Pregnancy and diabetes fact sheet
This fact sheet is available in two formats.
You can download and print out the PDF version here.
Or you can read it as a website page below.
This resource is also available in other languages. (Arabic, Bengali, Chinese simplified, Chinese traditional, Farsi, Greek, Hindi, Italian, Korean, Punjabi, Sinhalese, Spanish, Tagalog, Tamil, Turkish, Urdu, Vietnamese)
For women with type 1 or type 2 diabetes, the best preparation for a healthy pregnancy starts with getting the right information and advice before you fall pregnant.
Women with diabetes can have a healthy baby, but there are extra risks during pregnancy. With careful planning, and support from a team of health professionals, these risks can be reduced.
Having diabetes during pregnancy can increase the risk of birth defects and miscarriage. The risk is higher when blood glucose levels before and during early pregnancy have not been within the target range. There is also an increased risk of other complications during pregnancy, such as developing high blood pressure and pre-eclampsia, as well as having a large baby.
Contraception for women with diabetes
It’s possible to fall pregnant as soon as you stop using contraception, so it’s important to continue using contraception until you are ready to start trying for a baby.
Some methods of contraception are more reliable than others—and all have benefits and side effects. The most effective are long-acting reversible methods of contraception, including implants and intrauterine devices.
The oral contraceptive pill is another form of contraception often used by women with diabetes. To be reliable, the pill must be taken as prescribed. If you have high blood pressure or diabetes complications, it may not be a suitable option for you.
Talk to your doctor about the best contraception for you.
Planning for a healthy pregnancy
If your blood glucose levels are mostly within the target range, this reduces the risk of birth defects in your developing baby and the chances of an early miscarriage. For this reason, it’s important to plan your pregnancy and become pregnant at a time when your diabetes is well managed.
Make an appointment with your diabetes health professionals as soon as you start thinking about having a baby. It’s recommended that you have a review of your diabetes and general health at least three to six months before you start trying for a baby.
If you have any other health problems, make sure you also discuss these with your health professionals before you start planning your pregnancy.
To plan and prepare for pregnancy, talk to your health care team about the following:
It’s important to use effective contraception until you are ready to start trying for a baby. Ask your doctor about the best type of contraception for you.
When planning to have a baby, there are a number of general health checks that all women need. Your doctor can advise you about blood tests, vaccinations and the nutrient supplements you need to take before pregnancy.
Diabetes in pregnancy specialists
When planning your pregnancy you will benefit from the support of a team of health professionals, including your doctor and diabetes specialists. If you are not already seeing these diabetes specialists, ask your doctor for a referral.
If you are not sure who to contact, or if you live in a rural area where services are limited, ask your doctor about Telehealth or shared care with a major hospital.
Blood glucose levels
If your blood glucose levels are well managed before you fall pregnant, and during the early stages of pregnancy, you can reduce the risk of complications for yourself and your baby.
Before trying for a baby, have your blood glucose levels checked with a HbA1c test to make sure your levels are in the recommended range:
- Current guidelines recommend an HbA1c of 6.5% (48mmol/mol) or less before pregnancy.
- The target recommended to you will depend on the HbA1c you can safely achieve with the lowest risk of hypoglycaemia (low blood glucose levels).
Discuss your individual blood glucose targets with your diabetes health care team and how you can stay within those targets.
Not all medications are safe to use during pregnancy. Ask your doctor to check all the medications you are currently taking to see if they are safe.
Folic acid (folate)
Folic acid can help reduce the risk of certain birth defects. Women with diabetes need to have a higher dose of folic acid than women without diabetes. Start taking high-dose folic acid every day, ideally three months before becoming pregnant. Your doctor will recommend you take half to one 5mg tablet, depending on other supplements you are taking.
Diabetes-related complications can worsen during pregnancy and may increase the risk of other health problems. Before you fall pregnant, you need to have a full complications screening (eyes, kidneys and nerves) and have your blood pressure checked. Treat any existing health problems before pregnancy.
Being a healthy weight before pregnancy can reduce your risk of health problems during pregnancy. Healthy eating and being physically active can help you manage your weight. A dietitian can help with an eating plan that suits your needs.
Diabetes during pregnancy
There are a number of ways that pregnancy will affect your body and your diabetes. These changes will affect your blood glucose levels and insulin requirements. You may also experience more hypoglycaemia (hypos) in early pregnancy and your hypo symptoms may change. You will need to have your diabetes management reviewed more often during pregnancy.
When you have diabetes, pregnancy can sometimes be challenging. It’s important to seek the support you need from your health care team, partner, family and friends during this time.
If you find you have an unplanned pregnancy, contact your doctor and diabetes specialists as soon as possible. They will be able to help you manage your diabetes and can discuss any concerns you may have.
Having diabetes does not mean your pregnancy shouldn’t continue or that you won’t have a healthy baby. Early contact with your health care team is vital and can help improve the chances of a healthy pregnancy.
Visit ndss.com.au/pregnancy for more information.
Pregnancy planning checklist
Start planning and preparing for pregnancy at least three to six months before you start trying for a baby.
Use this checklist as a guide to discuss with your health care team.
What you need to do BEFORE you fall pregnant:
- Use contraception until you are ready to start trying for a baby (ask your doctor if this is the most reliable contraception suitable for you).
- Talk to your doctor for general pregnancy planning advice.
- Make an appointment with health professionals who specialise in pregnancy and diabetes.
- Aim for an HbA1c of 6.5% (48mmol/mol) or less (or as close to this target as possible, depending on hypoglycaemia risk). Discuss individual targets with your health professionals.
- Review your diabetes management with your diabetes health care team.
- Have all your medications checked to see if they are safe to take during pregnancy.
- Start taking a high-dose (2.5mg–5mg) folic acid supplement each day.
- Have a full diabetes complications screening and your blood pressure checked.
- Aim to be a healthy weight before pregnancy.
The NDSS and you
A wide range of services and support is available through the NDSS to help you manage your diabetes. This includes information on diabetes management through the NDSS Helpline and website. The products, services and education programs available can help you stay on top of your diabetes.
This information is intended as a guide only. It should not replace individual medical advice and if you have any concerns about your health or further questions, you should contact your health professional.
Version 4 June 2020. First published June 2016.