Pregnancy and type 1 diabetes

[HOBIE]

I am a midwifery student and have a presentation on pregnancy and type 1 diabetes I'm talking about normalising and a sense of coherence. I was wondering if you could tell me yours views on how we as midwives could make things more "normal" and make you enjoy and feel better during and afte pregnancy and birth. Any good or bad stories you would like to share and you don't mind me sharing with my peers anonymously would be great X

Good luck with things. Its a stressful time for everyone. 🙂

 

[Autumn]

Good luck with things. Its a stressful time for everyone. 🙂

Thank u Xx

 

[grainger]

Thank you for your reply this is really interesting and a debate we have had !!! Some trusts monitor mums blood sugars postnatally where others allow mum to. The majority opinion was that allowing mum to continue her own etc was best so it didn't seem like it was not sure how to word it but basically so it wasn't a case of whilst your here we don't think you can do it but then you go home and are expected to do it. Does that make sense your thoughts would be greatly appreciated.continuity is one thing which is always brought up and I know each trust works differently could u not have asked when the same midwife was on again so she could come out to see you ? Its good to hear you was treated as normal and had some good experience other than the consultant xx thank u so much for taking the time to reply I can't wait to discuss this with my peers if you are ok with me doing so ?

I completely agree that in most cases that allowing the mum to be in control herself is absolutely the right idea. For me personally though it would have been nice to feel a little more supported simply something like maybe a couple of conversations about levels etc/correcting doses etc. I hadn't slept in quite a while, been through major surgery and had a newborn (my first!) - I think if there's ever a time when the more support given the better this would be one! Would also be nice if the first follow up visit at home could include a conversation about how's your diabetes going - but I know that's asking a lot and a huge amount of additional knowledge would be required (because you'd have to include any chronic condition not just diabetes really to be fair!)

Absolutely fine with you discussing anything I've said on here. Hope it helps. If you need anymore info just let me know.

 

[Autumn]

I completely agree that in most cases that allowing the mum to be in control herself is absolutely the right idea. For me personally though it would have been nice to feel a little more supported simply something like maybe a couple of conversations about levels etc/correcting doses etc. I hadn't slept in quite a while, been through major surgery and had a newborn (my first!) - I think if there's ever a time when the more support given the better this would be one! Would also be nice if the first follow up visit at home could include a conversation about how's your diabetes going - but I know that's asking a lot and a huge amount of additional knowledge would be required (because you'd have to include any chronic condition not just diabetes really to be fair!)

Absolutely fine with you discussing anything I've said on here. Hope it helps. If you need anymore info just let me know.

Thank you so much for all your information xx

 

[Autumn]

Hi its me again can i ask anyone what thoughts/concerns did you have extra whilst you was pregnant ?

 

[trophywench]

Autumn - have you seen the newly published report on Diabetes care whilst planning or being pregnant? It's the 2013 results they have based it on, its the one in Summaries billed as 'Pregnancy Care for Women with Diabetes'

See https://www.diabetes.org.uk/Professionals/Service-improvement/National-Diabetes-Audit/NDA-reports/

It contains all sorts of useful info like the incidence of planned or emergency Caesarians, what general effects higher HbA1cs have, etc.

One piece of info that caught my eye, was the fact that for ALL diabetic women of child-bearing age, ALL general diabetes appointments should include info on pre-conception and pregnancy. Apparently T1 patients get the right advice more often and quicker than do T2s, since they are much more likely to do all the right things/see the right people earlier. This doesn't surprise me at all because T1s are much more likely to be seen in hospital diabetes clinics than the vast majority of T2 people of either gender. So - bearing in mind the paucity of brilliant GP care for T2 in the first place - these are definitely things that ALL GPs, their surgery nurses and ALL pregnancy practitioners at surgeries and in hospital need to be aware of so that they are able to ensure that patients have access to the right people at the right time.

I'd be interested to know whether forum ladies of child bearing age DO get that advice at general diabetes appointments, wherever they take place, in the first place?

 

[Autumn]

Autumn - have you seen the newly published report on Diabetes care whilst planning or being pregnant? It's the 2013 results they have based it on, its the one in Summaries billed as 'Pregnancy Care for Women with Diabetes'

See https://www.diabetes.org.uk/Professionals/Service-improvement/National-Diabetes-Audit/NDA-reports/

It contains all sorts of useful info like the incidence of planned or emergency Caesarians, what general effects higher HbA1cs have, etc.

One piece of info that caught my eye, was the fact that for ALL diabetic women of child-bearing age, ALL general diabetes appointments should include info on pre-conception and pregnancy. Apparently T1 patients get the right advice more often and quicker than do T2s, since they are much more likely to do all the right things/see the right people earlier. This doesn't surprise me at all because T1s are much more likely to be seen in hospital diabetes clinics than the vast majority of T2 people of either gender. So - bearing in mind the paucity of brilliant GP care for T2 in the first place - these are definitely things that ALL GPs, their surgery nurses and ALL pregnancy practitioners at surgeries and in hospital need to be aware of so that they are able to ensure that patients have access to the right people at the right time.

I'd be interested to know whether forum ladies of child bearing age DO get that advice at general diabetes appointments, wherever they take place, in the first place?

Thank you for sharing that document I hadn't seen that one I'm gng to share it with my cohort it looks a really interesting read and there is loads of information I can use. I'm going to print it tomorrow always easier reading on paper. You also raise some good questions part of our presentation is to find out this information.

Many thanks

 

[trophywench]

Worth a read of the actual audit for you too, to see how your area score! - whether, and where you need to improve !

I hadn't realised that they aren't quite as strict about BGs now as they were even a short time ago. have to admit I'm not always fully au fait with all the preg stuff - difficult to absorb it all when it doesn't apply personally! LOL