During your pregnancy
You will be offered extra monitoring appointments and scans during your pregnancy to help you keep good control of your blood glucose and check your baby’s growth and development. You should have contact with your diabetes team every one or two weeks.
Your doctor will encourage you to do extra blood glucose tests and agree on personal target levels. Generally the aim is for before meal levels of 3.5–5.9mmol/l and less than 7.8mmol/l one hour after meals.
You may find you are more at risk of hypos due to tighter control. You should be given a glucagon kit: ensure that family/friends understand how to use this if you are unable to treat a hypo yourself.
Top tips for a healthy pregnancy
- Stop smoking
- Avoid alcohol
- Eat a healthy balanced diet
- Keep active
After the birth
Generally, your experience should be the same as anyone’s. But because you have diabetes, doctors will take some extra steps to make sure you and your baby are off to a healthy start.
- Your baby: All babies’ blood glucose levels drop after separation from the mother. Breastfeeding soon after delivery and at regular intervals usually resolves this.
- Your baby’s blood glucose will be regularly checked after birth and extra feeds may be given if needed. Your baby should stay with you unless there is a medical reason why he or she needs admitting to a neonatal unit for extra care.
- After delivery, your insulin needs will significantly drop. You may need an intravenous insulin/glucose drip for a few hours after delivery and your insulin dose will be adjusted as needed.
- Your blood glucose will be checked regularly, until your levels stabilize. When you resume your normal diet, you should also return to your pre-pregnancy insulin dose. If you were taking insulin for gestational diabetes, the insulin can usually be stopped immediately after delivery.
- Most women who deliver by Caesarean section are given antibiotics after delivery in order to decrease the risk of infection at the wound site.
Breastfeeding and diabetes
Breast is best, and there’s no reason diabetes will change this. There’s no reason why women with diabetes cannot breastfeed. You may have some early difficulties – for example if your baby needs extra feeds, or if you were initially separated from your baby due to Caesarean section or your baby’s treatment in the neonatal unit – but with patience and practice you and your baby should be able to establish a good breastfeeding pattern.
- Breastfeeding may lower your insulin needs by up to 25 per cent. Breast milk contains sugar called lactose. Every time you feed your baby, you will lose that sugar and your blood glucose will drop, which may cause a hypo. To help avoid hypos, you may need to eat 40–50g more starchy foods per day while you are breastfeeding.
- Even though you will be eating more, breastfeeding will not make you gain weight. In fact, it may help you lose weight.
- If you take Metformin or glibenclamide for Type 2 diabetes, you can usually resume or continue taking these while breastfeeding, if your doctor is in agreement.