How type 1 or 2 diabetes might affect your pregnancy

The most common problems associated with diabetes and pregnancy are:

• having a large baby (macrosomia)
• pre-eclampsia
  
• premature birth (giving birth before 37 weeks).
  

You may also find it harder to tell when your glucose level is getting low (known as hypoglycaemia or having a hypo) when you are pregnant. Vomiting or feeling sick during pregnancy can affect your glucose levels and can be particularly problematic if you are taking insulin.

Pregnancy can also increase your risk of developing eye or kidney problems or make existing ones worse.

What diabetes means for your baby

Having diabetes does not mean that your baby will be born with diabetes.

If you have diabetes, there is a higher risk of the baby:

• not growing properly (fetal growth restriction)
  
• having health problems after the birth and needing hospital care
• developing obesity or type 2 diabetes in later life
  
• stillbirth
• dying soon after birth (neonatal death).
  

This can be very difficult to read. But try to remember that the vast majority of women (98%) with diabetes have a healthy pregnancy and healthy baby. You will have extra care throughout your pregnancy and labour to check that you and your baby are healthy.

"Having the risks explained to me was ultimately my motivator to getting my blood sugars perfect." 

Zoe

Retinopathy and nephropathy and pregnancy

People with diabetes are at risk of developing problems with their eyes (diabetic retinopathy) and kidneys (diabetic nephropathy).

Pregnancy can increase your risk of developing these problems or make existing ones worse. Ideally, you will have eye checks and kidney checks before you start trying to have a baby.

You’ll be offered an eye examination at your booking appointment (unless you have had one in the last 3 months), and another at 28 weeks. If you are diagnosed with diabetic retinopathy at your first visit, you’ll have another test at 16-20 weeks.

If eye screening shows that you have diabetic retinopathy, this shouldn't affect your treatment during pregnancy. It also doesn't mean that you can't have a vaginal birth. If necessary, you will be referred to an eye specialist.

You’ll be offered a kidney test at your booking appointment (unless you have had one in the last 3 months). If a kidney test shows that you have diabetic nephropathy, this may affect your blood pressure, which can lead to pre-eclampsia. You should be offered treatment and you may be referred to a kidney specialist to help manage this.

You may need extra scans and more detailed checks on your baby's growth and development if you have circulatory or kidney problems.

Diabetic ketoacidosis

Some people with type 1 diabetes can develop diabetic ketoacidosis, where harmful chemicals called ketones build up in the blood. Make sure you are have a written copy of sick day rules so that you know how to manage high glucose levels if they occur during pregnancy.

Reducing the risks of diabetes complications in pregnancy

If you have diabetes, you will probably already be used to carefully managing your glucose levels. But pregnancy will mean that you will probably need to spend more time and effort doing this.

The best thing you can do is to make managing your diabetes one of your top priorities. We know this may be challenging, but your healthcare team will be there to help and support you throughout your pregnancy. You will be offered extra antenatal care appointments and telephone and email contact.

Your mental health

Some women take pregnancy with a long-term condition in their stride, while others may find it stressful. Talk to your midwife if you are feeling worried or anxious. They will be able to reassure you, or signpost you to more help and support, if you need it.

You can also call speak to our midwives on our pregnancy line on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected].

Find out more about your emotional health.