Diabetes and Pregnancy

2024/10/14

Will it be more difficult for me to get pregnant if I have diabetes?
How might diabetes affect my baby during pregnancy?
Does having diabetes mean I am considered ‘high risk’ during pregnancy?

These are just a few of the questions you might have if you are living with diabetes and planning to start a family. Many women with diabetes have gone through successful pregnancies and delivered healthy babies, thanks to careful planning and early support from their healthcare team. Here are some key things you can do to ensure the best outcome for yourself and your baby.

Plan ahead

Having diabetes should not affect your fertility, but there are risks associated with having diabetes during pregnancy. Planning ahead can significantly reduce these risks. It is best to consult with your healthcare team at least six months before trying to conceive.

It is crucial to maintain your blood sugar levels as close to normal as possible, both before pregnancy and during the early weeks (first trimester). This is important to lower the risks of miscarriage and birth defects.
Aim for an HbA1c (a measure of average blood sugar levels over the past three months) of 6.5% or lower.
Your healthcare team will discuss ways to achieve this target, including healthy eating, physical activity, medications, and blood sugar monitoring.
Some medications may need to be stopped or changed, especially if you are also being treated for high blood pressure or high cholesterol.
While you work towards optimal diabetes control, use contraception until you are ready to conceive.
Stop smoking.
Take folic acid daily as soon as you begin trying for a baby, as it supports the normal development of your baby’s brain and spine.
Ensure your eyes and kidneys are checked as part of diabetes complication screening.

Keep your medical appointments and work with your healthcare team

It is important not to miss your medical appointments throughout your pregnancy, even if you feel well.

See your doctor as soon as you confirm your pregnancy.
Discuss your diet and exercise plan with your healthcare team during pregnancy.
Monitor and regularly share your blood sugar levels with your healthcare team.

Generally, the blood sugar targets during pregnancy are:

4.4 – 5.5 mmol/L before meals
5.5 – 6.6 mmol/L 2 hours after meals

Your blood sugar levels may gradually rise throughout pregnancy due to hormonal changes in your body. Your healthcare team will support you in adjusting your medications to maintain ideal blood sugar control.

Keeping your blood sugar levels within the target range helps reduce complications such as high blood pressure disorders during pregnancy, stillbirth, large babies, low blood sugar, or breathing difficulties in the newborn.

On the other hand, blood sugar levels that are too low (hypoglycaemia) is also harmful and should be avoided. The risk of developing low sugar levels tends to be higher during the first trimester of pregnancy.

Your obstetrician will monitor your baby’s health and discuss the best timing and mode of delivery with you. Additionally, you will need to undergo more frequent diabetes eye screening during pregnancy.

Take care of yourself after delivery

Many mothers focus on caring for their baby after giving birth, but it is equally important to look after yourself, both physically and emotionally. Your healthcare team will continue to support you during this period.

Having diabetes should not prevent you from breastfeeding. There are many benefits for both you and your baby if you choose to breastfeed.
You may need to adjust your diabetes medications after giving birth; your healthcare team will guide you on this.
Continue to eat healthily and stay active.
Fertility can return quickly after childbirth, regardless of whether you are breastfeeding. Discuss contraception options with your healthcare team to avoid unplanned pregnancies.
Make sure to attend your follow-up medical appointments.

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