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Diabetes: Planning a pregnancy?

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Advice for a healthy pregnancy

Planning a pregnancy with diabetes will help to reduce risks and help to improve outcomes during pregnancy, labour and the postnatal period.

Women with diabetes have an increased risk of miscarriage, malformations of the baby’s heart, limbs, spine or other vital organs.

Baby’s growth can also be affected, with increased risk of stillbirth and neonatal death in the early weeks of life.

Achieving a target HbA1c (48mmol/mol) at the outset of conception and maintaining target blood glucose (4.0- 7.8 mmol/L) are important to avoid complications and ensure best outcomes for you and your baby.

HbA1c

HbA1c is your average blood glucose (sugar) over the last 2 to 3 months. A high HbA1c means you have too much sugar in your blood.

If the result is above 86mmol/L (10%) you will be strongly advised to avoid pregnancy, aiming for less than 48mmol/L (6.5%) before you conceive.

Blood glucose monitoring to achieve stability is very important, if you feel that you would benefit from additional diabetes advice please contact the local hospital diabetes team .

Hypoglycaemia (low blood glucose)

The recognition and management of hypoglycaemia (blood sugar below 4mmol/L) is particularly important during pregnancy.

Ensure you always have your blood glucose monitoring equipment to hand, and rapid acting glucose to treat the hypoglycaemia, such as orange juice or jelly babies. Remember to follow the rapid acting glucose with a carbohydrate snack to keep blood glucose stable.

Not Yet

  • Avoid pregnancy if HbA1c is above 86mmol/L (10%)
  • Use effective contraception
  • Start Folic Acid 5mgs daily
  • Aim for a healthy weight
  • Arrange a medication review
  • Stop smoking and alcohol intake
  • Contact the diabetes team, the general practitioner or the preconception Clinic

Nearly There

  • HbA1c improving
  • Continue Folic Acid 5mgs daily
  • Aim for Blood Glucose 4.0- 7.8mmols/L
  • Know how to treat hypoglyca emia
  • Eye, blood pressure & kidney check • Diabetes team review
  • Ensure any medication changes have taken place

Your There

  • HbA1c ideally less than 48mmol/L (6.5%), and avoiding severe hypoglycaemia
  • Stop contraception
  • Maintain stable blood glucose
  • Continue Folic Acid 5mgs daily
  • Regular Diabetic review

Confirmation of pregnancy

Once your pregnancy is confirmed, contact your Community Midwife (based at your GP health care centre) and your Diabetes team.

If you need further advice you can contact your local antenatal clinic.

Your joint antenatal care will be co - ordinated as much as possible throughout your pregnancy. It will consist of regular contact with the following healthcare professionals:

  • Diabetes Consultant
  • Obstetric Consultant (Pregnancy Specialist)
  • Diabetes Nurse Specialist / Diabetes Midwife Specialist
  • Community Midwife • Dietitian
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