At least for me, being diabetic and pregnant meant staying on an ever-present schedule, with little spontaneity. Every moment was either a time to monitor my diabetes, an occasion to record the results of the routine, or an opportunity to feel guilty for doing neither.

I met with a perinatologist, an obstetrician who specializes in high-risk pregnancies, even before conceiving. He ordered a battery of tests to determine if I were healthy enough to support a pregnancy and then helped me improve my blood glucose control. It is important for a pregnant diabetic to keep her blood sugar levels as close to normal as possible, since high glucose levels in the mother can contribute to serious health problems for the baby, even before the woman realizes she is pregnant.

Under the perinatologist’s guidance, I worked for almost two years to lower my average blood sugar level. I faxed him my glucose tests weekly and, in turn, he suggested adjustments in insulin dose and timing. He was eventually satisfied with my diabetic control and gave me the green light to try to conceive. I was delighted to be pregnant within a month.

Then it was up to me to continue the routine I had developed over the long period of preparation. Each day I ran 10 to 15 blood glucose tests to detect any high or low blood sugar levels promptly and gave myself five to eight insulin injections in response to those readings.

This regimen continued around-the-clock. At night I set my alarm to ring at 3 a.m., so I could test my blood sugar, once again. If my glucose level was high (hyperglycemia), I gave myself supplemental insulin. If it was low (hypoglycemia), I drank milk. Much of the time I felt awful, but it was hard to discriminate between just being pregnant or actually having hypoglycemia, so I ran blood tests frequently to determine the culprit.

Living out this daily routine was more of an extravaganza than either my husband or I had expected, but we tried to keep a sense of humor throughout the nine months. The larger I got, the more I complained, and I was especially loud and grumbly at night. Eventually, I moved to a downstairs bedroom where my husband had installed a baby monitor. This way he could hear me shout if I had an emergency, but he also had the option of turning down the volume on my moans and groans.

There was a sudden change of plans at 37 weeks. By then, I was only able to sleep comfortably for 20 to 30 minutes each night, and my blood pressure was beginning to rise. The perinatologist thought it was time to induce labor, and I seconded the motion.

Thirty-six hours and one emergency Caesarean section later, our daughter was born. She was a 9-pound 10-ounce bundle of determination. My feelings of pride and satisfaction — not to mention exhaustion — had never been greater.

While I felt especially courageous to be a diabetic giving birth to a baby, I realize now that my pregnancy required the same of me that it requires in any woman, diabetic or not. Vigilance and discipline? Yes. Discomfort and loss of sleep? Surely. Joy tempered by worry? Of course. Perhaps I needed to develop these attributes a little earlier than some pregnant women do, but the qualities themselves are not unique to a woman who is diabetic.

It turns out to be fairly easy to describe the difficulties of a diabetic pregnancy but much harder to convey the sense of fulfillment in having a child. My daughter’s birth has deepened the meaning of “challenge” for me and has amplified the meaning of “joy.”

My naivete was a blessing, as it is unlikely I would have chosen to get pregnant had I really understood the complexities of my carrying a baby. In exchange for a pregnancy full of routine, I plowed ahead and delivered a little girl who has reintroduced spontaneity, gusto and pizzazz into my life.