Vodka Pasta and the Mental Gymnastics of Motherhood With Type 1
Mom of three Diane S. shares her open and honest account of pregnancy and 15 years of parenthood with type 1 diabetes.
It started with a plate of vodka pasta on the night of the 2026 national college football championship. To an outside viewer, it was just about carb counting – but really, it was about so much more. As I stared at that plate, my mind began spiraling through years of parenting decisions, all while living with type 1 diabetes for more than four decades.
You would think I’d have this figured out by now. Some days, I do. But parenting, especially with diabetes (I would also imagine any chronic condition, just with different scenarios), is a constant learning curve. Every day brings new situations, and sometimes I’m genuinely blindsided by what to do next and how to respond to my kids.
Then, there are the not-blind-sided “normal” moments that just come with the type 1 turf, things we all deal with every single day: the beeping in the house (or embarrassingly, during a kid’s school show); the dinner and grocery shopping decisions and how or if my choices will influence my kids’ relationship with food; the moments when you are cuddling in bed with your kid and they rip off a pump site (I once went into a four day hospital DKA stay from this); you get my point…
Before I explain why that one evening in January with vodka pasta sent me into a mental tailspin, I need to rewind about 15 years.
When I was pregnant with my first child, I had a wonderful diabetes educator and an early version of a Dexcom CGM. Still, pregnancy felt like nine months of educated guesswork. I was told the CGM could help identify trends but wasn’t accurate enough for pregnancy, so I woke myself up two to three times a night to check my blood sugar with a meter. I had to be very good at math and change the settings every three weeks as my hormones changed. Simple things like eating bread and cereal, which are pretty much the only things some nauseous pregnant women crave and can keep down, were not simple for me at all. The exhaustion went far beyond typical pregnancy fatigue, and the constant second-guessing of insulin needs was mentally draining.
I had vivid dreams that sugar was literally swimming to my baby – that something terrible would happen if I didn’t keep things well managed. Often, I overcorrected and rage bolused with insulin, which led to frequent lows and weight gain. Anxiety drove many of my decisions. But my baby girl was born healthy, and I counted my blessings.
Four years later, in 2014, pregnancy number two looked similar. The technology was slightly better, and again I did the best I could – still without an automated insulin delivery (AID) pump. My baby boy was born healthy – I counted my blessings.
In 2017, there was a big change in diabetes advancements. I was ecstatic when the first AID system became available, and I was among the first in my area trained on the Medtronic 670G. I even accomplished running a half-marathon using it.
A few months later, I found out I was pregnant with my third child – unexpected news that reignited many of my earlier anxieties. Because pregnancy glucose targets are lower (63-140 mg/dL) than what the algorithm allowed, I couldn’t use AID auto mode and had to revert to manual pump mode management. The fears from my first two pregnancies came rushing back, but my baby boy came out just like my others.
All of my children were born healthy, and for that I’m deeply grateful. But the mental toll of those years is something I’ll never forget. I only had one close friend with type 1 diabetes (also a 1980s diagnosis) who had been through pregnancy two years before me, and I leaned on her heavily to vent, to cry, to feel less alone.
Fast forward to now. In early 2026, diaTribe published a vitally important international consensus statement on the use of diabetes technology during pregnancy. How I wish this guidance – and today’s technology – had existed 15 years ago, or even eight. The diabetes community applauds all the companies working tirelessly to advance diabetes technology, create faster insulins and new medicines for blood sugar management, and the groundbreaking science moving us closer to a cure.
If I were pregnant again, I’d probably sleep with this consensus paper under my pillow to be extra familiar with the tips. I’m hopeful that in the near future, expectant mothers with diabetes will have this kind of life-saving, practical information at their fingertips. And, what a great future it might be if CGMs and pumps had a “pregnancy” setting that you could toggle on with specific settings for each trimester and post-partum.
The physical and emotional nature of pregnancy and post-partum with type 1 brings curveballs that no one can fully prepare you for. Fifteen years later, I’m facing a different set of mental hurdles. Parenting challenges are universal, with or without a chronic condition – but there are situations that really only arise when you’re parenting with type 1. I often wish there were a manual or a consensus statement for these moments. Until then, I rely on my peer support circle, sourcing credible education, and my gut instinct.
My three kids are now 7, 11, and 15, each in very different stages of life. I’m continuously learning how type 1 weaves itself into our household and my relationship with each of them. While I experience some of the same joys and frustrations as my friends with fully functioning pancreases, there are certainly specific differences – and moments – when I think, “Wow, I wish I could handle this with a naturally working pancreas.”
For example, in the infant years, hypoglycemia sometimes hits fast during breastfeeding. In a sleep-deprived fog, I didn’t always have glucose within arm’s reach. More than once, I had to abruptly place my crying baby on the floor so I could treat a low safely. The guilt was heavy, having my baby cry on the floor while I took care of myself. Bath time brought similar moments – lifting a soapy, cold baby out of the tub because my blood sugar was dropping. Looking back, these were close to life-and-death safety decisions, but the mom guilt lingered. Now, I remind myself: “Self, grace.”
