Dr. Denice Feig is an endocrinologist and a renowned diabetes researcher who champions women’s health. She is the head of the Diabetes in Pregnancy Program at Mount Sinai Hospital and an Associate Professor at the University of Toronto’s Department of Medicine. Dr. Feig’s combined background in medicine and clinical epidemiology allows her to treat patients and carry out research uncovering ways to improve their health.

The focus of Dr. Feig's research is on the impact of diabetes on pregnancy. Her goal is to improve the standard of care for pregnant women living with type 1, type 2, or gestational diabetes. Type 1 diabetes is an autoimmune condition where your body attacks and destroys your pancreas, preventing your body from producing insulin - a hormone your body needs to control blood sugar levels. In type 2 diabetes, your body can make insulin, but it is typically not enough, or your body cannot use it effectively. Both result in high blood sugar levels. Gestational diabetes only occurs during pregnancy.

Pregnancies in women living with diabetes are complicated, and they, and their newborns, do not always fare well health-wise. Newborn mortality rates are unfortunately high and newborns can develop conditions that merit a stay in the neonatal intensive care units, including low blood sugar, respiratory issues, and skeletal injuries. Some babies are born larger than average, increasing the risk of delivery complications and impacting the mother's health. Mothers can also develop high blood pressure (hypertension).

Studies have shown that the complications experienced by pregnant mothers with diabetes can be minimized by controlling their blood sugar levels. Dr. Feig’s work centres on implementing effective treatment options and monitoring tools to ensure the mothers’ blood sugar levels are controlled and remain within the normal range throughout their pregnancies. Doing so leads to better health outcomes for mothers and their babies.

Dr. Feig’s research in this field is vast and has covered diverse topics over the years, including investigating potential risk factors for developing gestational diabetes. Two of her recent notable projects are CONCEPTT and MiTy trials.

In the CONCEPTT project, Dr. Feig highlights the benefits of incorporating Continuous Glucose Monitoring (CGM) on pregnancy outcomes of women living with type 1 diabetes. CGM is a device that tests blood sugar levels in real-time and displays the results on the patient’s insulin pump or cell phone. The monitoring tool allows mothers to act quickly and take insulin whenever their blood sugar levels increase. CGM improves their blood sugar control and allows for healthier newborns. CGM devices are available in Canada, and Dr. Feig suggests that clinical practice guidelines should be updated to recommend offering CGM to pregnant women living with type 1 diabetes.

In the MiTy project, Dr. Feig explored the benefits of prescribing Metformin, in addition to insulin, to pregnant women living with type 2 diabetes. Metformin is an oral drug used to decrease blood sugar levels by reducing the amount of sugar the liver releases. It helped control the mothers' sugar levels during pregnancy, decreasing pregnancy complications. A follow-up project by Dr. Feig, MiTy Kids, aims to further cement the benefits of Metformin. She is examining whether babies indirectly exposed to Metformin during pregnancy experience any long-term benefits, such as a decreased risk of developing type 2 diabetes or obesity.

Dr. Feig was awarded the Canadian Diabetes in Pregnancy Study Group Award for Excellence for her influential work in the field.

— Written by Ayaat Hassan