Diabetes and pregnancy

Your healthcare professional team will work with you to aim to ensure you and your baby’s wellbeing before, during and after birth.

Support from your GP

If you’re planning to start a family or you may get pregnant (not using contraception) then it would be important to discuss your health before pregnancy. This can be done with your GP, your practice nurse or during your annual diabetes review. Your GP may also refer you for further discussion with the hospital diabetes team in the Preconception Clinic.

The team will discuss the importance of keeping blood sugars as good as possible before and during pregnancy. The blood test used to measure on average how high your blood sugars have been, is called the HbA1c and ideally you should aim for less than 48 mmol/mol if possible. Some of your diabetes medications may need to be altered to achieve this. Some medications are not known to be safe in pregnancy and will need to be stopped. Commonly, metformin and insulin are used safely in pregnancy. Some other medications for blood pressure or cholesterol are often held whilst trying for a baby.

If you are trying for a baby, it is very important that you take folic acid before getting pregnant and up to 13 weeks after a positive pregnancy test. This needs to be the higher dose (5 milligrams/day) which will be prescribed by your doctor, but you can also take the over the counter folic acid tablet (400 micrograms/day) whilst you are waiting for a prescription. If you are not trying for a baby but there is a chance you may become pregnant, then it may also be useful to take folic acid as it will protect you and your baby if you do become pregnant.

While you will receive ongoing support from your healthcare team, there are things you can do to help you have a healthy pregnancy:

What are the risks to you and baby

High blood sugar before and during early pregnancy can lead to up to a 10% chance (1 in 10 chance) of a significant problem with the baby, including heart, brain or nerve problems. Prescription folic acid (5 milligrams) and keeping blood sugar to target levels (ideally an HbA1c of less than 48 mmol/mol) can significantly reduce the chances of this.

High blood sugar during pregnancy can also lead to problems such as miscarriage, pre-eclampsia, (condition with high blood pressure and blood vessel damage), early or difficult labour, large for gestation babies and a higher chance of a caesarean section.

We want to ensure you maintain your own health and wellbeing as well as helping you avoid any complications before, during and after pregnancy. It is very important to speak to your GP surgery, midwife or healthcare team if you are thinking about having a baby or there is a chance you may get pregnant in the near future to make sure you have the care and support you need.

Useful links for further information

Diabetes and pregnancy – NHS (www.nhs.uk)

Pregnancy and diabetes | Diabetes UK

Other useful resources