Diabetes is the most common medical condition that women experience in pregnancy.
You may have been diagnosed with Type 1 or Type 2 diabetes before pregnancy (pre-existing diabetes) or develop diabetes during pregnancy which then goes away after delivery (gestational diabetes).
It is very important that women with pre-existing diabetes prepare for pregnancy and receive pre-conception care from their GP or diabetes hospital team. Pre-conception care includes:
- Working to control blood glucose levels so HbA1c before pregnancy is less than 48mmol/mol if possible. This reduces the risk of complications in pregnancy. This may involve changing diabetes medications to those which can be safely used in pregnancy (Metformin and Insulin) and the use of diabetes technology.
- Review of other medications to check they are safe for pregnancy eg. blood pressure medication
- Looking for any diabetes complications particularly with the eyes or the kidneys
- Starting Folic Acid 5mg
Pre-conception Information
During pregnancy you will be cared for by a multi-disciplinary team including diabetes doctors, diabetes specialist nurses, diabetes specialist midwives, obstetricians and dieticians
Gestational Diabetes is checked for if you have risk factors identified when you book your pregnancy. You will be offered a glucose tolerance test.
- A pregnancy with diabetes is higher risk including:
- Miscarriage
- Congenital abnormalities
- Having a larger than expected baby
- Difficulties with delivery if baby is large
- Blood pressure problems and pre-eclampsia with risk of having a smaller than expected baby
- Baby being born early
- Increased chance of needing caesarean birth
- Increased risk of baby needing to go to the neonatal unit
- Increased risk of stillbirth
- Worsening of eye or kidney problems in pregnancy
The team will work hard to support you through your pregnancy and help to reduce the risk of these complications as much as possible. We will support you to control your blood sugars as well as possible and you are likely to be given diabetes technology to help support this. We will give you Aspirin to reduce the risks of pre-eclampsia and we will monitor your blood pressure and kidneys closely. You will have regular eye tests. We will perform scans to monitor how your baby is growing. Most women can have their care at their local maternity unit. Women who have significant diabetes complications may need support from the Maternal Medicine Centre.
The information from the register has identified which epilepsy medications are safest for women to take during pregnancy. Joining the register is a simple process of providing information about your treatment. Details about baby’s health will be collected a few weeks following delivery from your GP.