Back and babbling on as usual!

So, a long overdue update. Why haven't I been here?

Welp, I found out that I was pregnant about a month after I made this post. October 12, 2007, to be exact. According to my perinatologist, I am 20 weeks pregnant today. Due date June 17, 2007. It only took us two months of active trying, and trust me, we're still shocked. (Happy! But totally flabbergasted.) I stepped back from the blog because it was accessible by people at work, and I didn't end up telling my manager until about a month ago. Now that the Ricola man has practically yodeled my pregnancy from the mountaintops, I feel it's safe to blab on the blog again ;)

I should probably make a post about how hard it has been to be diabetic and pregnant, but the truth is I haven't experienced serious insulin resistance yet. I did have some Fun With Lows^TM during the first trimester; enough fun that I joked about hooking up to a juice box as well as my pump. This past week has brought a few changes and challenges, but so far it hasn't been anything that's made me want to tear my hair out. As an example, if anything I have upped my carb intake and my last A1C, drawn on the 14th, was a 4.5. That is just utterly and completely whack. I've heard it said that A1C measurements are not as reliable during pregnancy (if they are ever reliable in the first place), but the fact that I'm a whole 2 points lower than when I first conceived is remarkable to me. I would have been happy to be in the 6s throughout my pregnancy. I don't feel like my efforts have been Herculean, and for that I'm thankful - I hope my baby is still reaping the benefits of lower numbers. I test about 10 times a day, and I catch at least one high and one low per day. Most of these highs have been easy and quick to get down, but of course I'm already experiencing mommy guilt about the ones that weren't so easy.

The mommy guilt. That's what I really wanted to write about. I read a comment on diabetesmine.com today that made me so angry. Angry enough to rehash in tedious detail on my own blog! I wasn't angry at the commenter, but I was immediately on the defensive at the idea her comment suggested, at the possibilities it raised.

The commenter said that she would be happy to see the Type I gene disappear, and that she intended to adopt her children rather than pass on her genes. (She has an immediate family member with Type I as well as herself.)

My first reaction is that that's a very noble choice to make, if you are able and willing to adopt. I'm not just talking financial resources, although that's probably #1 for most people - but y'know China won't allow Type I diabetics to adopt even if they are willing. That thought tied into what really irks me about not passing on "the Type I gene." It's that there's this assumption of inferiority. And since Type Is are inferior, we should not raise children. We certainly shouldn't be reproducing, passing on our inferior genes. Hey, maybe diabetics should be prevented from having kids, full stop. And while we're at it, throw in all those folks with cystic fibrosis or autism or whatever particular flavor of the week we feel like eliminating. Why spend all that money on a cure when we could just have a little eugenics party?

That belief terrifies me and pulls up a bunch of yammering Big Brothers in my mind. GATTACA, anyone?

I think my bottom line is that I would rather my child live with diabetes than live a in world that resembles Winston Smith's or Vincent Freeman's; a world where the privilege of having children and a full, happy life is extended only to those with valid, or superior, genes . . . a world where there's a Big Brother deciding what valid is and what's best for each individual.

Would I have made the choice to get pregnant if I had a strong family history of diabetes? (I am the only person in my family with an autoimmune disease - and I'm extending that statement out to cousins, aunts, uncles. I do have a family history of heart disease, and to a lesser extent, cancer.) I don't know where I draw my lines, but as someone living with diabetes I still don't feel that I have the right to pass judgment on the reproductive choices of others. Maybe my mind is making some sort of arbitrary categorization of diseases. "Well, if I had that disease, I wouldn't have kids. But for diabetes it's okay." Is that because I have diabetes? Is it because that disease is so much worse, or more deadly, or more painful?

My gut says it's because it doesn't make sense to live in fear of diabetes. Yes, the world would be a better place without diabetes - but I don't think diabetes is going to disappear because diabetics stop having children. Scary genetic mishaps are in all of us, diabetic or not, and genetic mishaps are not the sole cause of diabetes. Diabetes does have a genetic component; for some this is more true than others. But me, with my random lightning bolt on an otherwise sunny day . . . why should I allow that one event to control my life any more than it already has?

