Pregnancy and Diabetes - What You Need To Know Before Conception
This article is going to firstly look at what diabetes is and the different types of diabetes that can affect women during pregnancy. It includes recommendations for women who have pre-existing diabetes.
Whether you have diabetes or not, the ideal situation is to prepare for a healthy pregnancy before conception. Some women manage this very well and plan significant lifestyle changes months ahead, or even more, before becoming pregnant.
1. What is diabetes?
Diabetes occurs when a person’s body cannot store glucose in the blood properly. There is a hormone in the body, called insulin, which is produced by the pancreas, and this is what helps our bodies deal with glucose properly and use it for energy.
When a person has diabetes it means that the amount of sugar in the blood (glucose) is too high. Diabetics need help to control their sugar levels.
2. What types of diabetes can affect you during pregnancy?
There are 3 types of diabetes that may affect you during pregnancy.
Type 1 Diabetes
Type 1 diabetes is when a person’s body cannot produce any insulin. It often starts in childhood, which means that women with type 1 diabetes will be fully aware of their condition at the time they are considering becoming pregnant. A type 1 diabetic takes insulin in order to control their blood sugar levels.
Type 2 Diabetes
Type 2 diabetes is when the body can’t produce sufficient insulin, or the body may produce insulin, but it doesn’t work effectively. Those who are overweight are more prone to this type of diabetes, as are people over the age of 40. In Asian and black people, it can occur earlier in life.
Tablets can be used to lower the blood sugar levels for type 2 diabetes, although some may need insulin injections.
Gestational diabetes can happen at any stage during pregnancy, although it is more likely to occur during the second half of pregnancy. It happens as the demands of pregnancy can be too much for some women to produce enough insulin.
It goes away once the woman has given birth, however women who experienced gestational diabetes are twice as likely as other women to develop type 2 diabetes as they become older.
3. What are the risks associated with diabetes and pregnancy?
For women with either type 1 or 2 diabetes, there can be a higher risk of:
- Having a bigger baby
- This in turn increases the chances of a difficult birth, which may mean having a caesarean section or your labour induced
- There can be a higher risk of miscarriage
Women with type 1 may be subject to the following risks:
- Abnormal development
- Higher risk of heart abnormalities
- Being stillborn
- Dying quite soon after birth
- Health issues soon after birth, such as breathing difficulties or heart issues
- Your baby may also be prone obesity or diabetes as she/he gets older
4. What diabetics should do before conception?
If you have type 1 diabetes, there is a good chance you will have been managing your diabetes for many years before you start considering becoming pregnant. Those who have been involved in helping you learn to live with diabetes may have already discussed your healthcare for when you wish to become pregnant. Ideally preconception care should start off as young as possible, so that you are totally fluent and aware of what you need to do.
Once a type diabetes 1 female is of childbearing age, her healthcare provider will recommend some form of contraception, so that she doesn’t become pregnant without proper planning.
Blood sugar control
As is true for your diabetes on a day to day basis, good control of your blood sugar levels is the first important step to preparing for a healthy pregnancy. Once you become pregnant this continues to be of the utmost importance.
First 8 weeks of pregnancy
The first 8 weeks of pregnancy are the most risky, in terms of your baby developing any problems.
Retinopathy (eye problems)
You should have your eyes checked as part of your healthcare routine. However if you already have eye problems, this is even more vital to control. During pregnancy more pressure is put on the small vessels of the eyes, therefore eye problems really need to be cared for before pregnancy.
Medications need to be checked
There are some medications used for diabetes that should not be administered to pregnant women. Therefore you need to get your medication assessed as early as possible.
Angiotensin-converting enzyme (ACE) inhibitor, statin, or angiotensin-11 receptor antagonist are known to risk damage to baby’s development. Additionally some tablets prescribed for type 2 diabetes can also be harmful to baby.
Your healthcare team may switch you to insulin injections for a period of time. Once you have given birth, you should be able to take tablets again.
Even if you are not a diabetic, it is not recommended to drink alcohol during pregnancy, and low intakes of alcohol or none at all, can be helpful while you are trying to conceive.
If you are diabetic then alcohol affects your blood sugar levels, increasing your risk of hypos. Ideally cut out alcohol as early as possible, when trying to become pregnant. Do not drink alcohol during your pregnancy.
Eat well to keep your glucose levels balanced
As a diabetic you will know how you should eat to keep your glucose levels balanced. Ensure you stick to the recommendations before becoming pregnant and even more so during pregnancy.
Cigarettes contain sugar and are unhealthy for anyone, whether pregnant or not. As a diabetic it is highly recommended to stop smoking as soon as possible.
Take folic acid
All women need to take folic acid, which helps prevent issues such as spinal cord problems. For women with diabetes it is recommended to take 5mg, which you will need to get on prescription.
Being prepared for pregnancy with diabetes
Follow all of the recommendations in this section and plan your pregnancy care closely with your healthcare professionals.
Other articles from this series:
Midwife sonographer facilitated
Consultant Led, Centre of Medical Excellence
All articles on the blog and website are intended as information only. Please do not consider any of the information provided here as a substitute for medical advice. At all times seek medical advice directly with your own doctor and medical team.
This website was formerly Merrion Fetal Health. The clinic has undergone a rebrand and is now known as Merrion Ultrasound.