Supporting your family member or friend
Women with diabetes can have a healthy baby, but there are some extra risks during pregnancy and lots of effort needed by the mum-to-be at this time.
As a family member, friend or colleague of a woman with diabetes, you can be an important support person before, during and after pregnancy.
Every woman’s pregnancy will be different, but there are some things that you can keep in mind to support your family member or friend along the way to help make their pregnancy more enjoyable and less stressful.
Offer to be a support person
During pregnancy, your family member or friend will need to go to more medical appointments than usual. She may already have the support of a partner to attend these appointments, but sometimes another family member or friend may be able to help as well. Let her know that you are happy to join her if she would like you to. Being a support person can also help you learn more about diabetes and pregnancy.
Be a listening ear
Pregnancy with diabetes can be a very different experience to a pregnancy without diabetes. Managing diabetes during pregnancy is challenging, and requires a lot of effort. Sometimes there can also be anxiety about managing diabetes and worries about the baby’s health. For these reasons, let your pregnant family member or friend talk about her feelings and ask her how she would like you to help. Remember, you don’t need to have solutions to her worries or problems – just being a listening ear without judgement is a great help in itself.
Acknowledge the hard work
Pregnancy with diabetes requires planning and intensive day-to-day management – which can be hard work. Keeping blood glucose levels within target range can also be more challenging during pregnancy, and this can be frustrating for your family member or friend. Acknowledging and supporting the efforts she is putting into managing her diabetes is important.
Offer practical support
Ask your family member or friend what practical support she needs, and how you can best help. This might be with things such as caring for other children so that she can attend appointments, helping around the house or with meals/shopping.
Letting her know you are comfortable with her checking her blood glucose levels and taking insulin around you can also be helpful. She will need to do this more often during pregnancy, and it can be reassuring for her to know that friends and family are okay with this.
Help her to take time out
It can be very beneficial if you can encourage your family member or friend to do some nice things for herself. This can help take the focus off the daily demands of diabetes.Doing enjoyable things together like making time for a walk, exercise class, coffee or a chat are other ways of taking time out. Organising catch-ups before baby arrives can be a nice break for the mum-to-be. Once the baby is born, send a text message (so mum can get to it when she’s ready) asking if there is a good time to visit, rather than arriving unexpectedly.
Nagging your family member or friend all the time can cause more stress than support. Remember to be supportive and encouraging of how much she is doing to stay healthy, offer to help where you can and find out what, if any, extra support she needs.
Try to avoid making comments about what she should and shouldn’t be eating, as it isn’t always obvious what a good choice is for people with diabetes. It is also important not to pass judgement on how her diabetes is being managed – this is up to her and her health professionals.
Be aware of the signs of diabetes ‘burnout’
Keeping blood glucose levels within target range while planning for pregnancy can be exhausting, especially if it takes some time to fall pregnant. After this, there are another 9 months of intense work ahead, followed by the arrival of the baby.
Diabetes management never stops, and the constant changes in the body are challenging. Some women go through ‘diabetes distress’ whereby they may feel overwhelmed by diabetes, believe they are ‘failing’, become frustrated by how unpredictable diabetes can be and guilty when things get ‘off track’. If not managed, this may lead to ‘diabetes burnout’ or feeling emotionally exhausted by the demands of their diabetes and being tempted to give up on taking care of their diabetes. This is a very important time to have the support and reassurance of understanding family and friends.
If your family member or friend is experiencing ‘distress’ or ‘burnout’ due to her diabetes, it’s recommended that she seek the help and support of her diabetes in pregnancy team. These feelings should be taken seriously. If she needs additional emotional support, there are counselling services available. Her doctor or diabetes team can assist her with information about what is available locally.
Depression and anxiety can also occur more frequently during pregnancy and especially after the baby is born. Be aware of the signs and encourage your family member, friend or colleague to seek any support that she needs. Again, signs of depression and anxiety should not be ignored. The good news is that there are treatments available.
Help with hypos
Women with type 1 diabetes or those with type 2 diabetes taking insulin are at risk of what’s known as a ‘hypo’ (hypoglycaemia). This is when blood glucose levels fall too low (below 4mmol/L). During pregnancy, women may experience more hypos than usual, especially in early pregnancy. Some women also notice that their early warning signs for hypos (such as feeling shaky or sweaty) change when they’re pregnant. This means that hypos can happen without much or any warning, increasing the risk of a severe hypo (when a person with diabetes can’t treat the hypo themselves and needs help from someone else).
It’s sometimes recommended that family members of women with type 1 diabetes attend an information session with a doctor or diabetes educator to explain when and how to use a glucagon injection (GlucaGen®). Glucagon can be used to reverse hypoglycaemia in someone who has lost consciousness due to a severe hypo. It helps the body to release glucose stored in the liver and raises blood glucose levels quickly.
After the baby arrives
Taking home a new baby is incredibly exciting, but this can also be a stressful time. This is a time when your family member or friend will need your support. This may include practical help such as shopping and meal preparation, as well as giving her some time out for rest and recovery. Ask her how she would best like you to help.
Remember too that depression and anxiety can also occur more often after the arrival of a new baby. Be aware of the signs, and help your family member or friend seek any support that she needs.
Acknowledgement: Thank you to the women living with diabetes and their partners who kindly reviewed the content of this page and to Helen Edwards for her contribution to this page.