Diabetes and pregnancy requires extra dedication but you should receive excellent care through your pregnancy.
We look at some of the risks that are involved as well as how good control can reduce these risks and the care you should expect to receive along the way.
Diabetes and pre-eclampsia
Pre-eclampsia is a condition that causes very high blood pressure and protein in the urine which can occur during pregnancy.
Pre-eclampsia results from problems in the development of the placenta.
People with diabetes have an increased risk of pre-eclampsia occurring. You will receive blood pressure and urine tests through your pregnancy which should pick up any signs of pre-eclampsia.
Mothers with diabetes are more likely to have large babies (weighing over 10lbs) than mothers without diabetes.
If the baby is large, you may be advised to have induced labour or a caesarean section delivery.
Blood glucose control
Good blood glucose control is important all the way through your pregnancy but is especially important at the start of your pregnancy, in the first trimester.
The target HbA1c for people with diabetes is 6.1% (or 43 mmol/mol). Keeping your blood glucose under control during your pregnancy requires dedication but you should be offered plenty of support from your healthcare team to help you achieve the target.
If you had diabetes before you became pregnant, you may experience some changes to your medication routine. People with type 1 diabetes on injections may be advised to go onto a pump for instance. People with type 2 diabetes may be moved from tablets onto insulin through their pregnancy, depending on the medication and the level of diabetes control needed.
Your antenatal care team should provide you with all the advice you need and answer any questions you have about your routine through your pregnancy.
Blood glucose testing during pregnancy
People with diabetes are advised to test before each meal as well as one hour after eating. Mothers on insulin are advised to test before going to sleep.
Hypoglycemia during pregnancy
As you will be aiming for tight control during your pregnancy, you may be at a higher risk of hypoglycemia.
Your care team should ensure you are prepared to deal with any instances of low blood sugar during your pregnancy.
Folic acid during pregnancy
You will be advised to take 5mg of folic acid for the first 12 weeks of your pregnancy.
This is higher than the general advice for women without diabetes, who are advised to take 0.4mg of folic acid a day.