Sometimes pregnancy causes the blood sugar to go up in women who do not have diabetes. This is called gestational diabetes. Women who have diabetes also need extra care during pregnancy and should discuss this with a healthcare professional when they are considering starting their family.
Pregnancy makes the body need more insulin to control the levels of sugar (glucose) in the body. Therefore, women with diabetes usually need more treatments to control their blood sugar when they are pregnant.
If the diabetes is not well controlled during the pregnancy this may cause harm for both you and your baby. Therefore you will need more regular check-ups with a doctor, and to see a specialist during the pregnancy. This will help to reduce the risks and help you to stay well and have a healthy baby.
What is the advice for women who have diabetes before pregnancy?
The risk of problems for you and your baby can be greatly reduced by the following advice:
Avoid unplanned pregnancies. It is very important to plan any pregnancy and so contraception is very important.
Good control of blood sugar (glucose) levels before and during pregnancy reduces the risks of stillbirth, miscarriage, congenital malformation and neonatal death.
It is essential to follow dietary advice, weight control and exercise advice given to all people with diabetes.
Make sure you are regularly checked for any complications of diabetes, including regular eye assessments and other assessments and appointments with your practice nurse, GP or specialist.
If you are planning to become pregnant then you should take 5 mg of folic acid daily until 12 weeks of pregnancy to reduce the risk of birth defects in your baby.
Ketone testing strips should be used to test for ketones if you become unwell. Ketones are substances the body makes if there is a lack of insulin in the blood.
Reduce or cut down on Your alcohol in take
Think positively about breastfeeding
It recommends that:
If you have type 1 diabetes, you should be offered continuous glucose monitoring (CGM). This can help you and your baby.
If you have type 1 diabetes but cannot use CGM, you should be offered intermittently scanned CGM (commonly referred to as flash glucose monitoring).
Problems during pregnancy
Premature birth: babies are more likely to be born early (before 37 weeks).
There is an increased risk of miscarriage or of the baby dying late in the pregnancy (stillborn).
Babies tend to be a higher birth weight and this may make giving birth much harder. There is an increased risk of your baby becoming distressed during labour (fetal distress).
There may be too much fluid around your baby (polyhydramnios).
You may experience more infections during the pregnancy and the infections may be severe.
There is an increased risk of needing to give birth by caesarean section.
Problems for the baby after pregnancy
Congenital abnormalities are more common.
Low blood sugar (hypoglycaemia) is common and may be severe.
Respiratory distress syndrome is more likely.
Yellowing of your skin or the whites of your eyes (jaundice) is more common.
Birth injury is more likely.
There is an increased risk of the baby dying soon after birth.
Problems for the mother
There is an increased risk of problems during the pregnancy, including high blood pressure and blood clots.
There is an increased risk of the blood sugar being very high (ketoacidosis) or too low.
There is also risk that long-term diabetes complications may become worse, including eye problem and kidney problems
What is the treatment?
You will need frequent checks during your pregnancy. It is essential to have regular checks of your diabetes control and checks of your baby. You will also need the checks that all women need during pregnancy. A specialist will be involved to help look after your diabetes and your unborn baby.
It is recommended that women who have diabetes give birth in hospital. There is a risk that your baby may be distressed and it is essential that specialised care is immediately available.
