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For women with type 1 diabetes

Before you fall pregnant

If you are thinking about having a baby, there are some things you need to do before you start trying for a baby.

Ask your GP, endocrinologist or obstetrician for help to choose the best contraception for you and your partner while you are planning and preparing for pregnancy.

Ask your GP for referrals to see diabetes health professionals such as an endocrinologist, credentialled diabetes educator/diabetes nurse practitioner and accredited practising dietitian, and discuss your options for specialised maternity care.

Aim for an HbA1c of 6.5% (48mmol/mol) or less before pregnancy (or as close to this target as possible depending on hypoglycaemia risk). Discuss individual blood glucose targets with your health professionals.

Start taking high-dose (2.5–5mg/day) folic acid ideally months before becoming pregnant and continue during the first three months of pregnancy.

Ask your doctor to review all the medications you are taking (including diabetes tablets, blood pressure and lipid medication) to check if they are safe to take during pregnancy.

Ask your diabetes health professionals for information about continuous glucose monitoring (CGM) or flash glucose monitoring (Flash GM) technology and access through the NDSS.

Talk to your health professionals about whether the type of insulin you are taking and your insulin doses need any changes. Consider whether an insulin pump might be a good option for you.

Have a full complications screening and any complications treated and stabilised before becoming pregnant. A thyroid function and coeliac disease screening should also be done. Your doctor may also do additional tests such as checking your vitamin D level.

Have your blood pressure checked and stabilised before becoming pregnant.

Aim for your weight to be as close as possible to the healthy range before pregnancy. Discuss pregnancy weight gain with your health professionals.

Take a supplement that contains at least 150 micrograms (150ug or mcg) of iodine and check with your doctor and/or dietitian whether you need to take a multivitamin or other supplements. Women with an overactive thyroid or Graves disease need to see their doctor for advice before taking an iodine supplement.

Make sure your rubella and chickenpox vaccinations are up to date. If needed, immunisations should be done at least one month before conception. You will be advised to have influenza (flu) and whooping cough vaccinations during your pregnancy. Discuss immunisations for pregnancy with your doctor, including current recommendations regarding COVID-19 vaccination.

If you are a smoker, stop smoking. Ask your health professionals for help. Avoid alcohol and other drugs completely during pregnancy.

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Diabetes Australia acknowledges Aboriginal and Torres Strait Islander peoples as the Traditional Owners and Custodians of this Country. We recognise their connection to land, waters, winds and culture. We pay the upmost respect to them, their cultures and to their Elders, past and present. We are committed to improving health outcomes for all Aboriginal and Torres Strait Islander people affected by diabetes and those at risk.

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