That could be interpreted as me being hellaciously selfish. I can't apologize if you see it that way; my baby is healthy, today, as am I. I'm enjoying the rest of my sunny day, and I hope that others also seize the opportunity to enjoy theirs. I know that life is a privilege and not a right, but I don't feel that the privilege given to me should be cut down to an acceptable shape by a someone else's labels and levels and judgments of what is or is not good enough.

I promise the rest of my pregnancy posts won't be as dark or muddled. (Well, they will probably still be muddled.) I am very happy with my life right now; new home, new baby on the way. Tons and tons and TONS of stuff rattling around in my mind about the future, from paint colors to cribs to more nebulous events and concepts like impending birth and motherhood. Can't wait for any of it!

Level II ultrasound is tomorrow. Send an urge to flash to my child, if you would be so kind :D

The Future of Diabetes

This is a question I've read on other blogs: What is going to happen to us? What is our life going to be like?

Assume there isn't a cure coming out in the next 10, 20, 30 years (I know, I know). Assume that you're going to be diabetic until the day you die. What's going to happen to us? "Us" meaning the people diagnosed with diabetes in the current era of diabetes management - daily self monitoring and self adjustment, carb counting, continuous glucose monitoring systems, pumps, and regular endocrinologist appointments. What is our life expectancy? Are we going to lose our eyes and feet even if our A1Cs are under 7?

I started thinking about this yesterday when yet another woman on Diabetic Mommy was the victim of a side-comment from a nurse that ended up being incredibly scary and / or hurtful. Her A1C was 6.9, and on her forms the nurse marked "uncontrolled diabetic" and then said that it made sense to her, looking at the readings downloaded from the woman's blood sugar monitor.

Hold up now. What the hey? I'm the queen of spinoffs, so I'll try and stop myself before I get off on a tangent. . . but isn't an A1C of under 7.0 considered pretty damn good, according to the ADA? Your body makes no insulin. Unless you want to spend your days eating the same meal, at the same time, and pretend like you live in a vacuum with no emotional upsets, exercise, stresses to the body or mind in any way . . . crap, even that won't work. A Type I diabetic is going to have major blood sugar flucuations NO. MATTER. WHAT. She is busting her ass, testing like crazy, and doing everything as best she can. So what is this "uncontrolled" garbage? How about having a box on the form that says "This disease sucks ass; all things considered she is doing very well." Then the other box can say "This disease sucks ass; patient doesn't give a hell and walked in with a jumbo-sized Pixie Stix."

I guess that box on the form hints at the fact that the ADA may very well be full of caca-poopy. How do they know that an A1C of under 7.0 guarantees long life? What if the only way to escape DEATH BY DIABETES is uh, if you aren't diabetic? (And let's not even get into the "the A1C is not a good indicator of overall control" discussion.)

The word on the streets right now is that no one really knows what's gonna happen to us "kids" working to keep our A1Cs under the magical threshold. All the studies on what creates complications are based off of the older diabetes models and patients. The whole culture and feeilng surrounding diabetes is best summed up by those magazines I receive from my insurance company in the mail . . . some cheap, thin rag with a retired gentleman walking his dog on the cover, and the same tired "information" inside. Are you testing your blood sugar regularly? (I could cut glass with these finger calluses.) Do you know the symptoms of hypoglycemia? (Rattle n roll, tootz.) A yummy meal plan for you! (Wow, fat free imitation butter spread AGAIN? Shocker.)

Is 6.9 good enough? Is 6.8 (my last one, in January) good enough? Is 6.2 (my 2nd-to-last one, in September) good enough? Is anything we do good enough, or are the complications inevitable?

I guess I'm also curious at what a typical A1C is for people who are "controlled" - I mean people who test more than 4 times a day, count carbs every time they put something into their mouths, and think they have a pretty good handle on basal rates and bolus ratios. I think my view of this is a little skewed since I'm a regular DM visitor, where the ladies have some of the most stellar blood sugar records around (babies have a way of motivating like nothing else). It's easy to feel "out of control" there when your two hour post prandial reading is - gasp - 140 or your A1C rockets off the charts at 6.5+.