Preparing for Pregnancy with diabetes

NHS Borders 

Borders Diabetes team

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Deciding to try for a baby is just as exciting for you as it is for everyone else! Happily, most people with diabetes will have a healthy baby – but diabetes increases the risks to both baby and mother, and the chance of having a miscarriage or birth abnormality is higher.

Planning your pregnancy reduces these risks, it is therefore very important that before becoming pregnant you meet with your primary care and diabetes teams to plan your pregnancy.

• talk with your GP or Practice Nurse at least 1 year prior to planning a pregnancy and continue with your contraception. Ask to be referred to the Borders General Hospital Diabetes Nurse team to discuss planning for pregnancy with diabetes
  
  
• make healthy lifestyle choices such as eating well, reducing alcohol intake and quitting smoking, along with increasing activity levels and keeping a healthy weight. Your Primary Care team, Wellbeing Service and Stop Smoking Team can support achieving these goals
  
  
• recommended diabetes Hba1c level is below 48 mmol/mol, as a high Hba1c level can affect how baby develops. To meet this target you will need to check your blood glucose levels regularly. The diabetes team will help you to achieve this target, by helping with diet and exercise and using diabetes medications that are suitable for pregnancy
  
  
• start taking folic acid at least three months before stopping contraception. Women with diabetes need a higher dose – folic acid 5 mg daily – which is only available on prescription
  
  
• pregnancy can make some complications of diabetes worse such as eye and kidney problems. It is therefore important to ensure you are up to date with eye screening and blood and urine tests to ensure your kidneys are working well prior to pregnancy
• some medications are known to be safe in pregnancy but others (for example some medications used for cholesterol, blood pressure and some diabetes medications) are not advised in pregnancy. Please discuss with your GP or diabetes team before pregnancy, as your treatment may need to be changed

If you think that you might be pregnant already please make an urgent appointment with your GP so that you can be referred to the Borders General Diabetes Pregnancy Team, who will support and guide you through your pregnancy.