When you are planning a pregnancy, there are many things you have to consider. You stop drinking alcohol, you take vitamins, you make sure you are as fit and healthy as you can be.
But when you are diabetic, the planning required is just like preparing your body for a race. Athlete Melanie Stephenson-Gray welcomed her baby girl in 2021 and described it as the "most rewarding but hardest thing" she has ever done.
The Cardiff born athlete was diagnosed with diabetes when she was 13-years-old. She said she had all the typical symptoms of the condition: "I was getting up through the night to go for a wee, I was incredibly tired, so much so that I wasn't able to go to school. I had lost about two stone in weight and I was just really thirsty as well. But it isn't really something we considered, just because we didn't realise how much diabetes we had in the family at the time.
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"We saw the doctor, because I was so fatigued more than anything, and we got a phone call shortly after to say get straight to the hospital and I was diagnosed that same day. It was a shock. I felt a lot better when I was started on the insulin injections and knew what was going on, but it is a big upheaval for you and your family."
"It was a lot. I remember that. It took a little while, like after I got out to hospital, the diabetes nurses came to my house the next day and explained to me about carbohydrates and hot to do my injections, do my finger pricks. And obviously, as a teenager, you just want to be like everybody else, you know, there's a lot of moments growing up where you kind of wonder, well, how did this happen to me, why me?"
Melanie quickly learnt how to manage her diabetes and by the time she was 16 she started to compete in athletics professionally. The 34-year-old said: "Before there was a focus on what my body couldn't do anymore, then starting to do sport and enjoying it was like something that I could do."
When discussing what it was like as an athlete with type 1 diabetes, Melanie said it took a lot more preparation for her to compete than it would those without the condition. She has to make sure her blood sugar is in the right place and constantly monitored her nutrition.
She said: "But at the same time, there's not many athletes that can say they know that kind of detail what is going on in their body, so I tried not letting it be a negative thing as I was growing up. When I was starting off I didn't know any other athletes who have type one. But now there's quite a few different people that have diabetes."
She urged young people with type 1 not to let the condition interfere with following a career in sport, or anything. She said: "The other huge thing is that in the last 20 years, technology, and the support, we've got to manage our diabetes on a daily basis, has completely been revolutionised. Whereas I used to do finger prick tests all the time, now I wear a glucose sensor that can tell me on my phone or on my insulin pump, what's going on. I don't do injections anymore, I wear an insulin pump instead. Those advances make it a lot easier to do the things that you enjoy."
Melanie said she had to apply the same preparation to planning a pregnancy as she did for competing in a race. She said: "You have to plan in advance when you're going to have a baby with diabetes as much as you can because the outcomes are better if your blood glucose levels long term is in the right place.
"So it took quite a while to get everything ready in that respect. I was preparing with my diabetes team. How you manage your diabetes when you are pregnant becomes even stricter.
"During pregnancy women struggle with insulin resistance, so you have that on top of your type 1 diabetes. So your insulin needs change and you are having to really rely on the diabetes technology to see what's going on in real time.
"So that was a real challenge. I think that's the first time I felt really frustrated with my diabetes because I just wanted to have a regular pregnancy. There's no cure for diabetes, it is just doing your best to manage it. And thankfully, it all worked out and we had a healthy baby girl and I'm really grateful."
Melanie added that it was a challenge to manage her diabetes when her baby arrived due to the sleepless nights and trying to breastfeed. She said she was trying to control her diabetes while trying to meet her energy demands for keeping up with breastfeeding as well as monitoring it through the night. She said she was so grateful to have the support of her husband through it all.
"It is quite a lot to think about. But it is absolutely worth it, I don't, you know, I don't regret a minute of." She advises anyone else living with type 1 diabetes and wanting to get pregnant to reach out to your diabetes team for support and guidance.
Melanie is taking part in the Blue Balloon Challenge in an attempt to raise as much money as possible for Life for a Child. Life for a Child is a non-profit organisation dedicated to providing life-saving insulin and basic medical devices to children with diabetes in developing countries.
The BlueBalloonChallenge kicked off last month and will run until the end of November, National Diabetes Month. Organised by Medtronic, the challenge invites members of the public to step into the shoes of those who live with diabetes by posting a photo or film themselves as they try to keep a balloon in the air - a metaphor for the constant balancing act required to manage diabetes. For every post Medtronic will donate €5 to Life for a Child .
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