Diabetes and pregnancy

Diabetes and pregnancy

Pregnant women who have diabetes as a condition before becoming pregnant have special health concerns. In addition to the new demands that pregnancy makes on their body, women with diabetes must also carefully monitor and control their blood sugar levels, and manage their diabetes medications.
If you have diabetes and would like to get pregnant, there are steps you can take to lessen the risks to you and your baby.

 Preparing for pregnancy when you have diabetes

If you have diabetes, discussing everything with your doctor before becoming pregnant is very important to maximise your chance of a healthy pregnancy. Your doctor can help you determine if your diabetes is controlled sufficiently for you to stop your  contraception. A blood test called the glycosylated haemoglobin test (HbA1c) can help your doctor evaluate how well your diabetes has been controlled over the past six to 12 weeks. Ideally, while you are planning a pregnancy, you should be aiming for a HbA1c below 6.1% (providing this is safely achievable) and you should be offered HbA1c testing every month.

 Having other medical tests before you become pregnant can also help your doctor monitor your health and prevent the development of diabetic complications during pregnancy. Some of the tests your doctor may recommend include:

An assessment of kidney function to screen for diabetic kidney complications.

 Cholesterol and triglyceride blood tests.

An eye examination, in the form of a retinal assessment, to screen for retinopathy.

Self-monitoring of blood glucose levels.

 In this pre-conceptual period, it is important to discuss with your doctor the safety of any other medications that you take, since some may be unsafe in pregnancy.

 Women with diabetes who are planning a pregnancy, should also take 5mg folic acid daily whilst trying to become pregnant and for the first 12 weeks of pregnancy. This reduces the likelihood of having a baby with a neural tube defect (for example, spina bifida).

 A pre-conception counselling appointment with your doctor is another important step in preparing for pregnancy. Pre-conception counselling helps educate women so they can be physically and emotionally prepared (and healthy) for

 Blood sugar control before and during pregnancy

Good diabetic control both before and during pregnancy lessens the risk of complications during pregnancy. Good blood sugar control means keeping blood glucose levels within the ideal range, as well as balancing meals, exercise, and diabetes medications.

 Good blood sugar control is important before becoming pregnant because many women do not even know they are pregnant until the baby has been growing for 2-4 weeks. If blood sugar levels are high early on in the pregnancy (before 13 weeks), this can be a cause of birth defects.

 Good blood sugar control is just as important during pregnancy when women should be aiming for their recommended target blood glucose levels, because high blood sugar levels can increase the risk of miscarriage and of developing diabetes-related complications.