Pregnancy and Diabetes
 

If you have Type 1 or Type 2 diabetes, it is very important to talk to your diabetes team before you start to try to become pregnant. This is because your blood sugars should be stable and as near normal as possible to ensure that you remain healthy and that your baby grows and develops normally. In order to achieve this, you may need some help adjusting your diet or diabetes treatment.

Before becoming pregnant, there are a number of things to think about:-

  • Try to keep blood sugars as near to normal for at least 3 months before trying to become pregnant. We recommend 4-6mmol/l before meals and no higher than 8mmol/l 2 hours after meals. The HbA1c test looks at your long-term blood sugar control – you should aim to have this below 7% before a pregnancy.
  • Start taking folic acid supplements for at least 3 months before pregnancy – when you have diabetes there is a higher risk of the baby developing spina bifida. Folic acid helps to lower this risk and we would recommend that you take the higher dose of 5mg daily until you are 12 weeks pregnant. This dose of folic acid is available from your GP.
  • You may need to change your diabetes medication before considering pregnancy –
    • If you are on diet only for your diabetes then it is likely that you will need to start on insulin at some stage either before or during pregnancy
    • If your diabetes is treated with tablets – then is advisable to change to insulin before pregnancy
    • If your diabetes is treated with insulin – you may need to change your doses or increase the number of times a day you take injections to help improve your blood sugar control.
    • If you are taking blood pressure or cholesterol medication these may need to stop or be changed before becoming pregnant.
  • It is a good idea to have your rubella (german measles) status checked by a blood test – if you are not immune to this, you will need an injection as contracting rubella in the early stages of pregnancy can put the baby at significant risk of abnormalities.
  • If you smoke – please stop. Stopping smoking will help protect your baby’s health as well as your own. We can provide you with support to help stop now if you would like (??tel no for smoking cessation)
  • It is also important to stop or cut down on alcohol before becoming pregnant.
  • It is important to eat a healthy balanced diet before embarking on pregnancy – if you have any concerns, it would be a good idea to speak with your dietitian and have your diet reviewed
  • You should consider having your eyes checked before pregnancy – your diabetes team can organise this for you.

It is important that you continue with your usual contraception until your diabetes team are happy that it is safe for you to become pregnant and give you the ‘go-ahead’.

Once there is a gap of 5 weeks since the start of your last period, check a pregnancy test. As soon as you know you are pregnant – tell your GP and diabetes specialist nurse who will arrange for you to have an early visit to the hospital antenatal clinic.