Diabetes and pregnancy risks, for women with type 1 diabetes
Women with type 1 diabetes can have a healthy baby, but there are a number of extra risks during pregnancy. These include an increased risk of miscarriage and health problems for both the mother and her baby.
Looking after yourself and your diabetes can help reduce these risks
For this reason, it’s best that you become pregnant at a time when your diabetes is well managed and there are no other health issues. It is recommended that all women with diabetes plan their pregnancies and seek out specialist diabetes care before they fall pregnant to help prepare for the pregnancy.
If you become pregnant unexpectedly, make an appointment with your doctor and diabetes team straight away. They can help you with information, advice and support.
Risks to your baby
Diabetes can increase the risk of birth defects (congenital abnormalities) in babies. These abnormalities are more common when diabetes management before and during early pregnancy has not been optimal.
Damage to the baby’s heart, spine and kidneys can occur during the early stages of pregnancy, often before women even realise that they are pregnant. Miscarriage can also occur, as it can for all women, regardless of diabetes.
The first eight weeks of pregnancy is the time when a baby’s major organs develop, so it is important for your blood glucose levels to be as close to your target range as possible when you conceive and during the first part of your pregnancy.
This reduces the risk of health problems in the developing baby and the chances of an early miscarriage. The risk of miscarriage increases when the HbA1c level is elevated before falling pregnant and in the early stages of pregnancy.
Reducing the risk
To reduce your chance of miscarriage and of your baby developing abnormalities, it is important to maintain the best diabetes management possible.
Your diabetes in pregnancy team will stress the importance of frequently checking your blood glucose levels and keeping these as close to your target range as possible. It is also important to minimise the frequency of mild hypos and the risk of serious hypos, and to try and limit the swings in your glucose levels. Talk to your diabetes in pregnancy team about your individual blood glucose targets.
The aim is to have your HbA1c less than 7% (53mmol/mol), if possible for three months before becoming pregnant. Your diabetes in pregnancy team can advise you on your personal HbA1c goal before you conceive. Have your blood glucose meter checked and upgraded, if necessary, to make sure your readings are accurate.
Along with your own efforts to achieve target blood glucose levels, pregnancy-related changes can also cause a drop in your HbA1c. The recommended HbA1c during pregnancy is 6% or lower, but this should be discussed with your diabetes team.