When I presented a Sugar Surfing™ Workshop in Houston on February 3rd 2018, a young mother approached me. In her arms she held her lovely 3 month old daughter. Her name is Emily Vocke. She related a story to me which literally brought me to tears. I asked if she would share her journey and allow me to share it with you. It speaks to the power of Dynamic Diabetes Management to benefit new moms and their unborn children.
I remember it like it was yesterday. My heart was filled with two things- the first was this incredible desire to be a mother and the second was fear. Fear that I would never be able to get my A1C below 6.5%, much less to the 6.0% target my PA said should really be my goal. I had never gotten my A1C below 7% despite all of my efforts. My PA is a type 1 himself, and he assured me that it was possible and gave me some tips that I scribbled down through my feelings of helplessness. I had tears streaming down my face on my drive back to Houston after that visit. I couldn’t fathom a world in which my A1C was 6%. But more importantly, I couldn’t fathom a world in which I wasn’t a mother. It seemed impossible and I felt defeated. It felt like diabetes was finally going to win.
The next day I was going through my notes from the visit and saw that I wrote down the name of a book I had never heard of that my PA suggested. Little did I know that this book would change my life. I had been searching for answers about how to better utilize my Dexcom CGM, and I found those answers in Dr. Ponder’s writing. Knowing that he is a type 1 himself gave me a higher sense of confidence in what he writes in his book, Sugar Surfing. I finally had something to validate how I felt about the static approach that I was so used to taking for 17 years. I had toyed with adjusting my insulin based off what the arrow on my CGM was doing, but always felt like I was straying from the settings on my pump. I felt like I was going to get in trouble with my doctor for overriding my pump so often. Sugar Surfing offered a way that made sense to take this more dynamic approach that I had tried without much luck on my own. It empowered me to not worry so much about my basal rates and insulin to carb ratios but rather fine tune things in the moment and base it off of how I felt in addition to what my CGM was doing. I began bolusing 20 minutes before meals and got in the habit of checking my CGM like a 14 year old checks Taylor Swift’s Instagram (that’s a lot in case you’re wondering). I forced myself to be patient with lows and only use a few glucose tabs or skittles to nudge my blood sugar up rather than my old ways of drinking a can of apple juice and ending up around 200 mg/dL [11.1 mmol/L]. I got an Apple Watch and felt like a complete diabetes nerd for how excited I was to see my blood sugar with a flick of my wrist. This meant that I could track what my blood sugar was doing at any moment with ease. This meant that safely becoming pregnant was POSSIBLE. This meant that having the “normal life” I wanted so badly was possible.
When I found out I was pregnant, my A1C was 5.4%. It then dropped to 4.9% in my second trimester and 4.7% in my third trimester. I didn’t go on any crazy diet or eliminate carbs. I still enjoyed fajitas and virgin margaritas, and I never said no to bread or pasta at a good Italian restaurant. I did workout three times a week because I knew controlling weight gain was important, and frankly I enjoyed it and surfed my way through crazy blood sugars that come with the territory of working out. I learned that exercise causes my blood sugar to rise (so I would nudge it down with a unit of insulin during my workout) and then fall about 30 minutes later (so I would skip the pre-bolus for dinner and just eat as soon as I got home to avoid a low). Sugar Surfing taught me to trial and error workouts and meals until I found out what worked best for me. I counted carbs as best I could, pre-bolused, and surfed my way to these A1Cs. I worked with an amazing CDE at TCH-Pavilion for Women who was open to my Sugar Surfing ways and offered research articles to help even more. I definitely dealt with my fair share of low blood sugars because of how tight of control I was trying to keep in addition to whacky hormones associated with pregnancy, but I did it. Or rather, we did it. My husband read Sugar Surfing to better understand what I was doing and offered immense support when I was ready to throw my CGM out the window from the alerts (I had my alerts set to alarm between 60-130 mg/dL) [3.3-7.2 mmol/L]. Our hard work paid off because on October 17th, 2017 we welcomed our sweet Juliana Marie into the world. She is a healthy baby and has no complications from my diabetes, my ultimate goal on this journey.
So in the end, my diabetes didn’t win. It didn’t stand a chance against a determined mother-to-be who surfed her way through pregnancy, thanks to Dr. Ponder and my team at TCH-Pavilion for Women.
Emily Vocke is a physical therapist who loves to dance (those are the workouts she refers to above). She has an open Instagram account (@emilyvocke) where she shares about being a type 1 as well as some of her dance workout videos aimed to empower other type 1's. Emily also shares what it means being a type 1 and a mom these days :)
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