Pregnancy information

Diabetes in pregnancy

If you become pregnant and you have diabetes, you should go on to have a healthy baby. But there are some possible complications you should be aware of.

The information on this page is relevant for you if you were diagnosed with type 1 or type 2 diabetes before you got pregnant.

It does not cover gestational diabetes, which is high blood sugar that develops during pregnancy and usually goes away after the baby is born.

If you already have diabetes

If you already have type 1 or type 2 diabetes, you may be at a higher risk of:

People with type 1 diabetes may develop problems with their eyes (called diabetic retinopathy) and their kidneys (diabetic nephropathy), or existing problems may get worse.

What it means for your baby

If you have type 1 or type 2 diabetes, your baby may be at higher risk of:

  • having health problems shortly after birth, such as heart and breathing problems, and needing hospital care
  • developing obesity or diabetes later in life

There's also a slightly higher chance of your baby being born with birth defects, particularly heart and nervous system abnormalities, or being stillborn or dying soon after birth.

But managing your diabetes well, before and during your pregnancy, will help to reduce these risks.

Reducing the risks if you have pre-existing diabetes

The best way to reduce the risk to your own and your baby's health is to ensure that your diabetes is controlled before you become pregnant. Ask your GP or diabetologist (diabetes specialist) for advice. You should be referred to a diabetic pre-conception clinic for support before you try to get pregnant.

Find diabetes support services near you.

You should be offered a blood test called an HbA1c test, which helps to assess the level of glucose in your blood.

It's best if the level is no more than 6.5% before you get pregnant, as long as this does not cause problems with hypoglycaemia.

If your HbA1c is higher than this, you would benefit from getting your blood glucose under better control before you conceive, to reduce the risk of complications for you and your baby.

Your GP or diabetes specialist can advise you on how best to do this.

If your HbA1c is very high (above 10%), your care team should strongly advise you not to try for a baby until it has fallen.

Folic acid

If you have diabetes and are trying to get pregnant, you should take 5 milligrams (mg) of folic acid each day (and until you are 12 weeks pregnant). A doctor will have to prescribe this, because you cannot buy 5mg tablets from a pharmacy or shop without a prescription.

Taking folic acid helps prevent your baby developing birth defects, such as spina bifida.

Your diabetes treatment in pregnancy

Your diabetic treatment regime is likely to need adjusting during your pregnancy, depending on your needs.

If you take drugs for conditions related to your diabetes, such as high blood pressure, these may have to be altered.

It's very important to keep any appointments that are made for you, so that your team can monitor your conition and react to any changes that could affect your own or your baby's wellbeing.

Expect to monitor your blood glucose levels more frequently during pregnancy. Your eyes and kidneys will be screened more often to check that they are not deteriorating in pregnancy, as eye and kidney problems can get worse.

You may also find that as you get better control over your diabetes, you have more hypoglycaemic (low blood sugar) attacks. These are harmless for your baby, but you and your partner need to know how to cope with them.

Diabetic eye screening in pregnancy

You will be offered diabetic eye screening at recommended intervals during pregnancy if you had diabetes before you got pregnant (pre-existing diabetes)

This screening test is to check for signs of diabetic eye disease. including diabetic retinopathy.

Everyone with diabetes is offered diabetic eye screening, but screening is very important when you are pregnant, because the risk of serious eye problems is greater in pregnancy.

Diabetic eye screening is strongly recommended in pregnancy. It is part of managing your diabetes, and diabetic retinopathy is treatable, especially if it is caught early.

If you decide not to have the test, you should tell the clinician looking after your diabetes care during pregnancy.

Labour and birth

If you have diabetes, it's strongly recommended that you give birth in a hospital with the support of a consultant-led maternity team.

Your doctors may recommend having your labour started early (induced). This is because there may be an increased risk of complications for you or your baby if your pregnancy carries on for too long.

If your baby is larger than expected, your doctors might discuss your options for the delivery and may suggest an elective caesarean section.

Your blood glucose should be measured every hour during labour and birth. You may be given a drip in your arm with insulin and glucose if there are problems.

After the birth

Feed your baby as soon as possible after the birth (within 30 minutes) to help keep their blood glucose at a safe level.

Your baby will have a heel prick blood test (or newborn blood spot test) a few hours after they're born to check if their blood glucose level is too low.

If your baby's blood glucose cannot be kept at a safe level, or they're having problems feeding, they may need extra care. Your baby may need to be fed through a tube or given a drip to increase their blood glucose.

Read more about special care for babies.

After your pregnancy, you should not need as much insulin to control your blood glucose. You should be able to decrease your insulin to your pre-pregnancy dose or return to the tablets you were taking before you became pregnant. Talk to your doctor about this.

You should be offered a test to check your blood glucose levels before you go home and at your 6-week postnatal check. You should also be given advice about diet and exercise.

Last Updated: 13/06/2023 11:00:22
The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website