One woman’s journey to planning a baby

Planning

KK (who doesn’t want to be identified) lives with type 1 diabetes and wants to have a baby. Who should she talk to?

“I went to see my doctor and diabetes educator. They wanted me to aim for an HbA1c of 7% (53mmol/L),” she said.

To reduce the risk of complications for baby, an HbA1c of less than 6.5% (48mmol/mol) is recommended; however, everyone’s situation is different and hypos need to be considered with type 1 diabetes.

KK understood reducing her HbA1c would be challenging. She had to continue working, look after her family, manage her fear of hypos and complete the pregnancy planning checklist.

Continuous glucose monitoring

KK also knew that a continuous glucose monitoring (CGM) device would help.

“I’d used some of the continuous glucose monitors before but the cost made it difficult” to continue using, she said.

When the NDSS subsidy for women planning a pregnancy started in March last year, KK had her CGM within three weeks. For her, it was “a game changer”.

“With the CGM I chose, I was not only linked in with my health care team but also my husband (PK) and family too. One day PK came home from work and understood why I was on the couch … without having to ask! It just filled in the gaps for him.”

KK felt that the CGM made it easier for others to start a conversation about her diabetes with less judgment. It also helped with her hypo anxiety.

Hypo anxiety

“The fear of hypos never goes away but the CGM is a very helpful tool. It gave me confidence in what I was feeling,” she said.

“It gave me information that was reassuring, especially before going to bed or starting exercise.”

For KK, exercise was part of the plan for a healthy baby. Research shows that being overweight or underweight before and during pregnancy can increase the risk of complications for her and her baby.

Limitations

It’s important to remember that CGM has its limits and users need to be aware of those limits. KK understood this only too well.

“You have to remember that the CGM cannot do all the thinking for you. You have to remember about lag time and to do blood finger prick tests.

“One day I felt I was low but my CGM was reading 4.8mmol when I was actually 3.1mmol.”

This lag time is between 5 to 7 minutes behind blood glucose readings because CGM is checking glucose levels from fluid in between the cells.

KK also knew that CGM products have a shelf life and that there is a limit to the supply she could access.

She recommends being prepared.

“One day the sensor just stopped working; there was no reason for it. I had to wait a week for a replacement.”

KK has reached her goal of an HbA1c of 7%, after months of hard work with her diabetes team.  Also, completing the pregnancy planning checklist helped her achieve all of her pre-conception goals.

Now for a baby!

 

Resources:

NICE Guidelines: https://www.nice.org.uk/guidance/ng3/chapter/1-Recommendations#preconception-planning-and-care-2

NDSS pregnancy planning checklist:

To access our psychologist, ring 1300 136 588.

NDSS subsidy: NDSS Helpline on 1300 136 588, Product Access Point: http://ndss.com.au

 

By Amanda Callaghan, RN and Credentialled Diabetes Educator

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