Anna Floreen, MSW, CDEDiabetesSisters Weekend for Women, Oct. 2017

Who We Are

T1D Exchange is driving better, faster research to improve care and speed development of new therapies for people and families living with type 1 diabetes.

{better} More informed research from the very

start, because our research starts and ends with the

patient community

{faster} Researchers have seamless access to

resources they need to conduct clinical studies

So why are we talking about pregnancy?

• Patient reported outcomes matter-and we don’t have enough of them!

Check out these crazy insulin requirements!

Our IRB survey: The highlights and need to knows

• 599 participants (Both online community Glu participants and Clinic Registry, data collected online from Feb-May, 2017.

• Criteria included

• having delivered a child within the last 10 years

• 18 yrs or older at conception

• have been previously diagnosed with type 1 diabetes prior to getting pregnant.

• 76% of women planned their pregnancies

• The average A1C at conception was 6.95%.

• 78% of women used insulin pumps

• 52% of women used a Continuous Glucose Monitor during pregnancy.

Outcomes to Note DON’T FREAK OUT!

• 28% developed preeclampsia during pregnancy. (national average is 2-4%)

• On average women delivered at gestational week 37.

• 65% of women had a C-section delivery. (national avg is 32%)

• 52% reported their child experienced neonatal hypoglycemia after birth.

• 41% of women reported their child was admitted to the NICU after birth.

• 22% of babies in this survey were born high birthweight, over 8lbs 8 oz, compared to 9% of the population overall.

If you have an a1c below 7% at conception-the data shows you are…

• More likely to deliver vaginally

• Less likely to have a child in the NICU

• Less likely to develop pre-eclampsia

• Less likely to deliver early

• Less likely to have a larger than avg. baby

• Less likely to have a child with a low blood sugar at birth

So now what? where do you start?

• Get a good team in place before you try…

• Ask every question under the sun

• Find some friends who been there done that…

• Get used to making your own changes to your diabetes

• Let it Goooo, let it goooo- a lot of pregnancy is out of our control

Things to expect

• A lot of appointments! (Like a lot)

• Eye dilations are key (once a trimester)

• You’ll pee in a cup at every visit to check protein

• Focus on the day to day blood sugars (CGM hello)!

• Not everything pregnancy related is because of diabetes-cue the cravings, acne, nausea etc

• Fetal echo to check on the heart around 22 weeks

• Once a month growth ultrasounds and twice a week ultrasounds starting around 32weeks

• You’ll likely be pregnant at least one less week than non type 1s! 39w is usually the max most doctors will let you go.

• SO much joy when you meet that little person-its worth all the stress and struggle!

Resources

• Kerri: www.sixuntilme.com

• Glu: www.myglu.org

• Ginger’s book: “Pregnancy with Type 1 Diabetes”

• Cheryl Alkon’s book: “Balancing Pregnancy with Pre-existing Diabetes”

• Social media groups?

• camps

• this conference!

• DO NOT GOOGLE!