Dietary considerations in T1DM pregnancies. Presented by Sally Marchini, APD
Hormonal changes during pregnancy cause alterations in blood glucose metabolism which can be challenging for women with type 1 diabetes. In Sally’s presentation she describes the effect of these hormonal changes during the stages of pregnancy. A summary of these are:
1st Trimester
- From conception to 3-4 weeks – a little more IR is noticed
- Through to 6-8 weeks – more sensitivity is noticed
- Through to 14 weeks there’s a severe risk of hypoglycaemia
2nd Trimester
- Insulin resistance begins to develop, and hypo risk becomes lower
- Adjust targets to be met by the end of the insulin profile times
3rd Trimester
- Insulin resistance worsens
- Encourage pre-meal insulin 40-45 minutes before eating
- Planning for hypos on birth day and what will happen with breastfeeding
- Infant likely to go to NICU, therefore activity + no food on top of vast changes in insulin requirements + delays in lactogenesis
Post-birth
- During breastfeeding insulin requirements are markedly lower than before and during pregnancy.
- Higher risk of mastitis - see lactation consultant
- Appropriate quantity and quality of CHO intake and good glycaemic control
- Particular attention should be directed to hypo prevention (In the setting of breastfeeding and erratic sleep and eating schedules)
Sally Marchini, APD is personally experienced with type 1 diabetes and coeliac disease. This gives her a unique perspective in her presentation on women with T1DM who are pregnant. She provides an empathetic, practical and evidence-based approach.
To register for the presentation and associated documents including the assessment quiz click here