Diabetes Deep Dives: What to Expect When Expecting…with Diabetes

0:00 [Music]0:03 hello and welcome to diabetes deep Dives0:06 my name is Candace and I'm from diabetes0:08 Canada if you are new to our video0:10 series thanks so much for joining us if0:12 you have been enjoying the series0:14 welcome back our diabetes deep Dives0:16 video series is designed to go beyond0:18 the surface of General diabetes0:20 information we hope to spark continued0:22 interest and learning and leave me with0:24 practical tips and tools that you can0:26 easily use subscribe to our YouTube0:29 channel and click on the notification0:30 Bell to be notified about new content0:33 you can also check us out on social0:34 media to find out when the next one will0:36 be posted to our YouTube channel thanks0:38 to those who have subscribed and0:40 supported our video series in this0:43 episode we will hear from Kimberly0:44 Hansen who is diagnosed with type 10:46 diabetes in 1997 Kim has two incredible0:50 Sons Owen and Hugo Kim and her family0:53 began working to fund research and bring0:55 financial support to others with type 10:57 diabetes in 30 plus years they have1:00 raised nearly $1 million for diabetes1:02 research currently Kim is the CEO of1:05 Health Partners before that Kim served1:08 for five years as executive director of1:10 advocacy for diabetes Canada Kim will1:13 walk us through her experiences of1:15 managing her diabetes while pregnant she1:17 will share what she learned about1:19 getting prepared navigating her healthc1:21 care team and medication needs during1:23 pregnancy and what to expect in the1:25 postpartum period She will share1:28 practical tips and resources for people1:30 who live with diabetes and are1:31 considering having a1:33 baby some of the content in this video1:35 may be difficult to hear and may trigger1:37 some intense emotions we encourage you1:39 to seek support and or stop the video If1:42 you find yourself reacting to the1:44 content in a distressing way we1:46 recognize that the content in this video1:48 may not be relevant for everyone and1:50 will depend on what your experience with1:52 diabetes is and what devices are1:54 available to you where you live if you1:57 have specific questions about diabetes1:59 management please reach out to your2:01 Healthcare team these videos are for2:04 educational purposes only the content2:06 discussed in this video is not intended2:08 to be medical advice and to the extent2:10 that medical advice is required you2:12 should consult with a medical2:14 professional the information discussed2:16 in this video cannot replace2:18 consultations with a qualified health2:20 care professional to meet your2:21 individual medical needs the views and2:24 opinions expressed in this video are2:26 those of the speakers and do not2:28 necessarily reflect the views or2:30 positions of diabetes Canada as always2:33 we hope that this video Sparks your2:34 interest in learning more about diabetes2:36 management and now over to our guest2:38 speaker2:40 Kim hi there I'm Kim Hansen and I'm here2:43 to talk to you about What to Expect When2:46 You're Expecting with2:50 diabetes I wanted to talk to you about2:52 some of the things that I've come to2:54 learn you can expect through my2:56 experience having a few pregnancies2:59 while living with diabetes so I think3:02 you can expect some raised eyebrows lots3:04 of questions that a head start really3:08 helps extra care so much insulin and3:13 probably squishy babies so let's dive3:18 in when I was diagnosed with type 13:21 diabetes in3:23 1997 the scariest thing I heard that day3:26 was that I might have trouble having3:28 children and and I remembered watching3:31 the movie Steel Magnolia in which Julia3:34 Robert's character who lives with type 13:37 diabetes ends up uh really struggling3:40 because of a pregnancy and ultimately3:43 dying I really want to stress that that3:48 is not the case for many people3:51 especially now and so it is very3:54 possible that you can safely have a baby3:57 even if you're living with diabetes4:01 before I became pregnant with my second4:03 child my GP my family doctor was really4:08 concerned she did not want me to have uh4:11 another baby especially after the age of4:14 35 and she was kind of scaring me with4:18 some of the warnings that she had about4:20 the risks that getting pregnant at a4:23 later age with diabetes would pose to me4:27 and my child and so I went and saw my4:30 endocrinologist and said you know I'd4:32 really like to have one more child um4:35 but I know that my doctor feels that4:37 it's getting really late what's your4:40 view and she said you know Kim I really4:44 I don't have to say I don't agree with4:46 your GP in this case uh in your4:49 particular case you know your A1C levels4:52 are pretty good your overall management4:55 of your diabetes is pretty good you're4:57 not