Whilst keeping your blood glucose levels within safe limits is a hugely important part of managing your diabetes, the guidance to staying healthy in pregnancy is similar to that for staying healthy at any other time of life with diabetes.
The guidance to staying healthy in pregnancy is similar to that for staying healthy at any other time of life with diabetes.
Diet in pregnancy with type 1 or 2 diabetes
When you are pregnant you may find that you need to make changes to your diet to help curb spikes and dips in your blood glucose levels. Try to aim for a varied diet that includes a combination of:
- carbohydrates such as breads, rice, pasta, grains and potatoes. Choose wholegrain varieties where possible
- fruit and vegetables
- pulses, such as baked beans, butter beans or lentils
- dairy products such as milk, hard cheese and yogurt
- lean meats and fish.
The amount of carbohydrates you eat has the biggest impact on your blood glucose levels after eating so it is important to be aware of this. Ask to be referred to a dietitian if you have not seen one already. Pregnancy is not a time to be on a diet so speaking to a dietitian will help you to make small changes to your diet that are safe for you and your baby.
"I did have cravings while I was pregnant – I did really want some chocolate and so I would buy myself just really dark chocolate so I could have just something." Maria, mum of one
You must take 5mg of folic acid, which you should receive on prescription, from when you start trying for a baby until you are 12 weeks pregnant.
All pregnant women are recommended to take 10mcg of vitamin D through your pregnancy and when breastfeeding, as well as eating rich sources of vitamin D in your diet – such as oily fish.
Exercise during pregnancy has lots of benefits for you and your baby so you should continue to stay active while you are pregnant. But if you have diabetes, exercise will have an extra effect on your blood glucose levels. When you work your muscles, they use up more of the glucose in your blood – and will lower your blood glucose levels. So if you treat your diabetes with insulin, you need to make sure you take the necessary precautions to avoid having a hypo:
- Discuss your plans for exercise with your healthcare team.
- Monitor your blood levels before and after exercise until you become familiar with how exercise affects your blood glucose levels.
- Take particular care to eat regularly, and carry snacks or glucose with you in case your blood sugar drops.
- Keep exercise moderate, with rest periods so that you do not become too hot or exhausted.
- You may need to have extra snacks before you exercise if you take insulin – ask your team for advice.
- Stay hydrated.
- If you are finding it hard to reduce your blood glucose levels, look at your activity levels to find ways to introduce more exercise into your daily routine.
Being active doesn’t need to mean joining a gym. Walking more instead of driving, going swimming or cycling a few times a week, can all increase your heart rate. Try to avoid long periods of sitting down.Find general guidance on safe exercising in pregnancy here.
Your healthcare team will be able to advise you on what to do, how often and for how long. If you don’t usually exercise, start with 10-15 minutes of continuous exercise three times a week. Over time, you can build this up to 30 minutes of exercise four times a week or more.
"I was advised to continue running because my body was used to it – I managed to run up until I was four months pregnant. When I felt unable to run anymore I did pilates and swimming, which I found hugely beneficial." Laura, mum of one
Managing your weight in pregnancy with type 1 or 2 diabetes
Keeping to a healthy weight is another important way of staying healthy. If you went to a pre-conception clinic, you may already have lost weight before you conceived. There is no specific UK guidance about how much weight you should put on during pregnancy but there are general guidelines to how much weight to put on in pregnancy here. Dieting is not advised as it may involve cutting out food groups.
Most diabetes pregnancy services weigh women with diabetes at every visit. This is because there is a strong link between high weight gain in the mother and macrosomia in the baby. If your team feel that your weight could be an issue, they will support you to manage your blood glucose levels and keep yourself and your baby healthy through the right diet and exercise.
It is all too easy to over-eat during pregnancy, but the phrase ‘eating for two’ is a myth. In fact, your baby will grow well for the first two trimesters of pregnancy without you eating any extra calories at all. During the last trimester of your pregnancy you may need up to 200 extra calories per day – the equivalent of a small snack. Find general guidance on safe exercising in pregnancy here.Find general guidance
- 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
- NHS Choices. Vitamin supplements in pregnancy.http://www.nhs.uk/conditions/pregnancy-and-baby/pages/vitamins-minerals-supplements-pregnant.aspx
- NICE Hypertension Guideline CG107 section 1.1.21, cited in NICE 2015
- RCOG 2006, Exercise in pregnancy, Statement No 4. Royal College of Obstetricians and Gynaecologists
- Harris, GD, White RD (2005) Diabetes management and exercise in pregnant patients with diabetes. Clinical Diabetes, October 2005. vol. 23 no. 4 165-168
- Mayo Clinic. Fetal macrosomia, risk factors.http://www.mayoclinic.org/diseases-conditions/fetal-macrosomia/basics/risk-factors/con-20035423.
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.
Managing your blood glucose levels can be much harder after you become pregnant. As your body changes, so do your blood glucose levels.
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.
ℹLast reviewed on September 1st, 2015. Next review date September 1st, 2017.