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 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/nurse practitioner and accredited practicing dietitian and discuss your options for specialised maternity care.
Blood glucose targets
Aim for an HbA1c of 6.5% (48mmol/mol) or less before pregnancy. Discuss individual blood glucose targets with your health professionals.
Start taking high-dose folic acid (2.5–5mg/day) ideally three 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 medication for managing diabetes, cholesterol and blood pressure) 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. Many doctors will recommend that you continue to take metformin during your pregnancy. Discuss this with your doctor or diabetes in pregnancy team.
If you are taking any other diabetes medications (apart from insulin), your doctor will recommend these be stopped before pregnancy (or as soon as you know you are pregnant). Your doctor may suggest you start insulin to help you manage your blood glucose levels.
Review insulin therapy
If you are taking insulin to manage your diabetes, talk to your GP or diabetes health professionals when planning your pregnancy. Ask about the types of insulin you are currently using and their suitability during pregnancy. Also discuss your insulin dose(s) and the number of injections you need to help you achieve your target blood glucose levels in pregnancy.
Diabetes-related complications and screening
Have a full complications screening and any complications treated and stabilised before becoming pregnant. Your doctor will check your thyroid function and may do some additional tests such as checking your vitamin D and B12 levels.
Have your blood pressure checked and stabilised before becoming pregnant.
Aim for your weight to be as close as possible to the healthy weight before pregnancy. Discuss pregnancy weight gain with your health professionals.
Diet and supplements
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 should 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.
Smoking and alcohol
If you are a smoker, stop smoking—ask your health professionals for help. Avoid alcohol and other drugs completely during pregnancy.