experiencing any complications s i i5:00 fortunately don't have uh any kind of5:03 kidney disease or or Advanced eye5:06 problems and so she said I don't think5:09 that you're at any greater risk in terms5:11 of having a pregnancy at this age than5:14 another person that didn't have diabetes5:17 would be so I just want our viewers to5:20 know that there can be some5:23 misconceptions about the risk of being5:26 pregnant while living with diabetes and5:29 some of those are really well5:31 intentioned but they might be based on5:33 information that's out ofd diabetes5:37 management uh methods have changed5:40 dramatically in the last 20 25 years and5:44 by virtue of that many of us are able to5:46 keep our blood sugars in a healthier5:49 range much more of the time than folks5:52 40 or 50 years ago had the ability to do5:56 so just recognize that even if folks are5:59 are raising their eyebrows wondering6:01 whether it's safe for you to have a baby6:04 wondering if that's the right thing for6:06 you to do that they're not necessarily6:09 the experts and it's really uh up to you6:12 to talk to your health care team6:14 including your diabetes specialist and6:16 make an informed decision for6:18 [Music]6:19 you you can expect to get lots of6:22 questions you will become an expert in6:25 so much medical jargon during the time6:28 that you're preparing to become pregnant6:30 and going through your pregnancy your6:33 healthc care team is going to want to6:34 look at a lot of things uh in order to6:38 understand how your health is doing and6:40 how the baby's health is doing they're6:42 going to check your weight and your body6:45 mass index they're going to want to know6:48 what your blood glucose levels are and6:50 your A1C that thre Monon average of of6:54 uh those ratings they're especially6:56 going to want to look at time and range6:58 if you're already already living with7:00 diabetes and for a great explanation of7:03 what time and range is I would encourage7:05 you to watch the diabetes deep diet on7:08 time and range but basically it's a7:10 measure of how much of your day you're7:13 spending with your blood sugars in the7:15 target range that you set with your7:17 health care provider and it's an7:19 indication of um how well prepared you7:22 are to enter into a pregnancy with7:26 diabetes even if you don't start your7:28 pregnancy with Di diabetes uh but you7:31 find out along the way that you have7:33 gestational diabetes you'll be checked7:36 regularly for your blood pressure uh7:39 other7:40 medications people are going to want to7:41 check feet heart eyes kidneys to make7:45 sure that diabetes isn't doing any7:48 damage to any of those organs and7:50 they're going to want to know about your7:52 family history and your genetics so that7:54 they can get a full picture of your7:56 health and the baby's health and they7:58 can know what to watch watch for so8:00 don't be alarmed if you're getting lots8:03 of questions uh diabetes can be a an8:08 extra sort of layer of complication in a8:10 pregnancy but it's very possible to have8:13 a baby healthfully even with8:18 diabetes a head start really helps so if8:21 you are considering becoming pregnant um8:24 it's really a good idea to reach out to8:27 your healthc care provider before hand8:30 um especially if you're already living8:32 with diabetes when I was wanting to8:35 become pregnant I started seeing a8:38 specialist in uh pregnancy and diabetes8:42 three months before I became pregnant so8:44 that I could get uh confident that I was8:48 I was um having the healthiest uh8:52 Behavior patterns diet sleep exercise8:56 that I had good management of my blood8:59 sugars at that point that I had a good9:03 um insulin regime that we understood and9:06 and knew how we would adjust as we9:08 needed to Etc and so I would really9:11 encourage that everyone reach out and9:14 get some uh Medical Care before you9:17 become pregnant if at all possible um9:21 everybody even if you're starting and9:23 you don't have diabetes it's great when9:25 you can optimize your weight and those9:27 patterns that I was talking about eating9:29 sleeping exercise make sure to take a9:32 fol folic acid supplement and that your9:35 vaccines are up to date that'll really9:37 help you through the period of pregnancy9:41 if you have diabetes uh and are about to9:44 become pregnant it's probably a really9:46 good idea to start or continue if you9:49 already do wearing a continuous glucose9:52 monitor uh and and learn how to sort of9:55 do your best to get your blood sugars in9:57 range the most of the time possible for10:00 you and just get checked out head to10:04 toe I really spent a lot of time with my10:07 healthc care team during before during10:10 and after my pregnancies and and I'm10:13 extremely grateful for that because they10:15 helped me have two amazing Healthy10:20 Babies you'll get extra care and