How does my diabetes affect my pregnancy?

Many pregnant diabetic women will have a healthy baby and birth, but there is a risk of complications to both the mother and the child and it is important to be aware of these. The most important thing to do if you are diabetic and planning on having children is to manage your diabetes well, both before, during and after pregnancy. Dr Bobby Huda, a leading endocrinologist, explains how diabetes affects pregnancy and how your treatment for diabetes can change as a result of being pregnant.

What risks are there of being diabetic and pregnant?

There are risks to the unborn baby, including:

• Congenital abnormalities
• Macrosomia, also known as large for gestational age baby (this can result in a difficult birth or the need for a caesarean section)
• Miscarriage
• Stillbirth

There are also risks to the mother, including:

• Gestational hypertension
• Pre-eclampsia
• Increased caesarean section rate
• Shoulder dystocia (a problem during birth when extra help is needed to deliver the baby, which can cause nerve damage in the shoulders or arms)

What special measures need to be taken if you are pregnant and diabetic?

The blood sugars need to be tightly controlled, both before and during pregnancy. If you are planning your pregnancy, before you become pregnant you should request monthly HbA1c tests which measure your blood glucose levels. If your blood glucose levels are at a certain level (more than 10%), you will be advised to delay trying for a baby until it has decreased. Before and during pregnancy it is also important to take higher levels of folic acid each day until you reach the 12 weeks of pregnancy. These can be prescribed by your GP or specialist.

Will my diabetic treatment change whilst I am pregnant?

Your diabetes treatment, in general, will intensify with some medications needing to be changed as well as more frequent monitoring from a multi-disciplinary team, including an obstetrician, diabetologist, dietician, specialist nurse and a midwife. You will also be advised to monitor your blood glucose levels more closely during pregnancy as morning sickness can affect them.

If you are diabetic and considering having a baby, make an appointment with an expert to discuss your new treatment plan.