Before you fall pregnant, for women with type 2 diabetes
If you are thinking about having a baby, here is a guide to what you need to do before you start trying for a baby.
Contraception and general pregnancy advice
Ask your doctor for help to choose the best contraception for you and your partner when planning your pregnancy. Seek advice on planning and preparing for pregnancy.
Ask your GP for referrals to diabetes in pregnancy specialists for pre-pregnancy care. Put together and meet your diabetes in pregnancy team.
Blood glucose targets
Aim for an HbA1c of 6% (42mmol/mol) or less before falling pregnant. Discuss individual blood glucose targets with your health care team.
Start taking high-dose folic acid for at least one month 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. Many women with type 2 diabetes will have been prescribed metformin. This is generally considered to be a safe medication during pregnancy and many doctors will recommend that you continue to take metformin during your pregnancy. Discuss this with your doctor or diabetes in pregnancy team. All other diabetes medications (apart from insulin) should be stopped before pregnancy or as soon as you know you are pregnant.
Review insulin therapy
If you are taking insulin to manage your diabetes, it is important to discuss your diabetes management with your health professionals when planning your pregnancy. This includes the types of insulin you are currently using and the advantages and disadvantages of different types during pregnancy. Also discuss your insulin dose and the number of injections you need to help you manage your diabetes during pregnancy.
Diabetes-related complications and screening
Have a full complications screening done before you fall pregnant. Any complications need to be treated and stabilised, if necessary before falling pregnant. A thyroid function test should also be done. Your doctor may also do additional tests such as checking your vitamin D level.
Check and stabilise your blood pressure before becoming pregnant.
Aim for a healthy weight before pregnancy by following a healthy eating plan and doing regular physical activity.
Make sure your rubella and chickenpox vaccinations are up to date. If needed, immunisations should be done at least one month before conception. Also discuss flu and whooping cough vaccinations with your doctor.
Smoking and alcohol
If you are a smoker, stop smoking—ask your health professionals for help. Avoid alcohol and other drugs completely during pregnancy.