Planning a pregnancy with diabetes
Most women with diabetes planning to have a baby go on to have healthy pregnancies, but it does need some careful planning.
See your diabetes care team before you become pregnant. Your care team can help decide if your diabetes is sufficiently under control so that you can try for a baby.
Advice from your diabetes care team before getting pregnant
Making an appointment with your diabetes care team before you get pregnant is an important step for women with diabetes. Your team can help to prepare you, physically and emotionally, for a healthy pregnancy. This appointment is likely to include:
- Evaluation of your weight. Try to reach your ideal weight before getting pregnant. If you are overweight you risk high blood pressure complications, and if you are underweight, you risk having a low birth-weight baby.
- Discussion of your lifestyle. Smoking and drinking alcohol are two habits that should be stopped for the best chance of having a healthy pregnancy and baby. Smoking during pregnancy affects you and your baby's health before, during and after your baby is born. The nicotine, carbon monoxide and numerous other poisons you inhale from a cigarette are carried through your bloodstream and go directly to your baby. These substances can reduce the amount of oxygen you and your baby receive and increase your baby's heart rate. They also increase the chances of you having a miscarriage or stillbirth. They also increase the risk of your baby being born prematurely, with a low birth weight, and increase your baby's risk of developing respiratory problems. Excessive drinking can lead to Foetal Alcohol Syndrome which can cause a variety of birth defects in your baby, including mental retardation, and cardiovascular, skeletal, and facial abnormalities.
- Discussion of any vitamin supplements you might need. The NHS says women with diabetes should take a higher dose of folic acid. The normal daily dose for women trying to get pregnant and for pregnant women is 400 micrograms. Women with diabetes, it says, should take 5mg a day. Your doctor can prescribe this high-dose folic acid. Taking folic acid helps prevent your baby from developing birth defects, such as spina bifida. Folic acid should be taken from the moment you start trying to become pregnant and until you are 12 weeks pregnant.
- Blood sugar screening to make sure your blood sugar is under control. It is important to get your blood sugar under control before you start trying for a baby, as often you can be a few weeks pregnant before you realise it. High blood sugar levels in the first 12 weeks of pregnancy can cause birth defects. High blood sugar levels during pregnancy can also increase the risk of miscarriage and of developing diabetes complications.
- Adjusting your medication. If you take insulin to control your diabetes, your doctor can tell you how to adjust your medication. Generally your body will require more insulin during pregnancy, especially during the last three months of pregnancy. If you take oral medications to control your diabetes, your GP may switch your medications to insulin during pregnancy, since certain oral medicines can harm your developing baby.
- Discussion about your diet. You might need to change your diet to help avoid problems with low and high blood sugar levels.