If you have diabetes, there is no getting around the fact that you will have a lot of medical care during your pregnancy. This is to keep you safe and keep the risks to you and your baby as low as possible.
The evidence shows us that these precautions can make a difference. To help keep your risks as low as possible you will be monitored closely during pregnancy to check that you and your baby are healthy.
Your antenatal care with type 1 or 2 diabetes
You will have more appointments and extra scans as well as ongoing adjustments to your insulin and/or other medications.
Each pregnancy is different, even for the same woman – so the approach each time will be slightly different. If there is anything about your treatment that you are unsure about, ask your healthcare team.
As soon as you become pregnant, you should be seen in the joint diabetes and antenatal clinic. Throughout your pregnancy, your team will work closely with you to check your blood glucose levels and make changes to your diabetes medications (including insulin doses). This is to make sure you are maintaining good blood glucose targets safely.
It’s very important that you keep a log of your blood glucose levels so that you can get a clear picture of what is going on.
'I think the main thing is having a supportive team. I can email or call them and I can always get hold of them or they will get back to me quickly.They are really helpful, and it means everything.' Svenja
If your diabetes is treated with insulin, remember that your insulin needs will change throughout your pregnancy. This means that your treatment needs to be regularly adjusted. You will be given advice on how to do this and manage hypos, as well as on injecting or using a pump if you are not used to doing this.
Make sure your healthcare team gives you the contact details for all the services you might need during your pregnancy, including contact numbers to use out of hours or in case of emergency. You should expect to have regular contact with your team every 1–2 weeks.
'Throughout the pregnancy my insulin requirements were changing constantly and I found it difficult to keep on top of, it got me down. I felt envious of my friends who were pregnant and weren't diabetic. They could just sit back and enjoy it, but for me, it was such hard work.' Laura, mum of one
You may feel sad or frustrated that your pregnancy or birth will not be as you had hoped. This is natural. You might find it helpful to share your feelings with other women who have been through a similar experience. Try looking at web forums (try www.diabetes.co.uk, which has a special pregnancy board), check out the various forms of support offered by Diabetes UK and ask your diabetes team about any local diabetes antenatal groups, which may provide a source of support.
If you do find things are getting on top of you, chat to one of your healthcare team about your feelings or call the Tommy’s midwife line on 0800 0147 800 (Mon-Fri 9-5pm).
If you have type 1/2 diabetes in the first trimester you will be referred to the joint diabetes and antenatal clinic.
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.
By the second trimester, as your baby grows and starts to kick, you may need more insulin. Your medication and insulin needs will be regularly reviewed with you.
If you have type 1 or 2 diabetes, managing your blood glucose levels can now be much harder in pregnancy. Testing is an important part of self-care.
If you are treated with insulin in pregnancy, by the third trimester your insulin requirements are likely to be much higher than they were before.
You may be able to use diet and exercise alone to keep your blood glucose levels within safe limits during pregnancy.
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.
Different local areas have different arrangements for type 1 and 2 diabetes care in pregnancy, but your team will include specialists in a number of different areas.
You may need support with your emotional well-being as you go through a pregnancy with type 1 or 2 diabetes
Organisations that can give you support
An interactive diabetes website from NHS Scotland
Pregnancy-specific information from diabetes UK
Information from NHS Choices about diabetes and pregnancy
A website for women with diabetes from the Queens University Belfast
A free downloadable app from Centre for Pregnant Women with Diabetes at Rigshospitalet in Copenhagen. All content in this app has been written by Chief Physician, Consultant at the Department of Endocrinology, Professor Elisabeth R. Mathiesen and Chief Physician, Consultant in Obstetrics Clinic, Professor Peter DammHide details
- 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
ℹLast reviewed on September 1st, 2015. Next review date September 1st, 2017.