uh that10:25 sometimes can feel a little bit extra as10:28 they would say but it's a real blessing10:31 especially here in Canada that we can10:33 get the care that we need you can expect10:36 that you'll probably get an10:37 ultrasound uh if you've got diabetes and10:40 are pregnant before people that uh are10:44 are not living with diabetes usually do10:46 in their pregnancy they'll just want to10:48 check and make sure that the baby's10:49 doing okay and get a good Baseline to uh10:53 watch through your10:55 pregnancy if you are diagnosed with10:58 gestation diabetes Midway through your11:00 pregnancy you'll notice that they're11:02 going to start wanting to see you more11:05 you might wind up being referred for11:07 Specialist Care at some point during11:09 your pregnancy there are some amazing11:12 experts that know a lot about managing11:15 diabetes as well as managing pregnancy11:18 uh among those with diabetes and so11:21 that's not uncommon to get referred to a11:24 specialist team and it doesn't mean that11:26 there's anything necessarily wrong it's11:29 just sometimes it's just a11:31 precaution you can also expect that you11:35 you'll have a maybe a little bit of an11:37 atypical experience right after baby's11:40 born it is very very common for babies11:44 of mums with diabetes to be taken to the11:47 neonatal intensive care unit for11:49 observation for the first 24 hours of11:52 their life while baby adjusts to not11:56 being tied to Mom's blood sugar levels11:59 and that's um not an easy thing to watch12:02 your baby being carried away right after12:04 you welcom them into the world but it's12:06 the best thing for them and so don't be12:08 surprised if that happens it doesn't12:10 mean that there's anything necessarily12:12 wrong with your baby either so lots of12:15 care lots of appointments um and and uh12:19 and and I think that I felt pretty lucky12:21 for12:23 that so much insulin so I should say12:28 that if you don't start your pregnancy12:30 with diabetes and develop gestational12:33 diabetes you may not end up needing12:36 insulin during your pregnancy but a12:38 majority of people seem to and during12:42 pregnancy because our hormone levels12:44 change so much it is common for people12:48 to be taking maybe three times as much12:51 insulin every day as they did under the12:54 same circumstances at the beginning of a12:57 pregnancy when we're pregnant our13:00 placenta causes us to become way more13:03 insulin resistant than normal so for13:07 many of us that means that we just need13:09 way more insulin to handle the same food13:12 that we ate before we were pregnant for13:15 me I went went from taking about 3013:18 units a day before I was pregnant to13:20 taking a 100 units a day easily uh13:23 eating very much the same diet so uh13:26 don't be surprised if you find that13:28 you're taking13:29 way more insulin than normal or or if13:31 you have just gestational diabetes that13:33 you need to start taking insulin I found13:36 I wore an insulin pump um before and13:39 throughout my pregnancy and I got to the13:41 point that I was taking so much insulin13:43 each day I would uh take my Bolis13:46 insulin using a syringe and just use my13:50 pump to run my basil insulin um so if13:53 you find that you need more and more and13:55 more and more that's normal during a13:57 pregnancy and you will also notice that14:00 it falls off your insulin needs fall off14:03 really rapidly right after you deliver14:05 your baby and the placenta uh and so14:08 what you might find is that within 24 to14:11 48 hours your insulin needs go back to14:14 what they were before you were pregnant14:17 and so you have to if you're wearing an14:19 insulin pump really uh be watching and14:22 start adjusting your basil rates back14:25 down if they had been pushed up and your14:28 healthare team can give you good advice14:30 on how to do that and how to watch for14:32 it so that you're not experiencing a lot14:34 of hypoglycemia right after delivering14:37 your14:39 baby I think many of you would14:42 experience squishy babies and I say that14:45 because people that have diabetes during14:48 pregnancy are statistically a bit more14:50 likely to have heavier babies usually14:53 the babies come out a little chubbier14:55 because they've been getting extra sugar14:57 from the mum's blood in utero this is a15:01 picture of me and my sister so I'm the15:04 one in the blue shirt and my sister's15:07 holding my son Hugo who was born five15:11 weeks early weighing 11 pounds super15:14 squishy and he is sitting beside his15:17 cousin who I'm15:19 holding Jack my nephew is only three15:22 months younger than Hugo and yet you can15:24 see how different they are in size so15:28 It's Not Unusual for people with15:31 diabetes to have large babies it will15:34 also mean that you get watched more15:36 carefully can slightly increase the15:38 