There were evenings I missed my son’s soccer games because I was simply exhausted or running late due to diabetes demands. To a 10-year-old, it’s hard to understand how a parent doesn’t “look sick” on the outside, but still can’t show up. In moments like these, I lean on a New Year’s resolution inspired by author Viktor Frankl: “There is a space between stimulus and response.” When blood sugars are high or low, that space of careful communication can shrink. Thus, my goal becomes to revisit the conversation later with my son, when we’re calm, and explain that diabetes does, in fact, stink, and that missing his game was never about a lack of care.
Then there are the countless times I’ve had to ask my children to wait for homework help because I finally reached a human being on the phone at the insurance company after an hour on hold. Do I hang up and start over tomorrow, or ask my son to wait? These are decisions that may not seem like a big deal, but to me, I have often had to choose the random stranger on the phone line (to get supplies I needed and the lack of time in the week to handle these calls) versus my kid asking for help.
The teenage years have been bringing curveballs that I also didn’t anticipate. When my daughter was 13, I started using inhaled insulin (Afrezza) to make mealtime insulin dosing easier and to have those stubborn highs come down faster when I want to quickly feel better for my kids. The first time she saw me use it, she blurted out, “Mom, are you vaping?” I was surprised. I hadn’t thought twice about it – inhaling in the kitchen or pre-explaining it to her. I was especially caught off guard since I had just spoken sternly to her about avoiding vaping at school. So, we had an open conversation about how, yes, insulin can now be inhaled and isn’t just the syringes or pump changes she was used to. I wasn’t prepared for that moment, but we navigated it together.
More recently, she got her learner’s driving permit. Like any parent, that brought anxiety, but with an added layer. There are times she really wants to practice driving, and I have to check my CGM trend arrows first. Even from the passenger seat, I need to be alert enough to guide her. This is one of those scenarios I know my friends without diabetes don’t ever have to think about.
Which brings me back to that plate of vodka pasta a few weeks ago during the college football championships. It was a rare evening when all three kids wanted to actually get along and cook together. They found a TikTok recipe for vodka sauce and asked to make it as a team. We ran to the store, gathered ingredients, and I watched, smiling, as they divided tasks in the kitchen. My daughter set the table and proudly called it “aesthetic.” She plated the pasta, so proud of herself and her little brothers, the sous chefs.
We sat down to eat. Meanwhile, my CGM read 160 mg/dL. I had pre-bolused, but I wanted to wait before taking my first bite. My daughter noticed. “Mom, aren’t you going to try it?”
I could see the disappointment flicker in their faces. So I made a choice to start eating, even as my blood sugar crept up. I stopped before finishing my plate, and she asked another time, “Do you not like it?”
At that moment, I had to decide: Do I explain pre-bolusing and delayed insulin action, or do I protect the great family kitchen moment? That night, I chose the latter. “It’s so good,” I said. “I’m saving the rest for half-time.” Was it the “right” choice? I’m still not sure, but I am also happy I protected the moment and didn't bring diabetes into the conversation.
There are, of course, times when diabetes must come first – especially in dangerous situations. Balancing the invisible with the unavoidable has taught me patience, empathy, and humility.
My intention in sharing these stories isn’t to dwell on the hard parts, but to validate them for all of us. Maybe you, as you are reading this, have had very similar experiences – I see you. Maybe you aren’t yet a mom, but are wondering what will come. Maybe you are older and have gone through way more than me, and could be a helpful mentor to others.
I hope my children are learning compassion and understanding through my difficult moments, and that their learned character traits will serve them well in their relationships and in life.
We often say YDMV (your diabetes may vary) when talking about choosing technology, carb counting, or insulin strategies. I’d add another layer: YDMGMY (your diabetes mental gymnastics may vary). Some families talk openly about every aspect of diabetes. Others keep it largely in the background. I fall somewhere in the middle. My youngest likes to check my CGM and report my numbers to me – he knows the range I like to be in. My kids know where the juice is when I need it. But I also make intentional choices about when diabetes becomes a family conversation and when it doesn’t.
I can’t anticipate what will come later in life, when the roles may reverse, and the child becomes their parents’ caregiver. I won't dwell on the future, but I will surround myself with people who can maybe provide advice. It's very inspiring to see peer groups pop up, like T1Dto100. I don't think any of us would have assumed, 30 years ago, living to 100 with type 1 diabetes.
These quiet, unassuming moments have taught me the most. Technology continues to improve, pregnancy outcomes continue to get safer, and parenting decisions will always be complex and unique with type 1. What makes the difference, and what has always made the difference for me, is reliable information and peer support. The recent technology and pregnancy consensus should be applauded. It will start people on a pregnancy path of being supported with the best knowledge about blood sugar management.
The rest we probably learn as we go. My advice? Find your people. Lean on them. Trust your instincts. And when the mental gymnastics feel overwhelming, remember to give yourself grace. Yes, pregnancy can seem scary, but there is so much hope today. For me, my kids have taught me more about myself than I ever expected, especially the quiet strength of patience as a person with type 1 diabetes – and that lesson alone feels like a profound gift.
As hard as parenting with type 1 is, I am reminded (as I am currently packing for a one-on-one special trip to Disney with my 7-year-old) that I have been able to travel many times alone and with my kids. Yes, I can feel annoyed with all of the worst-case scenarios, but because of the advances I’m grateful to have, I’m still packing the bags and will always dream big.
Read more inspiring stories about living with type 1 diabetes here: