Pre-pregnancy screening for diabetes-related complications, for women with type 1 diabetes
Before pregnancy it is important to be checked for any diabetes-related complications in your kidneys, eyes and nerves. Some women may also be advised to have a heart health check prior to pregnancy.
You will need to have your kidneys and eyes checked during your pregnancy as well.
Your doctor will ask you to have a urine test to check the amount of protein/albumin passing through your kidneys. You will also have a blood test to check the function of your kidneys.
If there are any problems, you may need to see a kidney specialist before your pregnancy and you will need to be monitored carefully during your pregnancy (especially in relation to your blood pressure). Even minor kidney problems (such as slightly increased levels of protein in the urine) can increase the risk of developing high blood pressure during pregnancy.
Make an appointment to see an optometrist or an ophthalmologist (a specialist eye doctor) to have the back of your eyes checked. Make sure they know you have diabetes. If you have damage to the small blood vessels at the back of the eye (diabetic retinopathy), this needs to be stable before pregnancy. Ask your eye specialist if you need any treatment before pregnancy.
Your podiatrist, diabetes educator or doctor can check for nerve damage in your feet (peripheral neuropathy), using simple physical examinations such as a tuning fork or a ‘monofilament’ that measures pressure sensation.
Some women with long-standing diabetes may develop another type of nerve damage called autonomic neuropathy. This can lead to problems with stomach emptying (feeling full or bloated), bowel movement (diarrhoea, constipation) and unstable blood pressure. If you have any of these complications, you should discuss them with your doctor before trying to become pregnant.
You may be advised to have a check of your heart health before pregnancy. This includes checking for symptoms of heart problems. If you have any symptoms of heart problems or a history of heart disease, further checks will be recommended before pregnancy.
Advanced diabetes-related complications
If you have advanced diabetes-related complications, discuss the risks of pregnancy with your endocrinologist/diabetes specialist, as well as other medical specialists (such as your ophthalmologist and kidney specialist), before planning to become pregnant. Pregnancy puts additional stress on your body and some diabetes-related complications can worsen during pregnancy, such as kidney disease and retinopathy (eye damage). Your specialist medical professionals can provide information and advice suited to your individual circumstances.
Managing and monitoring diabetes-related complications during your pregnancy.