Being pregnant can be stressful. There’s appointments, scans, and information overload. And for women with type 1 or type 2 diabetes, pregnancy can add stress to managing blood glucose levels and worry about risk of complications during pregnancy and/or birth. For these reasons, it’s important that women with pre-existing diabetes get the support they need before and during pregnancy. But what should that support look like?
Researchers at McMaster University in Canada asked three questions about women with pre-existing diabetes in pregnancy:
-
-
- What influences glucose levels?
- What are the experiences and diabetes self-management support needs?
- How do self-management and support experiences affect glucose levels?
-
Data were gathered in two ways. First, they ran a survey of 111 pregnant women: 55 with type 1 and 56 with type 2 diabetes. Data were collected at three time points during pregnancy. The surveys asked about self-care behaviours, and satisfaction with medical care. Data on average glucose levels (HbA1c) were collected from the women and from their medical records.
In a second study, the researchers interviewed a different group of 12 women: 6 with type 1 and 6 with type 2 diabetes. They were asked to talk about their experiences of managing diabetes and their support needs during pregnancy.
Most of the women were confident in managing their diabetes and had a HbA1c “on target”. This meant that the researchers couldn’t answer research questions #1 and #3 (listed above). Instead, they focused on research question #2 – what are the experiences and diabetes self-management support needs of women with pre-existing diabetes during pregnancy?
The women described their experience of managing diabetes during pregnancy as “terrifying”, “isolating”, and “mentally exhausting”. They feared diabetes-related health issues for their baby. This took a toll on the women’s mental health.
Even though most of the women were confident in managing their diabetes – and had glucose levels within recommended target range – they still mentioned several unmet needs. These included a lack of personalised healthcare and mental health support, and a desire for peer support from other women with experience of diabetes during pregnancy. The women also felt they would like more personal control over how their diabetes would be managed when the time came for labour and delivery.
All research studies have limitations. Both the survey and the qualitative study had relatively small sample sizes, and the researchers didn’t make known the age, socioeconomic status, and ethnicity of the women who were involved. Together, this means the findings may not be transferable or representative of other groups of women during pregnancy.
That being said, the researchers suggest their findings are important for clinical practice, research, and policy in several ways. Research needs to:
-
-
- Look deeper into the emotional and mental health of women with pre-existing diabetes during pregnancy
- Develop interventions to improve mental health during pregnancy
- Inform healthcare policies, e.g. in relation to the use of insulin pumps to support diabetes self-management during labour.
-
For more information, check out our other blogs on this topic here. You can also visit the following pages on the NDSS website:
___________________________________________________________
Reference:
Sushko K, Strachan P, Butt M, Nerenberg K, Sherifali D. Supporting self-management in women with pre-existing diabetes in pregnancy: a mixed-methods sequential comparative case study. BMC Nurs. 2024 Jan 2;23(1):1. doi: 10.1186/s12912-023-01659-1.
Note: There is a print link embedded within this post, please visit this post to print it.