likelihood that you might need a15:40 cesarian section but it gives you lots15:42 of baby to squeeze and to15:44 love I talked a lot about what it's like15:47 to be pregnant with uh and and the baby15:51 and and maybe that they might need to uh15:54 go to the NICU after they're born but15:57 what can you expect as as a a new parent16:00 of a newborn baby newly delivered of a16:02 baby in terms of your16:04 diabetes what I found in addition to the16:07 changing insulin needs that you'll have16:10 um you'll find that you may need to eat16:13 more than you normally would uh in a16:16 non-pregnant State especially if you16:19 choose to breastfeed and that is always16:22 recommended where possible um I used to16:25 have to keep a a sandwich i' keep a half16:29 of a peanut butter sandwich and a glass16:30 of milk in my baby's room that I would16:33 eat while I would get up to breastfeed16:36 him in the night because I found it hard16:38 to keep my blood sugar up if I didn't16:41 have that bit of extra food in the16:43 middle of the night um you'll find that16:47 you if you do end up needing a C-section16:50 and you're living with diabetes might be16:53 a little slower to heal than some other16:55 folks so just make sure that your uh16:57 Healthcare te team's really helping you16:59 with managing the wound and that you've17:02 got lots of family support around you17:05 because every new parent diabetes or17:07 otherwise is tired and it's an emotional17:10 time but a really joy-filled time as17:14 well and then finally I think you can17:17 expect after going through diabetes and17:21 a pregnancy a lot of love this is my17:25 family who I feel incredibly blessed to17:27 have my son Owen is now 21 and my son17:31 Hugo is now 12 and they're both Miracles17:35 I will say that I did experience a few17:39 miscarriages which are common to all17:42 women and diabetes makes it a little bit17:45 more likely that we experience17:47 miscarriages so I'm extra grateful to17:50 have the two healthy boys that I do they17:53 both spent a significant amount of time17:56 in the NICU right after they were born17:58 they were both born with some troubles18:01 breathing and needed some extra care for18:04 a few days which was scary but they've18:08 gone on to be perfectly healthy and18:10 pretty amazing18:12 people as much as having a new baby can18:16 be a time of very joyous time for people18:20 can also be a time that's hard for18:22 people mentally and emotionally as well18:25 as physically it's not uncommon for for18:28 people to experience postpartum18:31 depression or anxiety and living with18:35 diabetes can make us a little bit more18:37 predisposed to some of those mental18:40 health challenges than uh than other18:43 folks so if you need extra help uh18:47 coping with life as a new parent or18:51 anything please reach out to your18:53 healthc care team to uh your you know18:56 local um18:58 Emergency Services distress lines Etc uh19:03 there's the website want to talk about19:05 it that you can reach out to to get19:08 support if you're struggling with any19:10 aspect of mental health uh in in terms19:14 of dealing with your new19:15 baby I would refer you to some great19:18 resources on the diabetes Canada website19:22 you can check out the clinical practice19:24 guideline on diabetes and pregnancy that19:27 has some great tips19:29 for people living with diabetes at19:32 guidelines.19:35 diabetes.com other great patient19:37 resources on Diabetes Canada's website19:53 [Music]19:57 diabetes.com in this exciting change in20:00 your life or your family's life I wish20:02 you all the20:03 best thank you so much for tuning into20:06 this very informative episode of20:07 diabetes deep Dives and thank you to Kim20:10 for sharing her20:11 experiences again this topic may not be20:14 relevant to everyone living with20:15 diabetes but we do hope that you found20:17 it interesting and learn something new20:20 please take the opportunity to keep the20:22 conversation going by posting a comment20:24 in the comment section on YouTube you20:26 can provide us feedback about the video20:28 by clicking on the link to the feedback20:30 survey in the description box if you20:32 have ideas for other topics you'd like20:34 to learn more about you can include that20:36 in the comments or feedback survey as20:38 well Kim mentioned resources that would20:41 support diabetes management during20:43 pregnancy in the YouTube description box20:45 below the video we have included links20:47 to the resources she mentioned for quick20:49 access to them for more information20:52 about diabetes management please visit20:54 our website at20:57 diabetes.com info@21:00 diabetes.com line at 1800 Banting that's21:04 121:05 18226 8464 and speak to one of our21:09 information and support Specialists who21:11 can address your needs thanks again for21:13 joining us and see you next21:19 time