Jenna’s story 30 November 2021 Jenna was living a fast-paced life in her 20s when her life changed. She was losing weight inexplicably, she felt thirsty all the time, and her eyesight was on the blink. She mostly put it down to working long days in a busy job, until her GP intervened. “I kept getting a urinary tract infection that wouldn’t go away so my GP ordered a full set of blood tests,” Jenna says. “When she got the results, she called me and told me I had diabetes. It was quite a shock because at that point I felt invincible.” Jenna’s GP told her to go to hospital immediately. Stunned by the news, she spent the next 24 hours in hospital receiving treatment and learning how to monitor her blood sugars and inject insulin at home. “They explained that it would change every part of my life but just a little bit,” she says. “They kind of touched on pregnancy, but I wasn’t in a place to hear about it at that stage of my life, so I didn’t push it much.” Type 1 diabetes is an autoimmune condition. It causes the immune system to destroy cells in the pancreas which produce insulin. There is no cure for type 1 diabetes. Jenna learnt how to manage her diabetes so she could live a close to normal life. But a few years later, when she and her partner were thinking of trying for a baby, the significance of her condition re-emerged. Doctors in the United Kingdom, where she was living at the time, offered advice about how to prepare for pregnancy. They told her to avoid unplanned pregnancy and to make sure her blood sugars were in range before even thinking about trying. She was also advised to take a much higher dose of folic acid than other woman to prevent birth defects, along with aspirin, as preventative measures for her and her baby. It scared her. “I wanted children my whole life, but I became quite apprehensive about it. I thought what happens if I have a hypo and I’m carrying the baby down the stairs? Up until then, I felt quite empowered with my diabetes, and I owned it. I didn’t shy away from injecting myself at the dinner table,” she says In the UK, she was advised to change from insulin injections to a pump as a way to help manage her blood sugars. Jenna decided against it. She felt confident with what she was doing already. When she was 31, Jenna fell pregnant easily. But her first pregnancy ended in miscarriage two days before her 12-week scan. She will never know if diabetes contributed to the loss, but wishes she was told more about the possibility of miscarriage when she got pregnant. “I feel like the communication could have been better on that,” she says. A few months later, she fell pregnant with her first child, Harrison, who is now four. The pregnancy went well. She was monitored very closely by her obstetrician and endocrinologist who tested her frequently for complications associated with diabetes, such as pre-eclampsia. Jenna had to monitor her blood glucose much more closely throughout pregnancy and says it was hard to manage nausea because it led to cravings for foods she would usually avoid. For example, she wanted starchy carbohydrates like hot fried chips which could cause her blood glucose to increase. “I still ate the chips but I paid for it later,” she says of the thick headaches and nausea it seemed to cause. When Harrison was two, Jenna experienced another miscarriage at about six weeks gestation and then conceived her second child, Sam, who is now two. Despite her fears about managing diabetes during pregnancy and with babies, Jenna, now aged 36, says she made a conscious effort to relax as much as she could and let things flow. “I was raised by hippies, so I wanted nature to kick in a bit,” she says. “It can be tough, but there are options. If you have diabetes you need to trust the professionals you’re working with, and above all listen to your own body.” While some people might find it confronting to have a “high risk” pregnancy because of a condition like type 1 diabetes, Jenna took comfort in the close monitoring. “Rather than resent it, I enjoyed seeing my specialists every fortnight…I formed really great relationships with them.” Jenna told her story to Your Fertility for Fertility Week (December 6-10). For more information about factors that affect your fertility, visit yourfertility.org.au.