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Case Study Discussion

Dietary Advice to Support Glycaemic Control and Weight Management in Women with Type 1 

Diabetes during Pregnancy and Breastfeeding 

Ringholm. L (2022), https://doi.org/10.3390/nu14224867 https://www.mdpi.com/2072-6643/14/22/4867  

It is important to maintain glycaemic control as close to normal as possible (HbA1c <53mmol/l.) 

It is recommended to inform individuals with Type 1 Diabetes planning a pregnancy how to count 

carbohydrates, manage weight., blood glucose monitoring and individual insulin adjustment.   

 

Assessment of the effect of pregnancy planning in women with type 1 diabetes treated by insulin 

pump 

Mourou. L (2021) https://eds.p.ebscohost.com/eds/pdfviewer/pdfviewer?vid=12&sid=4a5825cd-fa34-429e-b2c0-f7c866eac644%40redis  

It suggests that individuals using advanced mode of insulin delivery still benefit from preconception 

counselling in this study it involved glucose control optimisation, folic acid supplements and 

suspension of potentially teratogenic medications at least 6 months before deciding to be pregnant.  

Unplanned pregnancy received the same counselling once they found out they were pregnant.  

The study results suggest that HbA1c was lower in planned pregnancy compared to unplanned 

pregnancy during pre-conception and all trimesters.  

Results also suggested planned pregnancy/ lower HbA1c concentration reduced risk of iatrogenic 

preterm delivery. 

 

Hyperglycemia in Pregnancy and Women's Health in the 21st Century 

McIntyre. HD (2022), https://eds.p.ebscohost.com/eds/detail/detail?vid=12&sid=51363a12-

26b1-4249-9f55-242bed6f7406%40redis&bdata=

JnNpdGU9ZWRzLWxpdmUmc2NvcGU9c2l0ZQ%3d%3d#AN=36554709&db=mdc 

Research suggests that elevated HbA1c pre pregnancy is associated with poor glycaemic control 

during pregnancy.  

As well as very poor glycaemic control pre pregnancy was associated with shorter pregnancy and low 

birth weight, this may be due to difficulty developing well-functioning placement not being.  

Other studies suggested for individuals with T1D using continuous glucose monitoring improved 

HbA1c during pregnancy compared to capillary glucose monitoring. 

 

Dietary Advice to Support Glycaemic Control and Weight Management in Women with Type 1 

Diabetes during Pregnancy and Breastfeeding

Ringholm. L (2022), https://doi.org/10.3390/nu14224867 https://www.mdpi.com/2072-6643/14/22/4867 

Glycaemic control should be as close to normal as possible (ADA recommendation) ideally HbA1c 

<48mmol in early pregnancy this reduces risk of congenital abnormalities.  

For the rest of the pregnancy is recommended HbA1c < 42 mmol as shown to reduce risk of 

preeclampsia, preterm delivery, and foetal overgrowth.  

ADA suggests the following blood glucose levels fasting 3.95.3 mmol, one- hour post prandial levels 

6.1-7.8mmol/L and two hour post prandial levels 5.6-6.7 mmol/L.  

 

Carbohydrate quantity is more closely associated with glycaemic control than weight in pregnant 

women with type 1 diabetes: Insights from the Diabetes and Pre-eclampsia Intervention Trial 

(DAPIT)

Hill. A (2022) https://doi-org.ezproxy-b.deakin.edu.au/10.1111/jhn.13042,

https://onlinelibrary-wiley-com.ezproxy-b.deakin.edu.au/doi/full/10.1111/jhn.13042 

In this study 63% of women were overweight or obese and 70% gained above the recommended 

(institute of medicine) gestational weight gain. The study suggests that there was no association 

between BMI or gestational weight gain and glycaemic control.  

The findings suggested that quantity and type of carbohydrate has a greater association on impact on 

glycaemic control than weight.  

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