Improving the chances for healthy pregnancies
By Susanne Martin, Managing Editor
When Erin Johnstone heard about a study testing the benefits of continuous glucose monitoring technology in pregnancy, she eagerly signed up. The 29-year-old Calgary mother with type 1 diabetes said she had two reasons for wanting to participate – to advance diabetes research and to carefully monitor her blood sugar levels during her third pregnancy.
Both Erin and her husband Chris live with type 1 diabetes (T1D), an autoimmune disease that makes them insulin-dependent for life. From the time of her diagnosis in 2003 until her participation in the study, Erin managed her diabetes with regular “finger pricks to test her blood sugar levels” and insulin injections.
“The CGM system includes a sensor on your body that gives you a reading every five minutes. It also alerts you when your levels are trending up or down, so you know when you need to eat something or take insulin.”
Erin Johnstone is living with with type 1 diabetes
“I always try to know what my blood sugar level is – I’m very careful that way,” Erin explains, adding that she typically tested a minimum of six times a day, before meals and bedtime, as well as when she felt her levels might be out of balance. Erin adds she has an easier time getting a good A1C – a measure of the body’s blood glucose levels – compared to other people with T1D like her husband, for example, since her pancreas produces a very small amount of insulin.
Keeping an eye on her blood sugar levels became even more important during her pregnancies since poor glycemic control can result in a number of serious complications, says Erin. Expectant mothers with T1D have a higher incidence of elevated blood pressure and preterm births, while their babies are at increased risk for congenital malformations and neonatal care unit admissions. Since the babies can be significantly larger than average, delivery complications are also more common.
While Erin diligently checked her blood sugar levels when she was pregnant with both her son Ewan (4) and her daughter Eilidh (2), the birth of her second child proved more challenging.
Eilidh’s birth weight of nine pounds, five ounces made the delivery difficult. “At one point, the doctor asked one of the nurses to start counting because the baby had gotten stuck for so long they were getting worried,” says Erin, who believes this wouldn’t have happened if she “hadn’t been diabetic or had better glycemic control during that pregnancy.”
Luckily, Eiledh suffered no permanent damage. But when Erin got pregnant with her youngest daughter Peyten (now four months old), she aimed for better control and signed up for the JDRF Canadian Clinical Trial Network’s (JDRF CCTN) Continuous Glucose Monitoring in Women with Type 1 Diabetes in Pregnancy Trial (CONCEPTT).
As part of the study, Erin was assigned to wear a CGM device and found it made monitoring her blood glucose levels easier. “The CGM system includes a sensor on your body that gives you a reading every five minutes. It also alerts you when your levels are trending up or down, so you know when you need to eat something or take insulin,” she says.
Another benefit included tracking blood glucose levels while she was sleeping, says Erin. “Overnight blood sugars can greatly affect the size of the baby. Without the sensor, you don’t know what your levels are unless you wake up to check. Having the sensor, I was able to monitor my blood sugars during the night and adjust my insulin,” she says, adding that an alarm when blood glucose levels go dangerously low at night can save lives.
Erin partly attributes Peyten’s healthy birth weight of seven pounds, six ounces to the added glycemic control the CGM system offered. And even though her participation in the trial has ended, Erin continues using the technology since “the information it provides makes controlling blood sugar levels a lot easier.
“And because of the study, my husband also started using a CGM device,” says Erin. “It used to be quite challenging for him to control his blood sugar but his A1C has improved dramatically since he started wearing the sensor.”
JDRF is the leading global organization focused on type 1 diabetes (T1D) research and the largest charitable funder and advocate for T1D research with the mission to find a cure for diabetes and its complications.
Driven by passionate, grassroots volunteers, JDRF is committed to improving the lives of people affected by T1D by accelerating progress on the most promising opportunities for curing, better treating and preventing the disease. JDRF continuously strives to help people at all ages and all stages of T1D live better, longer, healthier lives.
Through local chapters, international affiliates, volunteers, staff and corporate partnerships in over 100 locations worldwide, JDRF offers a diverse support network, outreach programs, advocacy initiatives and innovative fundraising programs.
See www.JDRF.ca for more.