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New Information about Planning a Family, Pregnancy & Diabetes

Most women with diabetes have normal pregnancies resulting in healthy babies but having diabetes does increase the chances of serious complications both for the mother and baby.

For women with diabetes, who do not plan their pregnancy, the risk of a serious complication is about 1 in 10. That is, they have a stillbirth or an infant with a malformation.

For women without diabetes about 1 in 50 have a serious complication when they get pregnant.

If you plan your pregnancy with your diabetes team, your risk of serious complications returns to much nearer that of women without diabetes.

Most of the damage is done very early (first six to seven weeks) in pregnancy, so it is important to get advice about preventing these complications if you are thinking about having a baby i.e. before you stop your contraception to become pregnant.

What are the risk factors for serious complications during pregnancy in women with diabetes?

1. Your pregnancy was not planned with your diabetes team.
2. Blood glucose levels higher than is healthy for your baby in the first six to seven weeks of pregnancy.
3. Not starting 5mgs of folic acid daily when you stop your contraception (this is higher than the usual 400µg dose recommended for women without diabetes).
4. Taking medication, other than insulin, for your diabetes. This includes some tablets taken for blood sugar control, blood pressure (ACE inhibitors) and cholesterol (statins).
5. Smoking yourself, or passively from other people you live with.
6. Being overweight before pregnancy.
7. If you are not immune to Rubella.

If any of these risk factors are true for you, then if you even start thinking about having a baby, please contact your GP or diabetes care team. They can help you reduce your risks of serious pregnancy complications

How You Can Plan Your Pregnancy?

1. See your GP as soon as you even start thinking about having a baby.
2. Make an appointment with your diabetes team, if you are thinking about having a baby within the next 12 months. They will review your diabetes treatment, as you may want to change it to get the best possible control you can manage, before stopping contraception.
3. Ask your GP to review all your medications especially tablets for blood sugar control, blood pressure and cholesterol.
4. Ask your GP for folic acid 5mgs daily.
5. Start monitoring your blood glucose levels at least 4 times daily.
6. Stop smoking or discuss this with the people you live with.
7. Ask for support on food choices to provide you and your baby with the best start.
8. Ask if you have been vaccinated against Rubella.

What if I am pregnant and did not plan it?

• See your GP as soon you think you might be pregnant.
• Discuss your diabetes and ask for an urgent referral to see your antenatal diabetes team. Expect an appointment within 1-2 weeks.
• Check that all your tablets are safe during early pregnancy.
• Start monitoring your blood glucose levels regularly so that your diabetes treatment can be made safe and effective as quickly as possible.
• Ask to be put on folic acid 5mgs immediately.

For more information about pregnancy and diabetes contact your local diabetes care team.

This leaflet has been produced by EASIPOD - The East Anglia Study Group - Improving Pregnancy Outcomes in Diabetes.
You can also view it as a pdf document.
More information about EASIPOD can be found on the Diabetes UK website.