Preparing your body for pregnancy when you have type 1 diabetes is a marathon, not a sprint. I started my preconception with T1D preparations 2 years before we knew we wanted to start having children. Of course everyone’s journey will be different, and there is no one right way to do things. But I wanted to share with you what I did, preconception, to prepare my body for a type 1 diabetes pregnancy.

Preconception with T1D

1. Get Off Hormonal Birth Control

The first thing I did on my preconception with T1D journey was to get off my birth control pills. Conventional advice suggests that you get off any kind of hormonal birth control (pills, injections, implants, rings, etc) a few months before trying to conceive (TTC).

But considering I had been on the pill for 10+ years and had 2 autoimmune diseases, I figured I’d give my hormones a much needed break. I tossed my birth control pills in the trash, experienced HORRIBLE hormonal acne for 6 months as my hormones came back into balance, and for those next 2 years I used NFP (natural family planning) as my source of birth control. In a nutshell, NFP, is just tracking your cycle so that when you’re in your fertile window you either use extra protection like condoms, pull out, or just abstain from sex for that week.

2. Get a Robot (or two)

My next step was to get on an insulin pump. Knowing how tight my control needed to be once I got pregnant I decided that a pump would give me the most control. I chose the Omnipod (see my reasons HERE) and it has been one of the best decision I have made in my diabetes management. Right next to getting a CGM (read about my experience with it HERE).

I made the switch about a year and a half before I knew we wanted to conceive. I wanted to feel comfortable with my robots well before conceiving. In my head I thought it would take months for me to get used to it, but in reality, the switch was pretty seamless. I didn’t experience many highs (and virtually no lows) in those first two weeks that we were adjusting my numbers to get the right ratios. And after those first two weeks of using it I already felt like a pro. So in hindsight I didn’t need as long of a time to adjust, but I’m still glad I switched when I did because the pump has given me an incredible amount of control over my blood sugar numbers.

3. Get A1c In Range

Have a good A1c is so important in general, but especially 6 months before you try to conceive for two big reasons:

One. Having an A1c above 7.0 decreases your fertility and increases your risk for an early miscarriage.

Two. An A1c over 7.0 can damage your eggs and negative affect your reproductive system which increases the risk of baby developing birth defects.

The healthier you are the healthier baby will be. Ideally you’d want to be 6.0 before conceiving, but anything below 7.0 will help to reduce your risks mentioned above.

4. Load Up on Nutrients

During the first trimester you’re bound to experience food aversions and/or morning sickness. You know what the most common food aversion has been with  me and in my circle of friends? Veggies.

Crazy, right?

The food with the most nutrients and minerals is the one thing that makes us want to run for the hills. So if you’re anything like us you may want to load up on nutrients ahead of time so you can build up some solid nutrient stores for baby to pull from in those first few months.

If you can, start ramping up your nutrition or take a quality prenatal 4 months prior to conception. If you want to be really good, then start a year or two before conception.

It’s especially important for type 1 diabetics to get the following nutrients prior and during pregnancy:

• Folate (not folic acid). If you’re wondering why folate and not folic acid, I’ll have to write a blog post on it because the original article & website I would link to (by Megan at Living Whole) has since been deleted. She did a great job at explaining the difference. This is the brand I use.
• Vitamins A&D. I like to get my vitamins from a food source whenever possible which is why I LOVE liver and fish eggs for these two vitamins. When I can’t get liver from pasture raised cows at my local farmers market I buy liver capsules. Here is the brand I buy for desiccated liver capsules. This is the brand of Fish Eggs I take.
• Magnesium. I do a combination of topical and oral magnesium.
• Quality Multi/Prenatal. This is the brand I use.
• Zinc. This is the brand I use. UPDATE: I have recently taken a more whole food approach to minerals/vitamins. I now eat oysters because they are an incredible source of natural zinc; the highest zinc food source in the world.
• Selenium. This helps with the absorption of thyroid hormones. Here is the brand I use. UPDATE: I have recently taken a more whole food approach to minerals/vitamins. I now eat Brazil Nuts because they are a great source of natural selenium, however the amount in each nut does vary. Things like location, soil quality, and harvest date are some factors that can make two nuts have drastically different levels of selenium.

Bone broth is a great source of nutrients too! I try to drink homemade bone broth as much as I can. It’s important that the bones are from humanely and organically raised chickens. Farmers Markets are a great spot to find these.

5. Get Thyroid In Check

If you already have a thyroid condition then you know the importance of getting your numbers in a good range. For pregnancy and preconception you’ll find that most doctors will want your TSH between 0-2. It’s also important that you levels of T4 are optimal because that’s what baby pulls from you before it can start producing its own thyroid hormones.

If you don’t have a thyroid condition, it’s still a good idea to have a blood work panel done before trying to conceive so that way you’ll know of any deficiencies (or thyroid problems) right from the start.

6. Read

If you’re anything like me, then you LOVE information. The more books, articles, studies, seminars, and documentaries I can get my hands (and eyes) on the better. Here my top 3 favorite books on preconception:

• Pregnancy with Type 1 Diabetes
• Your Healthy Pregnancy with Thyroid Disease
• The Nourishing Traditions Book of Baby & Child Care

7. Join Facebook Groups

Curious what a real T1D pregnancy is like? Want to dip your toes in the water before you’re 100% committed to jumping in? Join a pregnancy group on Facebook. These are real T1D women going through all the ups and downs of a real T1D pregnancy.

I learned so much from joining these groups. Whether you sit back and quietly read everything from the sidelines, or are actively posting questions, you will learn SO much just from being in one of these groups.

There are a lot of groups out there, but my favorite, hands down is: Type 1 Diabetes and Pregnancy
These women are lightning fast to respond and are so incredibly helpful.

What Are The Odds of Baby Getting T1D?

In a lot of the T1D & Pregnancy groups I’m in this question gets asked a lot, and for good reason. Here are the odds:

If the father has T1D the risk is 1 in 10, but if the mother has T1D then the risk drops to 1 in 25. Those odds get even better if the mother delivers the baby after the age of 25, dropping the risk down to 1 in 100, which is virtually the same as the average American. And if the mother developed T1D after the age of 11 that risk drops even lower. [1]

Sources
[1] Ginger Vieira, and Jennifer Smith. Pregnancy with Type 1 Diabetes. CreateSpace Independent Publishing Platform, 2017.