Vivências de mulheres diabéticas tipo 1 em relação à gestação

Abstract

Introduction: Type 1 diabetes (T1DM) is a chronic metabolic disease in which there is autoantibody-mediated destruction of pancreatic β-cells, causing severe insulin deficiency and a consequent increase in blood glucose. DM1 mainly affects children and adolescents, with an often-abrupt onset and the need for full insulin therapy from the moment of diagnosis. The combination of DM1 and pregnancy increases the risk of adverse outcomes for the maternalfetal binomial and can aggravate pre-existing maternal conditions, as well as increasing the risk of gestational complications. Studies show that women with DM1 have higher levels of anxiety and worry about the outcome of their pregnancy, feeling pressured to keep their blood glucose levels within the ideal parameters. Objective: In this context, this study aims to understand the experiences of women - pregnant or postpartum - diagnosed with DM1, seen at their respective UBS in the city of João Pessoa, identifying their feelings and experiences in relation to pregnancy. Methods: Firstly, an integrative literature review was carried out, published as an article in a scientific journal, with the aim of evaluating the bibliographic production on the psychosocial aspects that permeate pregnancy in women with DM1, reflecting on the feelings and experiences lived during this period. A qualitative field study was also carried out, in which eight women were subjected to semi-structured interviews, which were transcribed and their content analyzed using the technique described by Bardin. This study resulted in the preparation of an original article. Results: The integrative literature review article showed that, faced with the challenges imposed by the association between pregnancy and DM1, women can show negative feelings and need social support and a multidisciplinary and specialized health team that offers comprehensive, person-centred care. The field study, in turn, pointed out that, when faced with strict glycemic management, greater variation in blood glucose levels and a high risk of pregnancy complications, women with DM1 experienced intense feelings of fear, guilt and exaggerated responsibility, requiring social support and the support of a healthcare team to overcome these challenges. The care provided by the health team must be comprehensive, attentive to the psychosocial aspects of these women and must include pre-conception planning, which proved to be deficient for the patients in the study. Conclusions: The results of the literature review and the qualitative study highlight the need for comprehensive care, aimed at both biomedical aspects and psychosocial issues for women with DM1 during their gestational journeys. It is hoped that the results of this study will lead to a better understanding of the experiences of this group of women, which could provide support for care and care management, improving the experience of diabetic pregnant and postpartum women.