The baby was cranky. Mary Comeau was trying to get him down for a nap. Then she checked her blood sugar. “I dipped into the twos, which is quite dangerous. I want to be above four,” Comeau said. Comeau was referring to her blood glucose level, measured in millimoles per litre. Island Health says blood glucose that drops too low can cause serious symptoms and, in severe cases, loss of consciousness. Her partner had gone back to work, leaving Comeau alone with her newborn at the time. Comeau put her baby somewhere safe, contacted her partner to stay in touch and had some juice to bring her blood sugar back up. And as she tried to bring herself back to feeling well, one thought was impossible to ignore. “If something happened to me in that moment, who would be there to take care of him?” she said. For Comeau, the moment exposed something about new motherhood that is easy to miss from the outside. The work of managing diabetes is largely invisible. There are no obvious signs when a new mother has spent the night waking up to treat low blood sugar. No one necessarily sees the calculations behind every meal, the glucose checks or the insulin decisions made while caring for a newborn. Comeau has lived with Type 1 diabetes since she was nine years old. She says becoming a mother has brought the biggest challenge she has faced with the condition. “I had no idea what to expect,” she said. During pregnancy, her insulin needs changed. After delivery, they changed again. Her hormones were shifting. She was breastfeeding. Her sleep was interrupted. And suddenly, much of her attention was focused on a tiny person whose needs could not wait. “After childbirth, hormone levels change rapidly, which can significantly affect blood sugar levels and insulin requirements,” Island Health said in a statement to CTV News. “At the same time, new parents are often coping with disrupted sleep, irregular meal schedules and the demands of caring for a newborn.” Island Health said those changes can make it more difficult to monitor blood sugars consistently, eat regular meals and recognize symptoms of high or low blood sugar. “This is why close follow-up and individualized care are so important during the postpartum period,” Island Health said. For Comeau, breastfeeding was one of the biggest challenges. She said her blood sugar would start to drop immediately when she began feeding her baby. There were times when her baby was hungry, but she first needed to make sure her own blood sugar was high enough because she knew it could drop once she began breastfeeding. Then came the nights. Her baby was waking to feed, while Comeau was also waking three to four times a night to deal with low blood sugar. “I was very sleep deprived at the beginning of that,” she said. Comeau said waking up with high or low blood sugar on top of a night spent caring for her baby could leave her feeling “like a zombie” in the morning. “It would make the day a lot harder,” she said. Island Health said the weeks and months after delivery are a time of significant physical and emotional adjustment. “Ongoing follow-up helps ensure blood sugar levels remain in a healthy range and allows health care teams to adjust treatment plans as needs change after birth,” Island Health said. For Comeau, that follow-up included an obstetrician, a maternal fetal medicine specialist and a diabetes team at Victoria General Hospital. She says the care she received during pregnancy and postpartum has been the best she has experienced since being diagnosed with diabetes. But good medical care does not remove the demands of everyday life with a newborn. It can simply make them more manageable. For Comeau, self-care no longer means what people might traditionally imagine. “A good blood sugar day, my baby is happy,” she said. “That in general is a good self care day for me.” For Lauren Quinn, a mother with Type 1 diabetes living in Boston, Massachusetts, self-care can be even simpler. Quinn had a C-section and was recovering from surgery while caring for her newborn. “It was honestly very hard,” she said. “Even just taking a shower at the end of the day feels like self-care these days.” Quinn said there was a period when her diabetes effectively moved into the background as she focused on her baby. She never intentionally skipped insulin doses, but she found it more difficult to keep her blood glucose where she wanted it as her body adjusted to postpartum life. Within six months, she realized something had to change. “I have to take care of myself because this is my priority,” Quinn said. “For me to be a great mom, I have to do the things that make me feel better.” For Quinn, that meant continuing to check her blood sugar, take insulin and move her body when she could. But there was another challenge that had nothing to do with numbers on a glucose monitor. It was comparison. Quinn is active on social media, where she sees friends who are mothers but do not live with diabetes. “I just imagine a life where I could just run out the door with my baby and not have to worry about myself too,” she said. That emotional