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Managing Diabetes

Planning a Pregnancy

Why is it important to plan your pregnancy?

Planning a pregnancyRaised blood sugar levels before conception and during pregnancy can increase your risk of complications. It is therefore advisable to make sure your diabetes is well controlled before you conceive.

What levels should my blood sugars be?

Aim to run your blood sugars between 4-5mmol/l pre-meal and 7mmol/l  2 hours after a meal. Try to achieve this for 3months prior to conception and continue during the pregnancy.

What else should I be doing in preparation for a pregnancy?

  • You should have a full diabetes check, including an Hba1c blood test.
  • You should be screened for rubella (German measles) antibodies and vaccinated if necessary.
  • You should start taking Folic Acid 5mg daily and continue it for the first 3 months of your pregnancy.
  • If you smoke it is strongly advised that you should stop.
  • Contact your diabetes nurse or clinic when considering a pregnancy.
  • Consider making an appointment to see a dietician to discuss your diet and pregnancy.

As I have diabetes will it be more difficult for me to get pregnant?

If your diabetes is well controlled then this should not be any more of a problem than if you did not have diabetes.

Will my baby have diabetes?

It is extremely unlikely that your baby will have diabetes.

Will my type of insulin or dose have to change?

If you already have good control of your blood sugars then you will probably not need to change your type of insulin. Often to achieve the best control it is necessary to have 4 injections of insulin a day-clear fast acting insulin before a meal and a cloudy longer acting insulin at bedtime.

Often patients need a reduction in their insulin in early pregnancy and then an increase as the pregnancy progresses.

How often will I have to test?

You will need to check your blood sugars 4-8 times a day, which would be pre meal or 2 hours after finishing a meal. It would also be advisable to check your blood sugar before driving each time, as due to tight control and possible lack of awareness during pregnancy you need to ensure that your blood sugar is at a safe level.

Am I more likely to have hypos when I am pregnant?

It is possible you may be less aware of hypo symptoms or you may even lose awareness altogether. There may be a particular risk of overnight hypos and you may be advised to check your blood sugar during the night to find out what the level is.

You should ensure that you have Hypostop and Glucagon available and that your partner is aware of how to use them.

Will I have to come into hospital during my pregnancy?

Unless you are experiencing problems with your control or blood pressure then it is

Unlikely you will need to come in.

Will I have my baby early?

It is quite possible that your baby will be delivered between 38-40 weeks, this will

depend on the control of your diabetes and the scans of your baby.This will be discussed with you when you attend your ante natal appointments.

Can I breast feed my baby?

There is no reason why you should not breast feed and we would encourage you to do so. You will need to reduce your insulin and have extra snacks yourself.

 

Author – Liz Hartley, Diabetes Specialist Nurse