It is also more likely that you may have reduced awareness of the warning signals of hypoglycaemia when you are pregnant. This is called hypoglycaemia unawareness. If you are aiming for much tighter control, you will be paying much more attention to your levels, so you are likely to now notice changes that you might not have noticed before. Many women feel that they are doing everything they can and that their levels feel very out of control.
"The more often you test, the better your control is. There aren’t many pregnant diabetics who aren’t testing all the time. And when you’re pregnant, you have to test after your meals, as well as before."Sara, mum of two
The levels of certain hormones tend to be higher in the morning, which means that you are more insulin resistant around breakfast time. This rise in blood glucose levels, sometimes called the ‘dawn phenomenon’, does not only happen during pregnancy. If you notice that your fasting blood glucose levels are consistently high, talk to your healthcare team who can help you.
During pregnancy your insulin need will continue to rise until around 35 or 36 weeks, at which point it should stabilise. If you are having frequent hypoglycaemic episodes by the third trimester, contact your healthcare team to check that everything is OK.
"Because I had to get my control very fine, it was almost like learning to be a diabetic all over again. I had to change quite a lot from when I was first diagnosed. It was pretty rubbish in a way."
Hazel, mum of one
If you have type 1 diabetes, and those with type 2 and are having two or more insulin injections a day, then you should test:
- when you wake up (before breakfast)
- before other meals
- one hour after each meal
- at bedtime.
If you have type 2 and are managing your diabetes with diet and exercise alone, taking tablets, or taking one insulin injection a day, then you should test:
- when you wake up (before breakfast)
- one hour after each meal.
You may also be advised to test your blood glucose levels two hours after meals.
Try not to worry too much about the occasional high reading. As long as your blood sugar levels are not regularly high, one or two readings that are out of the recommended range will not be a problem.
- NICE (2015) Diabetes in pregnancy: management of diabetes and its complications from preconception to the postnatal period, NICE guideline, National Institute for Health and Care Excellence
- Mayo Clinic. Diabetes, Reviewed Oct 23, 2014. http://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/da...
- Vambergue A, Fajardy I (2011) Consequences of gestational and pregestational diabetes on placental function and birth weight, World J Diabetes. 2011 Nov 15; 2(11): 196–203. Published online 2011 Nov 15. doi: 10.4239/wjd.v2.i11.196
- Diabetes in pregnancy, Information for the public, National Institute of Health and Care Excellence
Keeping your blood glucose levels within safe limits is a hugely important part of managing your diabetes, but you also need to think about your physical well-being.
Hypoglycaemia happens when your blood glucose levels drop too low. This is more likely to happen if you treat your diabetes with insulin. If you treat you diabetes with diet or metformin alone, you are generally not at risk.
Hyperglycaemia is caused by blood glucose levels rising too high.
While you are pregnant, you will be at much higher risk of hypoglycaemia – especially in the early weeks. At the same time, you may not have your usual early warning signs (hypo unawareness), and the symptoms may be more severe than usual.
If you are ill with type 1 or 2 diabetes, more glucose is released into your bloodstream and your body becomes resistant to insulin.
Whatever treatment you were using to control your diabetes before you became pregnant may change. If you were using tablets, you may have to start using insulin.
If you have type 1 or 2 diabetes in pregnancy you will get extra care.
You will need to manage your type 1 or 2 diabetes in pregnancy by checking your blood glucose levels and adjusting your treatment according to the results.
Women with type 1 or 2 diabetes are at higher risk of some complications but the majority have normal pregnancies and healthy babies. There is much you can do to reduce the risks, for you and baby.
Many women with type 1 or 2 diabetes go on to have a healthy birth. But you are at higher risk of complications so your healthcare team will have recommendations for the birth of your baby.
If you have type 1 or 2 diabetes, you should to talk to your healthcare team if you are thinking about having a baby. There are some things you can do now to make your upcoming pregnancy safer.
The fact that you have type 1 or 2 diabetes in pregnancy does not mean that your baby will get it as a child. But they will have an increased risk of getting it later due to genetics.
ℹLast reviewed on September 1st, 2015. Next review date September 1st, 2017.