Brisbane Meet - Type 1 diabetes & pregnancy - 13 Nov

[susan]

Following a brief hiatus, I am pleased to announce another event for the Type 1 Diabetes Network in Brisbane:

TYPE 1 DIABETES AND PREGNANCY – EVERYTHING YOU NEED TO KNOW
Pre-pregnancy – planning and preparation
Pregnancy – what to expect
Postnatal – now what!

SPEAKER:

Professor David McIntyre, MB BS FRACP MD

Professor McIntyre has been working in the field of endocrinology for over 30 years. As well as clinical practice, David has been involved in systems development in diabetes, endocrinology and medical disorders of pregnancy.

Professor McIntyre became a member of the Mater Medical Research Institute board in 2010 and is currently a member of the Executive Committee, International Association of Diabetes in Pregnancy Study Groups.

WHEN: Sunday 13 November 2011, 2-4pm
WHERE: Mater Clinical School Meeting Room, Mater Health Services, Raymond Terrace, South Brisbane
COST: Free. Catering will be provided.

Lucky door prize!!

TRANSPORT OPTIONS:
- Car park stations at the Mater.
- Busway at the Mater.
- South Bank train station is a ten minute walk along Stanley Street.

RSVP: susan@d1.org.au by Monday 7 November 2011

For more info and a venue map, click http://www.d1.org.au/images/seminar/Brisbane_2011_type1diabetesandpregnancy.pdf.


This event is brought to you by Medtronic and the Type 1 Diabetes Network.

[Helga]

Hi Susan
brilliant! I was coming across to let people know Diabetes Counselling Online http://www.diabetescounselling.com.au and Health Counselling http://www.healthcounsellingonline.org have begun a sister site for pregnancy and parenting in diabetes and this was the first thread I saw!! It is athttp://www.pregnancy-and-parenting-with-diabetes.org for men and women.

We are keen to make this relevant and complementary to medical and other resources so would love to know the kinds of information and gaps people would find useful?? Your members can email support@diabetescounselling.com.au with suggestions and/or post here. Have also started a FB group http://www.facebook.com/groups/172441816175706/

Am planning some special "pregnancy and diabetes pamper" days in Adelaide which will have a holistic feel with pampering day spa services for pregnant women with diabetes ( not just type 1, but type 2 and gestational) and also some small group sessions with myself as a social worker and diabetes educator and to develop links between the women - more will be posted at the websites above

Hope the day goes well in Brissie!
Cheers
helen
Helen Edwards
:-)

[Yasmahne]

Hi all

Here are my notes I took from Sunday's Meet. Thanks for organising

kind regards
Yasmahne


Type 1 Diabetes and Pregnancy – everything you need to know
Seminar Notes (as prepared by a volunteer seminar attendee!)

Prof David McIntyre

Pre-conception Care is so important.
There is nothing more motivating that a positive pregnancy test to get your bgl’s in check! - but given that most of the organ development in a developing baby occurs by 6-8 weeks – tighter control before falling pregnancy is ideally required.

The target Hba1c for pregnancy is 6% and below - as long as there is no major hypo risk/occurrences in the women.

Getting to that level can be a struggle and developing a plan with your health care team pre-conception is really important. This may include getting into some structured education like DAFNE, insulin pump therapy – at the extreme end certain women undertaking islet cell transplants to get bgl cobntrol.

Care During Pregnancy

Tertiary hospitals like Mater and where Prof McIntyre works out of deal a lot with Type 1 Diabetic pregnancies through the Diabetes clinic.

Most Type 1 Diabetic pregnancies are considered ‘high risk’

In terms of blood glucose control because most women adopt an intensive insulin therapy in pregnancy, this often results in more hypos. It has been report that 40% of pregnant Type 1’s have required at some point in their pregnancy assistance with treating / getting over a hypo.

There has been no evidence found from studies undertaken that hypos affect the developing bub – the fetus is buffered from this.

Typically in a Type 1 Pregnancy scans are offered at 13 weeks - transnuchal scan to check chromosome issues, 19 weeks – checks organs and heart, 24 weeks - further check of heart, 28 weeks for general growth and 36 weeks – growth.

There is no one particular test that monitors the fetal development – which is why frequent visits to your Obstetrician and Endo are usually offered.
Doppler blood flow is used in many of the scans to check on fetal development – especially for small babies and if the mother is experiencing high BP etc.

Delivery – on paper full term 40 weeks
38 weeks for complications and further “discounts’ of weeks from this for other medical and obstetric complications.

Post Natal
Once the delivery of placenta has taken place the mother’s insulin needs have “holiday’ for about 24-28 hours. Some women don’t need any insulin at all during that first 24 hours. The mother is monitored and once the bgl hits 10mml – insulin is administered and monitored – usually the mother returns to pre-pregnancy insulin levels.

Birth
A question was asked by a seminar attendee if most Type 1 mothers have caesars and Prof McIntyre commented that it is typically higher in this group. He shared that at his clinic 60% of births were via C-Section – versus the stats from Private Hospital being 30% and in the public system being 20%.

Prof McIntyre also commented that even in well controlled Type 1 mothers a ‘big baby’ can happen – there is something like a 50% chance.

Discussion by attendees went into the monitoring of the baby once born and hypo management. Some of the attendees shared that they had hand expressed and stored colostrum from 35 weeks to assist their bubs in the case of low blood sugar (depending how low the bsl is – if very low 1-2 hours after the birth likely they would put bub on a drip to bring the bsl up) and Prof McIntrye agreed colostrum is a good option and generally breastfeeding is encouraged.


Kim Dodwell
Shared experiences from her two pregnancies – gave some great insight into how she managed on MDI (she is now on a pump)

She experienced large increase in her insulin requirements early in her pregnancy and had complications of massive fluid gain. Kim shared that exercise of yoga and deep water running really helped her manage her pregnancy.

In the final trimester Kim was asked about her insulin requirements and shared that it has tripled from pre-pregnancy levels.

[Cassie_B]

Yasmahne, thanks for the notes!!