Planning a healthy pregnancy when you live with type 2 diabetes will help lower the potential for complications to you and your baby.

If you become pregnant and you have diabetes, you should go on to have a healthy baby, but there are some possible complications you should be aware of. 

You have a higher chance of:

  • Having a miscarriage.
  • Problems with your eyes and kidneys.
  • Developing pre-eclampsia.
  • Having a larger baby which can cause problems during labour.
  • Interventions required during labour and birth.

There is an increased chance of your baby having:

  • Heart problems, spina bifida and other abnormalities.
  • Being stillborn or dying shortly after birth.
  • Problems after birth that require special or intensive hospital care.
  • Hypoglycaemia at birth (low blood sugar at birth).
  • Difficulty with thermoregulation (controlling their temperature).
  • Longer hospital stay.

In the longer term:

Developing obesity or diabetes later in life.

Contraception

In general, women with diabetes can choose from the same types of contraception as anyone else. If you have other medical conditions, discuss options with your healthcare team. When living with diabetes there are increased risks during pregnancy to you and your baby, so it's important to plan ahead. 

Home | Contraception Choices.

What if I get pregnant without planning it?

Don't Panic. And don't immediately stop your medications - it could be more harmful if your blood glucose or blood pressure suddenly become high in the first weeks of pregnancy. Speak to your GP practice nurse or a diabetes midwife and they will help to adjust the medications quickly and safely.

Pregnancy

Letting your GP or diabetes team know before you start trying for a baby gives you time to get your body ready for a healthy pregnancy.

Baby ready checklist

•        Agree a plan with your healthcare team -  organise this at least 12 weeks before trying to get pregnant. This will ensure all your medications, blood tests, diabetes care processes and eye screenings are up to date. (Diabetes health checks (annual review) | Diabetes UK).

•        Start taking 5mg Folic Acid daily - This can only be prescribed by your GP and helps prevent neural tube defects (spina bifida). Take 5mg Folic Acid for at least 3 months before pregnancy, and for the first 12 weeks after you become pregnant.

•        Take Vitamin D, 10 micrograms or 400 International Units (IU) per day. Recommended both before and during your pregnancy.

•        Maintain a healthy body weight and stay active. This improves your chances of getting pregnant, helps your glucose control, and overall health during pregnancy.

•        Review any current medications with your diabetes clinician. Current medications should be reviewed before getting pregnant. Avoid suddenly stopping medications unless specifically advised by your GP or diabetes Nurse. They will also tell you which medicines are safe to take in pregnancy. Metformin and insulin are safe to take.

•        Closely and regularly monitor your blood glucose levels. If you aren't already doing this you will be asked to do so by your GP or diabetes nurse as it is important. Additional support may be required to achieve the ideal target ranges below:

-  Finger prick tests: Ideal home glucose monitoring levels (finger-prick tests) are less than 5.3mmol/l before meals, and below 7.8mmols/l 1 hour after meals.

- Continuous Glucose Meter: The ideal range for pregnancy is 3.9-7.8 mmol/l and you should aim for a Time in Range (TIR) of 70 per cent or more.

I'm pregnant, what are the next steps?

Depending on your location in Kent and Medway the first step is to register yourself with the hospital where you would like to deliver the baby. This is the key in informing them of both the pregnancy and diagnosis of type 2 diabetes. You will then be contacted by a community midwife and a diabetes specialist midwife to arrange your first appointments.

Local maternity services

Managing the pregnancy journey

Labour and birth

  • If you have diabetes, it's strongly recommended that you give birth in a hospital with the support of a consultant-led maternity team.
  • Your doctors may recommend having your labour started early (induced). This is because there may be an increased risk of complications for you or your baby if your pregnancy carries on for too long.
  • If your baby is larger than expected, your doctors might discuss your options for the delivery and may suggest an elective cesarean section.
  • Your blood glucose should be measured every hour during labour and birth. You may be given a drip in your arm with insulin and glucose if there are concerns about your blood glucose levels during labour. Keeping your blood glucose levels very stable during labour will help reduce the chances of complications for you and your baby.

Videos

Early onset diabetes and pregnancy.

During your pregnancy.

 

Planning your pregnancy.

Diabetes midwife teams contact details: