Your health during pregnancy

When you are pregnant, you need regular support to manage your diabetes. You can come to our diabetes antenatal clinic every 2 weeks. 

We give you advice about your diet and medicines during pregnancy, and what exercise you can do.

It is important to have tight blood glucose control before getting pregnant. You then need to maintain this through the early stages of pregnancy. Some people find this stressful and demanding, while others cope well. Your diabetes and pregnancy team is here to support you.

This is likely to be a challenging period of your life as your body goes through many changes. We encourage people to talk about their needs and concerns openly with partners, family members and close friends. It is important to get support and understanding from people close to you, as well as from health professionals.

Diabetes antenatal clinic

When your pregnancy is confirmed, please call the diabetes department and make an appointment in the diabetes antenatal clinic.

We hold the clinic every Wednesday afternoon. It is made up of the:

•    diabetes midwifery team
•    specialist obstetrician (doctor specialising in pregnancy)
•    specialist diabetes midwife

Having all these specialists in 1 clinic means that they can work together to give you well-structured care.

Most people come to the diabetes antenatal clinic every 2 weeks. You can then get regular support with managing your diabetes during pregnancy.

Your diet during pregnancy

We recommend that you have an appointment with a dietitian specialising in diabetes. 

The dietitian can give you advice and support to have a healthy, balanced diet while you are pregnant. This includes making sure that you have enough:

•    energy
•    protein
•    iron
•    calcium
•    folic acid
•    vitamin D

The dietitian also explains which foods it is best to avoid when you are pregnant.

Your medicines during pregnancy

When you are pregnant, it is recommended that you take some food supplements to keep you and your baby healthy. We also need to review your diabetes treatment and any other medicines that you take.

Folic acid (folate)

Folate is a vitamin that helps to prevent your baby from getting certain birth defects of the brain and spine.

Most people can get the folate that they need every day by having a varied diet. This should include:

• green leafy vegetables
• fruit
• breads and cereals
• nuts
• legumes (such as peas or beans)

It is recommended that anyone who could get pregnant takes a folic acid supplement. Folic acid is the man-made form of the vitamin folate.

If you have diabetes, there is a slightly higher chance of your baby getting brain and spine defects. To prevent this, you need to take a higher amount (dose) of folic acid supplement. 

We recommend that you have a 5mg folic acid supplement 1 time each day. You should take this from at least 4 weeks before pregnancy and throughout the first 12 weeks of pregnancy.

You need to get a prescription for 5mg folic acid tablets from your GP.

Vitamin D

You need to take 10 micrograms (400 units) of vitamin D every day throughout your pregnancy and while breastfeeding. A microgram is 1,000 times smaller than a milligram (mg). This helps to give your baby enough vitamin D for the first few months of their life.

Vitamin D helps your baby to develop healthy bones. You can buy vitamin tablets for pregnancy that contain this amount of vitamin D from a pharmacy or supermarket. You can also buy plain vitamin D tablets or capsules.

Aspirin

If you have diabetes, you have an early scan when you are about 7 weeks pregnant. This scan confirms the number of babies and if your pregnancy is progressing without problems inside the womb. If your early scan is OK, we routinely prescribe aspirin for you.

You need to take 150mg of aspirin 1 time each day for the rest of your pregnancy after the early scan. This has been shown to reduce the chance of pre-eclampsia (when you get high blood pressure, swelling and protein in the urine).

Diabetes tablets

If you take diabetes tablets before pregnancy, you need to speak with your GP or diabetes specialist doctor about planning to get pregnant. Some medicines for diabetes are not recommended in pregnancy. We may change your treatment to insulin and/or tablets.

If you are on metformin tablets, you can keep taking them when you are pregnant. You may need to start taking metformin tablets if your blood sugar readings are above the target range. People with type 2 diabetes often need metformin tablets during pregnancy.

Insulin injections

Most people with diabetes need insulin treatment before and during pregnancy.

To get the best possible blood sugar control, we usually recommend that you inject insulin several times a day. This includes having injections with each meal. You also often need insulin at night and/or first thing in the morning.

We have more information on insulin changes during pregnancy.

Insulin pump

Some people use an insulin pump rather than having several injections every day.

A pump gives you a small amount of background insulin throughout the day and night. You then have extra doses of insulin through the pump when you eat.

You wear an insulin pump all the time and attach it to your skin. Insulin flows into your body through a small plastic tube (cannula) under the skin. You change the cannula every 2 or 3 days and move the pump to another part of your body.

Other medicines

We need to review every medicine that you take either:

• before pregnancy
• as soon as possible after you find out that you are pregnant

This includes any medicines to lower your cholesterol and blood pressure.

When you are pregnant, we may need to stop some of your medicines or change the dose.

Exercise during pregnancy

It is important to exercise regularly during pregnancy if you have diabetes. This can help you to:

• relax
• spend time with your friends
• manage your blood sugar levels

When you are pregnant, it is not the time to start a new heavy exercise routine. However, an activity like swimming is a good way to support your tummy (abdominal) muscles during pregnancy.

You can talk to your obstetrician (doctor specialising in pregnancy) or midwife about specific exercises or activities.

It is a good idea to include walking in your daily routine.