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Type 1 diabetes and pregnancy

Are you wondering about the ways you can manage type 1 diabetes and pregnancy? If you have type 1 diabetes and are planning to become pregnant or are pregnant already, you can have a completely healthy pregnancy and baby. The chance of your baby developing type 1 diabetes, if you have type 1 diabetes, is only 5%1.  However, it is still important to consider your risks and keep your diabetes under control during pregnancy to reduce risks to you and your baby.

 

Type 1 diabetes and pregnancy: Associated risks

Managing type 1 diabetes and pregnancy can be a challenge. Type 1 diabetes pregnancy risks include:

  • Becoming less aware of the symptoms of low blood sugar (hypoglycaemia), particularly during the first 12 weeks of pregnancy2. Up to 50% of women with type 1 diabetes experience severe hypoglycaemia during their pregnancy3.
  • Having a large baby (macrosomia)1. For women with type 1 diabetes, over half of babies were larger than average at the same gestational age4. This may mean you need to be induced or require a caesarean section1.
  • Pre-eclampsia, a condition that causes high blood pressure and can result in rare but serious complications such as life-threatening fits called ‘eclampsia’4.
  • Worsening of diabetes associated conditions such as diabetic retinopathy (problems at the back of the eye) and diabetic nephropathy (diabetes associated kidney problems)2.

To lower these type 1 diabetes pregnancy risks and help you and your little one experience pregnancy as safely as possible5:

  • Keep your HbA1c levels in check
  • Be conscious of your changing insulin needs
  • Monitor your blood sugar frequently

Read on to find out more on how to plan a pregnancy when you have type 1 diabetes.

 

Planning a pregnancy when you have type 1 diabetes

How can you manage type 1 diabetes and pregnancy? If you have type 1 diabetes and are planning on getting pregnant, here are a few steps to prepare for a healthy pregnancy and reduce type 1 diabetes pregnancy risks:

Top tip: If your pregnancy was unplanned, get in touch with your doctor and healthcare team as soon as possible; they can advise you on how to best manage your type 1 diabetes during pregnancy7.

 

Managing type 1 diabetes during pregnancy

It is vital to contact your doctor and healthcare team to adjust your diabetes management plan as soon as you discover you are pregnant. Your doctor may recommend changes to your current diabetes treatment, for example, you may be advised to adjust your insulin doses8.  During pregnancy, it is even more important that you regularly monitor your blood sugar, adhere to frequent check-ups with your medical team and follow a healthy and balanced diet1,9.

Top tip: It’s essential for you to avoid alcohol and smoking to maintain a healthy pregnancy9.

 

Type 1 diabetes and pregnancy: Labour and birth

You can expect a full-term pregnancy and a natural birth, although you may be advised to induce labour or have a caesarean section for you and your baby’s protection1.

During your delivery, your blood sugar will be under constant monitoring. Your doctor may formulate an ‘insulin plan’, which includes steps to monitor and regulate your blood levels during and after your delivery if needed, and the area of your body where insulin should be injected8,10.

 

After giving birth

Both your and the baby’s blood sugar levels will be closely monitored after delivery. This is likely to include a heel-prick blood test for your baby8. If your baby’s blood sugar is low, they may need extra support, such as a drip or feeding tube, which will be provided by the doctors and healthcare team11. As breast milk contains lactose, a type of sugar, every time you breastfeed, your sugar levels can drop. If you are breastfeeding, your doctor may adjust your insulin dosing and advise you to have a meal or light snack before each feed12.

It is important to continue looking after yourself and stay healthy after you have given birth. Try to maintain a healthy lifestyle by being active, eating a balanced diet, monitoring your blood sugar levels, and reaching out for support to your family, friends and healthcare team whenever needed.

Type 1 diabetes and pregnancy can seem stressful and overwhelming. But with careful planning and paying attention to your medical needs, you are likely to have a completely healthy pregnancy1,5

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References
  1. JDRF. Pregnancy. Available from: https://jdrf.org.uk/information-support/living-with-type-1-diabetes/health-and-wellness/pregnancy/ Last accessed: October 2022.
  2. NHS Oxford University Hospitals. Pregnancy and type 1 diabetes mellitus. Available from: https://www.ouh.nhs.uk/patient-guide/leaflets/files/65650Pdiabetes.pdf. Last accessed: October 2022.
  3. Feldman AZ, Brown FM. Management of Type 1 Diabetes in Pregnancy. Curr Diab Rep. 2016;16:76. doi: 10.1007/s11892-016-0765-z
  4. NHS. Pre-eclampsia. Available from: https://www.nhs.uk/conditions/pre-eclampsia/. Last accessed: October 2022.
  5. CDC. Type 1 diabetes and pregnancy. Available from: https://www.cdc.gov/diabetes/library/features/type-1-and-pregnancy.html. Last accessed: October 2022.
  6. Diabetes UK. Planning for pregnancy when you have diabetes. Available from: https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/pregnancy. Last accessed: October 2022.
  7. NIDDK. Pregnancy if you have diabetes. Available from: https://www.niddk.nih.gov/health-information/diabetes/diabetes-pregnancy. Last accessed: October 2022.
  8. NHS. Diabetes and pregnancy. Available from: https://www.nhs.uk/pregnancy/related-conditions/existing-health-conditions/diabetes/. Last accessed: October 2022.
  9. Diabetes UK. Managing your diabetes during pregnancy. Available from: https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/pregnancy/during-pregnancy. Last accessed: October 2022.
  10. ADA. Insulin Routines. Available from: https://diabetes.org/healthy-living/medication-treatments/insulin-other-injectables/insulin-routines. Last accessed: October 2022.
  11. Diabetes UK. After the birth. Available from: https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/pregnancy/after-birth. Last accessed: October 2022.
  12. NICE. Diabetes in pregnancy: management from preconception to the postnatal period. Available from: https://www.nice.org.uk/guidance/ng3/chapter/Recommendations#postnatal-care. Last accessed: October 2022. 

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