burden is difficult to see. “It’s a bit of an invisible disease,” Comeau said. A bad night of high blood sugar or a dangerous low can leave someone exhausted, even when everything looks fine from the outside. Marriage and family therapist and clinical counsellor Traci McGee works with parents experiencing postpartum mental health challenges. She also holds an international perinatal mental health designation. She says new parenthood already comes with a dramatic change in lifestyle, interrupted sleep and the constant responsibility of caring for another person. Add a chronic condition, she says, and meeting basic needs can become even more difficult. A parent with type 1 diabetes may need to eat regularly, monitor glucose and respond to changes in blood sugar even when a newborn is demanding their full attention. “If you’re a parent that is not well resourced, like if you don’t have a grandma there, or if your husband has had to go back to work, you’re really on your own,” McGee said. Sleep deprivation can have consequences beyond exhaustion. McGee says a parent who cannot sleep even when their baby is sleeping may be experiencing anxiety that is interfering with their ability to rest. She says guilt can make it harder to recognize when help is needed. New parents may tell themselves everyone struggles, they wanted this baby, they have a home, a partner or a supportive family, so they should be happy. “That inner guilt and shame sort of takes over good thinking,” McGee said. For mothers living with Type 1 diabetes, that guilt can come with an additional consequence: putting their own health aside while trying to meet the needs of their baby. McGee says support should not wait until a parent reaches a breaking point. And support does not always mean taking the baby. Sometimes, the most useful thing a partner, friend or family member can do is make dinner, change the bedding, do the laundry or simply sit with a new mother so she does not feel alone. “The first thing is for people to not assume what somebody needs, but to actually try to get them to talk about that,” McGee said. Island Health also emphasized the importance of a broader support system. “Partners, family members, friends and health care providers can assist with newborn care, help maintain routines and provide emotional support,” Island Health said. For some mothers, technology can provide another layer of support. Comeau wears an Omnipod 5 insulin pump and a Dexcom G7 continuous glucose monitor. Her glucose readings are sent to her phone, and she says the system can adjust insulin delivery based on her glucose readings. She says the technology has allowed her to spend less time actively thinking about diabetes while she is caring for her baby. “I would not be able to do it without my diabetes technology,” Comeau said. She can be changing a diaper while her phone alerts her that her glucose is falling. The technology does not eliminate the work of managing diabetes, but it can help move some of that work into the background. Quinn also uses a continuous glucose monitor and insulin pump. She says being able to check her glucose and manage insulin through her phone has dramatically improved her quality of life. “Diabetes technologies such as insulin pumps and continuous glucose monitoring systems can help make day to day diabetes management easier by providing timely information about blood sugar trends and helping guide treatment decisions,” Island Health said. For Comeau, the support does not stop with her health care team or technology. It also comes from an online community she has built by sharing the parts of diabetes and motherhood that are often difficult to explain. She has just over 1 million YouTube subscribers, more than 600,000 followers on TikTok and about 45,000 on Instagram. During pregnancy and postpartum, other mothers living with diabetes have shared their own experiences with her, often giving her a sense of what might be coming next. She says many of the experiences she has gone through are things other mothers had warned her about. That community has also helped reinforce a message she wants other women living with Type 1 diabetes to hear. “It is so possible to have a healthy pregnancy, and a healthy baby with diabetes,” Comeau said. Growing up, she did not think that would necessarily be possible for her. Now, six months into motherhood, she sees things differently. Quinn, whose son is 15 months old, has a similar message for women who may be afraid of becoming mothers because of the challenges of diabetes. She describes motherhood as the best thing she has ever done. Her son, she says, is her biggest motivation. For both women, caring for themselves is not about choosing their own needs over their babies. It is about making sure they are healthy enough to keep showing up. Sometimes that means treating a low blood sugar before feeding a hungry baby, asking for help around the house or admitting that the person caring for everyone else needs care, too. For a new mother living with Type 1 diabetes, that is not indulgence. It is essential care.
