Women with type 1 diabetes who have well-controlled blood glucose levels can have perfectly healthy pregnancies, but it’s important to plan carefully and look at what you can do to optimise your health and that of your baby.

Your blood glucose levels can affect the developing baby and so it’s important to not only read the numbers, but to adjust your insulin regimen and/or diet accordingly. You’ll have more frequent HbA1c tests too, so that your doctor or nurse can monitor how effective your glucose control is and help you to improve it if needed. 

If you are thinking of becoming pregnant, it’s advised that your HbA1c levels (average blood glucose levels over the past 3 months) should be well-controlled and less than 6.5% (48 mmol/mol) before you become pregnant.

Book an appointment with your diabetes clinic and get a health check, plus advice about what to expect and how you can avoid any health risks.

Your blood glucose control

Once you are pregnant, the key to a healthy pregnancy is good blood glucose control combined with healthy living. You‘ll be offered extra clinic checks and scans to make sure that everything is progressing as it should – try and keep all your appointments.

Pregnant type 1 patient (Carla) hanging laundry

Pregnancy changes the body quite dramatically and blood glucose levels can fluctuate widely as a result. In the first months, you might find that food cravings and/or morning sickness can make blood glucose control even trickier and it’s wise to monitor your glucose levels more often to be sure you keep track of what is going on. 

You can be more at risk of hypoglycaemia during pregnancy so always keep snacks with you to take when needed. You may need to use a glucagon kit if hypoglycaemia is severe – make sure friends and family know how to use it too, so that they can help if you are unable to use it.

In addition, checks for some diabetes complications, which you are at greater risk of during pregnancy – eye and kidney checks – are routine. 

What about labour?

It’s probably a good idea to give birth in hospital so that you have medical experts on hand, in case of problems. 

During labour, you‘ll be cared for by a specialist obstetric team who will monitor you closely and maintain adequate blood glucose levels. Early delivery by caesarean section can be carried out if there is any concern about your baby or your blood glucose control.

After you have given birth, you won’t need as much insulin to control your blood glucose and your insulin dose can be decreased. 

What about breast-feeding?

It’s absolutely fine for women with type 1 diabetes to breastfeed if they want to – just follow a few tips:

Eat sensibly and keep a snack with you – breastfeeding uses up glucose so your blood glucose levels drop as a result

Check with your diabetes team to find out which medications are safe to take when you are breastfeeding

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