30 Stories of Diabetes Education: Meredith Velan

Pregnancy, Diabetes Control,
Double Blessings

 
Diabetes was the last thing on Meredith Velan’s mind as the excited newlywed and her husband, Kevin, began making plans for a future family.
Those plans changed dramatically upon return from a weekend vacation when the 30-year-old Walgreen’s market planning and research group employee was diagnosed with type 1 diabetes, a chronic autoimmune disorder.
“I thought I had the stomach flu or possibly an infection,” states Velan, who recalls her unexplained weight loss, excessive thirst, fatigue and frequent trips to the bathroom. “The possibility of diabetes hadn’t crossed my mind.”
Results of a blood test and consultation at her local Walgreen’s Take Care Clinic left her reeling.
“At 30 years old I was newly married and excited to start a family,” she says. “I’d always been vigilant about maintaining a healthy weight, exercising and making healthy food choices. Now I was faced with the reality of living with a chronic disease.”
Due to her age, doctors initially suspected she had type 2 diabetes, and hoped lifestyle modifications might help to manage the disease. Additional tests soon revealed a type 1 diabetes diagnosis, and Velan learned she would need insulin therapy.
Over the next several months, she learned to count carbohydrates, control portion sizes and find time for 30-minute daily exercise sessions. She also says she thanked her lucky stars the disease was caught early, before she became pregnant.
According to American Diabetes Association experts, diabetes can be a significant complication for women during pregnancy. Because high blood glucose levels can cause birth defects in unborn babies, experts say it’s important for any woman with diabetes to carefully plan pregnancy and make sure her blood glucose levels are well managed from the very beginning of pregnancy.
“It was all for the greater good and my goals---learn how to manage my diabetes, get my blood glucose under control and then start a family,” states Velan, who says she completely “locked in” to her mission. “I told my doctors I didn’t care what it took and that I would do anything and everything I could to learn about and manage the disease so we could start our family.”
Initially unaware of her diabetes diagnosis and with an 8.0 A1C score---a test which measures average blood glucose control for the past two to three months---Velan intensified her exercise program. Following diagnosis, she started a diet and exercise regimen and within three months the level dropped to 6.5. The couple transformed their lifestyle together and watched everything they ate, focusing on healthy whole grains, fruits, vegetables, fish and chicken. Within six months her A1C was down to 4.9.
“Even my endocrinologist was astounded and told me many people without diabetes don’t have that good of a reading,” says Velan, whose 6 a.m. pre-pregnancy workout sessions included a combination of cardiovascular and strength training.
Transitioning to four insulin injections a day after the type 1 diagnosis was a blessing in disguise, admits Velan, who says the insulin helped her prepare for pregnancy and to gain even better control of her diabetes. It also allowed her be less strict in regard to what she ate and to regain a few pounds she had lost.
After receiving her doctor’s blessing, Velan and her husband began their journey into parenthood and were thrilled to learn they were expecting not one, but two babies.
“Having diabetes and being pregnant placed me in a high-risk category,” she says. “With the discovery of twins, I shot to the top of the spectrum for high-risk pregnancies and began working very closely with a medical team including diabetes experts and my obstetrician.”
While she did carefully watch carbohydrate consumption and nutrition, Velan says that since she had type 1 diabetes, there wasn’t really a need to change her diet during the pregnancy.
“However, decisions on what you eat can impact the health of your baby,” notes Velan, who says doctors prepared her for the possibility her babies could be born early due to the added complication of diabetes. “They stressed the need to tightly control blood glucose to help reduce the risk of complications with pregnancy. I had to report every insulin dose and every blood glucose reading so my medication could be appropriately administered.”
As her body changed and as the babies grew, blood glucose levels fluctuated and treatment plans needed constant revision.
According to the ADA, the key to a healthy pregnancy for women with diabetes is keeping blood glucose (sugar) in the target range — both before and during pregnancy. For those like Velan with type 1 diabetes, pregnancy affects the insulin treatment plan as the body's need for insulin increases—especially during the last three months of gestation.
“We vowed to simply take things one day at a time,” says Velan, knew well the risks for pre-term labor, pre-eclampysia and other potential complications. “I began by taking care of myself and continued to take a 30-minute walk every day, when doctors advised against vigorous exercise while being pregnant with twins. I was vigilant about my nutrition, and worked with my medical team to manage blood glucose changes and insulin needs.”
Seven months into her pregnancy, Velan was placed on strict bed rest.
“With an anticipated Dec. 14 due date, no one expected I could make it much further into the pregnancy,” she states. “But after another seven and one-half weeks on bed rest, at 9 a.m. on Nov. 26, the Friday after Thanksgiving, I delivered two full-term, healthy six-pound baby girls at Advocate Lutheran General Hospital,” she says. “We named them Elizabeth and Caroline. Doctors did all the tests and everyone was absolutely fine. Four days later we were home.”
The twins, who celebrate their second birthday later this month, are active, healthy and a source of true motivation to continue a healthy lifestyle. Velan, who was moved into a new role as senior manager on Walgreen’s continuous improvement team, says her daughters also inspire her to reach out, working with others to find a cure.
“The girls are very curious when mommy takes her blood glucose or injects insulin before we all sit down for dinner,” explains Velan. “When I think about how I will explain diabetes to them as they get older, it’s hard to put into words.”
For the first time this fall, Velan and her family joined others in the American Diabetes Association’s Step Out Walk To Stop Diabetes.
“I’ve worked at Walgreens for more than a decade and my co-workers have become like a second family to me,” notes Velan, who says she is especially grateful for the support, encouragement and compassion of co-workers who continue to pick healthy options for lunch and ordered her a sugar-free cake to celebrate her 10-year service anniversary.
“They listened, learned with me about the disease and let me vent every step along the way,” says Velan, who recently was asked to spearhead company support for diabetes prevention at scores of nationwide ADA Step Out events. “Knowing they are here for me means a lot.”
By Janice Youngwith orginally published in the Chicago Daily Herald