Having children is a big decision for anyone. If you are a woman who has diabetes, however, it is a decision that requires much more thought and careful planning.
Many women who have diabetes (Type 1, Type 2, and gestational diabetes) have healthy pregnancies and healthy babies. But this isn’t to say that it’s an easy experience – it requires a lot of work and dedication on your part. If you are planning to have a baby or think you are pregnant then it is vital that you speak to your doctor.
If you have diabetes and are thinking of getting pregnant it is vital that you ask your diabetes care team for pregnancy planning advice.
It is a good idea for you to know what tests and treatment to expect, and what you can do to get your pregnancy off to a healthy start. Ask to be referred to a pre-conception clinic which is usually run by a diabetes midwife and a diabetes specialist nurse.
Keep your blood glucose on target
You can increase your chances of delivering a healthy baby by keeping your blood glucose in control before conception and throughout pregnancy. The first eight weeks are particularly important for the physical development of your baby. If your HbA1c is more than 86mmol/mol you should avoid pregnancy: ideally it should be below 43mmol/mol.
Have your eyes checked
Pregnancy can place extra pressure on the small vessels in your eyes, so if you have retinopathy that has not been treated, make sure it’s treated before you become pregnant.
Check your medications
Some medicines used in the treatment of diabetes should NOT be taken by pregnant women. If you are on a statin, ACE inhibitor or similar blood pressure tablets you must tell your doctor if you plan to become pregnant or find out that you are pregnant, as these may damage your baby’s development.
Some tablets for Type 2 diabetes should not be taken in pregnancy because they may harm your baby. You may need to switch to insulin injections to control your blood glucose, but you can usually return to tablets after pregnancy. Your doctor will tell you whether or not you need to change your medicine.
Start taking 5mgs folic acid until the end of the twelfth week of your pregnancy to help prevent neural tube defects. This will need to be prescribed by your doctor
Avoid alcohol whilst trying to conceive.
Gestational diabetes mellitus (GDM) is a type of diabetes that arises during pregnancy (usually during the second or third trimester). In some women, GDM occurs because the body cannot produce enough insulin to meet the extra needs of pregnancy. In other women, GDM may be found during the first trimester of pregnancy. In these women, the condition most likely existed before the pregnancy.
An oral glucose tolerance test (OGTT) is used to diagnose GDM.