Ask the expert – pregnancy and diabetes

Having a baby is a big decision for any woman. But when you have diabetes, there’s a bit more to think about. Emma, our Clinical Advisor, pictured above, is here to answer all your questions about being pregnant and having diabetes, to help improve your chances of a happy pregnancy.

Can I have a baby if I have diabetes?

Yes, most women with diabetes have healthy pregnancies and healthy babies.

That’s not to say it’s going to be easy. There are a few more risks involved because of your diabetes. But with support from your healthcare team and good management of your blood glucose levels, you’ll be more likely to have a healthy pregnancy and baby. Have a look at these pregnancy stories from women with diabetes.

I’m thinking about starting a family.
Is there anything I need to do before trying to get pregnant?

It’s great to hear you’re planning ahead. This is so important for women with diabetes because of the risks involved. But you can really help reduce these risks by thinking about some key things:

  • Keep using effective contraception (or birth control) – get advice from your healthcare team and use one that works for you. Don’t stop using it until you decide you want to start trying.
  • Make an appointment with your healthcare team – they will refer you to a specialist clinic for support and information.
  • Get your Hba1c checked – this needs to be a healthy level before you start trying. Ideally aim to keep your HbA1c below 48mmol/mol if you want to get pregnant.
  • Get checked for diabetes complications like eye and kidney problems as pregnancy can make these worse.
  • Start taking a high dose of folic acid (5mg) – this will help to keep the baby healthy.
  • Make changes to your lifestyle – try to eat healthily, stop smoking, avoid alcohol and do regular exercise.

What’s folic acid and why is it so important?

It’s a vitamin that’s really important for your baby’s growth. It lowers the risk of things like spina bifida which is a condition where the spine and spinal cord can’t develop properly.

You need more folic acid than women who don’t have diabetes because your baby is more at risk of these kinds of problems. It’s best to take it before you start trying, right up to when you’re 12 weeks pregnant.

If you haven’t been taking it and just found out you’re pregnant, don’t worry – you can start taking it straight away. Because you need a higher dose you’ll need to get it on prescription and can’t buy it over the counter.

I have high cholesterol and I’m taking statins – can these harm the baby?

There are certain medicines used for managing diabetes that may harm your baby. These include statins, ACE inhibitors (or similar blood pressure medications), and many other meds used to manage blood sugar levels in Type 2 diabetes.

It’s really important to speak to your healthcare team as soon as you find out your pregnant. They’ll explain which meds to stop and which ones are fine to keep taking.

How often will I see my healthcare team?

You can expect lots of scans and appointments, because your healthcare team need to keep a close eye on you. This is to monitor your blood glucose levels and how your baby grows. Although it seems like a lot of time, all the attention is good for you and your baby.

I’ve just found out I’m pregnant and didn’t plan it – what do I do now?

Firstly, don’t panic. You can still have a healthy pregnancy and baby if you get things sorted right away. The first step is to get support from your healthcare team, so make that appointment now.

I want to have my baby at home but is that safe?

You’ll be strongly advised to have your baby in hospital, so that you’ve got the support of a consultant and maternity team. They’ll be close by if you or your baby need extra help during the birth, so being in hospital is the best place you both can be.

Would a small glass of wine really do any harm?

We know it doesn’t seem like a lot, but drinking during pregnancy can lead to long-term harm to your baby. So it’s safer not to drink at all.

Will my baby get diabetes?

Just because you have diabetes, it doesn’t mean your baby will have it.

If you have Type 1 diabetes there’s only a very small increased risk that your baby will develop Type 1 diabetes too. If you have Type 2 diabetes, there’s a stronger chance they’ll develop Type 2 diabetes later in life. But the risk of your baby developing Type 2 diabetes can be reduced by being healthy.

Your baby will have their blood sugar levels measured about 2–4 hours after they’re born but this isn’t a test for diabetes. It’s just to make sure their blood sugar isn’t too low. All babies’ blood sugar levels drop after they’re born. So it’s a good idea to feed them as soon as possible after birth which is usually within 30mins, and in regular intervals – every 2–3 hours. This will help keep their blood sugar at a safe level.

We hope we’ve answered some of your questions and helped you understand a bit more about pregnancy and diabetes. Having a baby is a big deal, but your healthcare team will be there to help you every step of the way. If you have more questions, why not add a comment below? Emma will get back with more advice and information.

You can also find out more info and read other people’s pregnancy stories at www.diabetes.org.uk/pregnancy.

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