What is known about the mental health of women with type 1 diabetes during and after pregnancy?

What is known about the mental health of women with type 1 diabetes during and after pregnancy?

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Research from the Australian ENDIA study explores stress and depressive symptoms during and after pregnancy in women with and without type 1 diabetes

By Jennifer Halliday

International Women’s Day takes place on 8th March. So, it is timely to reflect on the mental health of women with diabetes.

New Australian research has studied the mental health of pregnant women with and without type 1 diabetes. The research is part of the ENDIA study, which follows women from pregnancy to birth. ENDIA stands for Environmental Determinants of Islet Autoimmunity. In this study, the unborn children all have a close relative with type 1 diabetes – this might be the mother, the father, or a sibling. More than 700 women have taken part in the study.

The study compared the women on three key issues:

      • Mental health among those with and without type 1 diabetes. It found no differences between levels of stress or depressive symptoms in the two groups.
      • Mental health of women during their 3rd trimester of pregnancy (7-9 months) and after birth. It found women in the final 3 months of pregnancy had slightly higher levels of depressive symptoms than women who had given birth. About 10% of the women had high levels of depressive symptoms at one or both timepoints.
      • Relationship between mental health and glucose levels (HbA1c) of pregnant women with type 1 diabetes during their 3rd HbA1c was not related to stress or depressive symptoms.

The study did not look at diabetes-specific emotional problems, such as diabetes distress. Other studies have found women with type 1 diabetes are strongly motivated to maintain ‘in-target’ glucose levels during pregnancy. They may check their glucose levels more often, adding to the burden of managing diabetes. They may also feel a ‘loss of control’ of their own body. They may feel guilt and worry about the health of their unborn baby. After birth, they may worry about high and low glucose levels, bonding with the baby, and coping with motherhood.

Women with type 1 diabetes need ongoing support from their social networks (e.g. partner, family, friends) and health professionals during and after pregnancy. Recognition of their unique challenges and experiences is important for person-centred healthcare. Pre-pregnancy planning and care is also important for women with diabetes. You can read more about this in our previous blog.

M Hall, H Oakey, MAS Penno, K McGorm, AJ Anderson, P Ashwood, PG Colman, ME Craig, EA Davis, M Harris, LC Harrison, A Haynes, C Morbey, RO Sinnott, G Soldatos, PJ Vuillermin, JM Wentworth, RL Thomson, JJ Couper; on behalf of the ENDIA Study Group. Mental health during late pregnancy and postpartum in mothers with and without type 1 diabetes: The ENDIA Study. Diabetes Care 2022; dc212335. DOI: 10.2337/dc21-2335

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