If you had type 1 or 2 diabetes before you became pregnant, managing your blood glucose levels can now be much harder. As your body changes, so do your blood glucose levels.
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.
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.
'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
Hypoglycaemia
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.
Your insulin needs will continue to rise
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.
Read more about the third trimester with type 1/2 diabetes
'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
You will occasionally have high levels
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.
Also in this section
-
Labour and birth with type 1 or 2 diabetes
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.
-
Diet and exercise with type 1/2 diabetes
Using diet and exercise helps keep your blood glucose levels within safe limits.
-
Type 1 or 2 diabetes in pregnancy and your emotional health
You may need support with your emotional well-being as you go through a pregnancy with type 1 or 2 diabetes
-
Using insulin in pregnancy with type 1/2 diabetes
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.
-
Third trimester with type 1 or 2 diabetes
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.
-
First trimester with type 1 or 2 diabetes
If you have type 1/2 diabetes in the first trimester you will be referred to the joint diabetes and antenatal clinic.
-
Second trimester with Type 1 or 2 diabetes
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.
More sections on type 1 or 2 diabetes in pregnancy
-
Treatment of type 1 or 2 diabetes in pregnancy
If you have type 1 or 2 diabetes in pregnancy you will get extra care.
-
Risks of type 1 or 2 diabetes on pregnancy
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.
-
Labour and birth with type 1 or 2 diabetes
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.
-
Planning a pregnancy with type 1 or 2 diabetes
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.
Sources
- 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
ℹLast reviewed on September 1st, 2015. Next review date September 1st, 2017.
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