Mumbai doctor helps pregnant woman with Type 1 diabetes mellitus deliver healthy baby with the help of advanced technology

For Kainaz Wadia, who was managing her T1DM with insulin, achieving optimal control is even more critical during pregnancy. Photo Courtesy: Special Arrangement

In a perfect Mother's Day gift, Mumbai-based Dr Rajiv Kovil helped deliver the baby of a mother with Type 1 diabetes mellitus (T1DM) with the help of a complex procedure.

Type 1 diabetes mellitus (T1DM) is a chronic condition characterised by the body's inability to produce insulin. This necessitates external insulin administration to regulate blood sugar levels. For Kainaz Wadia, who was managing her T1DM with insulin, achieving optimal control is even more critical during pregnancy. She was instructed that the insulin may not be able to give her the kind of control required for a type 1 pregnancy, as her HbA1c and post-prandial sugars were slightly high.

During pregnancy, the demand for insulin often increases due to hormonal changes, making tight glucose control paramount for the health of both mother and baby. High blood sugar levels can lead to complications such as macrosomia (large birth weight), neonatal hypoglycemia (low blood sugar levels in newborns), and pre-eclampsia (High Blood Pressure with Proteinuria). She was treated by Dr Kovil, who is a diabetologist, head and co founder, Zandra Healthcare and Rang De Neela Initiative.

Kainaz's journey exemplifies the intersection of technology and determination in managing T1DM during pregnancy. While acknowledging the effectiveness of conventional insulin treatment, she embraced technology to optimize her diabetes management. She chose to utilise a high-end insulin pump (sensor augmented insulin ).

But what exactly does an sensor augmented insulin pump entail? An insulin pump is a small, computerised device that mimics the function of a healthy pancreas by continuously delivering insulin through a catheter placed under the skin. This technology offers precise insulin dosing, flexibility in timing and dosing adjustments, and the ability to tailor insulin delivery to individual needs.

Sensor augmented insulin pump automatically adjusts insulin delivery to your needs for an easier way to stabilise glucose levels. It features an advance level of automation for diabetes management, known as SmartGuard technology. If glucose levels are trending high, it gives more insulin. If they are trending low, it gives less or no insulin at all. Now it can even correct high glucose levels in cases where carb counts aren't exact.

For Kainaz, the insulin pump, coupled with continuous glucose monitoring (CGM) through a sensor, revolutionised her management approach. CGM provides real-time glucose readings, enabling proactive adjustments to insulin delivery based on trends and patterns, thus optimizing blood sugar control.

The relationship between T1DM and pregnancy is complex and noteworthy. While T1DM is a lifelong condition, pregnancy introduces additional challenges in managing blood sugar levels effectively. Women with T1DM may face increased difficulty in regulating glucose levels due to hormonal changes and increased insulin resistance during pregnancy. Managing blood sugar levels becomes doubly challenging in such cases, underscoring the importance of advanced technology like insulin pumps.

Kainaz's dedication to exercise, controlled dietary habits, and leveraging technology enabled her to achieve remarkable outcomes. Maintaining blood sugar levels within the recommended range (time in range) during pregnancy is notoriously difficult, yet Kainaz consistently surpassed expectations, achieving a time in range of over 80-85 per cent.

CGMS, or Continuous Glucose Monitoring System, is a medical device that tracks glucose levels in real-time throughout the day and night. TIR, or Time in Range, is a critical metric in CGMS data analysis, indicating the percentage of time spent within a predetermined target range of blood glucose levels set by healthcare providers. This metric offers valuable insights into the effectiveness of diabetes management by revealing how well blood sugar levels are being maintained over time. The information provided about insulin pumps, CGM, and TIR is clear and concise, offering readers a comprehensive understanding of these essential tools in diabetes management.

Ultimately, Kainaz's story underscores the pivotal role of technology, coupled with personal determination, in achieving successful pregnancy outcomes for women with T1DM. By embracing innovations like insulin pumps and CGM, individuals can navigate the complexities of pregnancy with greater confidence, ensuring the health and well-being of both mother and child.