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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


  • 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.

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