on the home screen of my insulin pump. Per FDA requirements I only need to calibrate the sensor every 12 hours (and soon, no calibrations!), so I had piece of mind with less finger pricks than my last pregnancy.

And we can't leave out the main event. I have been very lucky with both of my pregnancies to have an OBGYN that trusts my judgment and allows me to manage insulin delivery during labor and delivery. Last time, Chris was the keeper of my Dexcom receiver and kept my blood sugar steady in the 80's during the hour long pushing phase. This time the whole process went differently, and after an extremely painful (and long) stalled labor, a C-section became necessary. I was wheeled into the OR with insulin pump and CGM sensor still attached (both on my arms), and a very open and willing team of doctors perfectly content to let Chris monitor and adjust-as-necessary the Diabetes side of the house. I have heard other T1 delivery stories that are not this rosy, so the opportunity to self-monitor and self-administer is not lost on me.

2) Livongo Blood Glucose meter

Ehhh, ok, to be honest, I only use this blood glucose meter because it is free (and encouraged) with our insurance company. The program sounds great on paper - free test strips and lancets, mobile uploading to the cloud, color display, ability to input related information (i.e. just exercised, before lunch, etc). But I just haven't been impressed. The meter start up and test strip pre-check take longer than my previous meters, the free test strips are throttled based on usage and for some reason our neighborhood has poor signal for the uploading capability which I believe leads to an inaccurate test strip count. The meter itself is large, as are the test strips and lancing device - the ergonomics feel tailored for an older diabetic patient. But, all that said, the meter does test my blood sugar, so I guess I should stop complaining.

3) iPhone Apps: Dexcom, Clarity, myfitnesspal, runtastic

This time around I made full use of my phone applications to assist me in various aspects of pregnancy related care. In the diabetes department I used the Dexcom app to keep track of real time blood sugars and share them with Chris. Dexcom also has another app, called Clarity, that I used extensively to pull together trending data. The app makes it easy to run a report from the Dexcom data and save the various charts as a PDF. Then I could send that off to my Maternal Fetal Medicine doc who was assisting my OBGYN and Endo in tracking all the Diabetes schtuff. I really liked the ease of getting all of this data together via phone instead of physically plugging a device into a computer and downloading data before shipping it off - especially while I had the toddler in tow.

Beyond the obvious diabetes apps, I also used myfitnesspal daily for tracking carbohydrate intake (or looking up carbohydrate counts pre-bolus) and weight - both important numbers during a T1D pregnancy. I also used runtastic for keeping track of my daily walks, which really isn't necessary, but as an engineer, I love

4) Backup Plans: Paper and {insulin} Pens

Arguably, the most important T1 Diabetes technology - the backup plan. It's sort of like writing down a few important phone numbers in the off chance your phone dies at an inopportune moment. Similarly, I periodically wrote down my basal rates and other pump settings, in the off chance I had to revert to a multiple daily injection schedule. And I always carry around the proverbial "pen" - insulin pen, that is. Test strips, glucagon, and snacks are all part of my T1 Diabetes back up plan, whether pregnant or not.

5) Apple watch

So, I can't claim to have used this one during my pregnancy with little Otto, but, in an almost joke of sorts Chris gifted me one as a "push present" (which, I sort of think is ridiculous, but whatever). I have to say, I love being able to glance down at my watch to check on my blood sugar via the Dexcom app! I often have my pump (with the Dexcom graph) or phone (again, with the Dexcom graph) inaccessible, so the gentle readout on my wrist is an extremely welcome addition to my plethora of Diabetes tech. One of my favorite uses is during a workout session. I stuff my phone in a leg pocket and hit the trail - with Dexcom info being piped straight to my wrist in real time. There are even more updates coming to this technology soon that I am over the moon excited about!

As a note: I do NOT have affiliations with any of the specific companies or products listed in this post - you are getting just a pure, unfiltered, T1 Diabetic's, take it or leave it, high or low, fast acting or slow, busted pancreas or not ;-)


Popular posts from this blog

The road to curing Type 1 Diabetes

From the moment of diagnosis, the road is rough, the learning curve is steep and the stakes are literally life or death. The map is less-than-helpful - paths originating from virtually every corner, coalescing at a center point (aka "diagnosis") and bursting back outwards - some paths cross and wrap around each other but others are isolated. And even with all of these roads, most of the territory is uncharted - how did we all get here and how will we all exit? Where are the obstacles we haven't found yet? Which passage holds the key to unlocking the solution?

On any given day I feel pretty isolated with this disease - I'm the only T1D in my group at work, the only one in mission control, the only one in my family. I go through the logistics of calling insurance companies, ordering supplies, changing sites and troubleshooting malfunctions mostly on my own. Even those pesky carbs really only get counted in my brain, no group think for a meal bolus here. But there is b…


Last week I had the chance to mentor a newly certified ADCO trainee - the NASA process is called "Hot On-The-Job-Training", or Hot OJT. What makes it "hot" you ask? Well, essentially I am hands off - he is sitting at the console, working all the plan reviews and updates, making calls to other flight controllers and to the flight director, reacting to anomalies and preparing material for the shift handover. My job is to act as the fault tolerance - a backup ADCO of sorts.

Tuesday was his last official day and by Wednesday morning he was in the backroom sending commands to ISS in preparation for the docking of a three-person Soyuz.

The beauty of this system is the gradual buildup in responsibility. There is a subtle shift from student, to subject matter expert, to fresh operations trainee to advanced trainee and finally to certification and real-time operations flight controller - the process takes two years on average and is considered by many to be enough specializ…


Healthcare is such a tricky subject. Ironically, it seems the conversation has shifted away from health CARE in favor of divisive politics with a healthy side of cash. But I'm here to tell you there are real people dealing with real diseases behind all those numbers. And with a laser focus on the rising cost of insulin lately and advocacy groups like #insulin4all making waves, it prompted me to take a look at my own T1D cost breakdown.

**Please keep in mind I have (pretty good!) private insurance through my husband's employer and our income allows us to absorb these costs without pinching too many pennies. We have also been graced with good health (diabetes notwithstanding) and rarely order any prescriptions outside of those for my T1D. But its clear only a slight shift in this delicate equation can make for a dire situation.

Here's what my out-of-pocket looks like to cover type 1 diabetes annually:

The numbers above reflect simply the "baseline operating costs"…
01 09 10