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Diabetes in pregnancy Q&As

Published by Bupa's health information team, May 2009.

Answers to questions about diabetes in pregnancy

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

How could diabetes affect me during my pregnancy?

Having diabetes during your pregnancy does increase your risk of some health problems. These problems are less likely if your diabetes is well controlled and your blood glucose levels are stable. You can reduce the risks to yourself by following your treatment carefully, monitoring your blood glucose levels and keeping your midwife and doctor appointments.

Explanation

Being pregnant increases your chances of developing certain health problems. If you have diabetes as well, the risk of some of these problems is even greater. By following the right diet, being active and taking any treatment you need, such as insulin, you are more likely to have a healthy pregnancy. You will be asked to see a team of doctors and nurses who specialise in diabetes every one or two weeks throughout your pregnancy, as well as seeing your midwife. These appointments will help you to keep your diabetes well controlled and to stay healthy during your pregnancy.

The main problems for you to be aware of are as follows.

  • Early miscarriage. Diabetes that isn't well controlled can increase your chances of having a miscarriage in the first three months of pregnancy.
  • Pyelonephritis. This is an infection of your kidneys. It's more common in pregnancy and in people who have diabetes. The symptoms of pyelonephritis are: a fever, feeling or being sick, pain in your middle and upper back, going to the toilet to pass urine often and finding it painful when you do. If you think you have pyelonephritis see your doctor straightaway for advice. Pyelonephritis during pregnancy usually needs to be treated in hospital with antibiotics.
  • Pre-eclampsia. This is a potentially very serious condition that causes high blood pressure and can damage your liver, kidneys, brain and the placenta. The main signs are high blood pressure and protein in your urine. It's important to pick up any signs of pre-eclampsia early so that you can get the right treatment quickly. This is why it's vital to attend your all of your appointments whilst you are pregnant and to have your blood pressure and urine checked regularly.
  • Too much amniotic fluid. Amniotic fluid is the fluid around your baby. Having too much fluid can lead to early labour and problems for both you and your baby. Your doctor and midwife may either monitor you closely or admit you to hospital for treatment, depending on how severe the problem is.
  • Low and high blood sugar levels. Like someone who has diabetes all the time, not just during pregnancy (gestational diabetes), you may sometimes have very high or low blood glucose levels. Both high and low blood glucose levels can be very serious both for you and your baby. It's important that you check your blood glucose regularly and that you and your friends and family know what to do if you become unwell. Your midwife or doctor can give you advice and information about how to recognise the signs of low and high blood glucose levels and how to treat them.

If you feel unwell at all during your pregnancy you should talk to your doctor or midwife for advice.

Further information

Sources

  • Management of Diabetes: Management of Diabetes in Pregnancy. Scottish Intercollegiate Guidelines Network (SIGN), 2001. www.sign.ac.uk
  • Diabetes in pregnancy: management of diabetes and its complications from pre-conception to the postnatal period. National Institute for Health and Clinical Excellence (NICE), 2008. www.nice.org.uk
  • Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007: 781
  • Early miscarriage - information for you. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, accessed 21 March 2008
  • Acute pyelonephritis - management issues. Clinical Knowledge Summaries.http://cks.library.nhs.uk, accessed 21 March 2008
  • Pre-eclampsia and hypertension. BMJ Clinical Evidence. www.clinicalevidence.com, accessed 21 March 2008
  • Polyhydramnios. GP Notebook. www.gpnotebook.co.uk, accessed 21 March 2008
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Will the diabetes affect how my baby is born?

If your diabetes is well controlled and you don't have any other major health problems, a normal birth is possible. However, you are likely to be offered a planned birth either with induced labour or a caesarean section when your pregnancy has reached 38 weeks. As with any woman, whether you have diabetes or not, how your baby is born is very individual and will depend on your health and that of your baby's.

Explanation

Having diabetes during your pregnancy means that you are more likely to have your labour induced or to have a caesarean section than a women who doesn't have diabetes. Having diabetes means that your baby may be larger and you may be more likely to have a slow or very painful labour. These are the reasons why you are more likely to need to have a caesarean section than other women who don't have diabetes. Your midwife and doctor will monitor your pregnancy closely and will discuss your options with you. If your baby is large your doctor is likely to recommend that you have it at 38 weeks.

During the final part of your pregnancy your doctor and midwife will talk to you about pain control during your labour. Epidurals can be used safely in women who have diabetes. Once you are in labour your doctor and midwife will aim to keep your blood glucose levels between 4 and 7mmol/l. This might mean having insulin and glucose through a drip to help keep the levels well controlled.

You and your baby will be closely monitored all of the time that you are in labour to make sure that everything is happening safely. You will have your baby in a hospital that has the facilities to care for you both should there be any problems or if you need treatment quickly. There should also be a doctor that specialises in caring for new born babies at the birth.

Further information

Sources

  • Management of diabetes: management of diabetes in pregnancy. Scottish Intercollegiate Guidelines Network (SIGN), 2001. www.sign.ac.uk
  • Diabetes in pregnancy: management of diabetes and its complications from pre-conception to the postnatal period. National Institute for Health and Clinical Excellence (NICE), 2008. www.nice.org.uk
  • Management of gestational diabetes. GP Notebook. www.gpnotebook.co.uk, accessed 21 March 2008
  • Recommendations for the management of pregnant women with diabetes (including gestational diabetes). Diabetes UK. www.diabetes.org.uk, accessed 21 March 2008
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How long will it take for the diabetes to go away once the baby is born?

Usually diabetes that develops during your pregnancy (gestational diabetes) goes away within a few weeks of the birth of your baby. When this happens you will still need to have regular checks as you are more likely to develop diabetes in the future. However, for some women their blood glucose levels don't return to normal and they are diagnosed with diabetes that needs life-long treatment.

Explanation

You should be able to stop treatment for diabetes, including any insulin injections, after your baby is born. Your nurse or doctor may also give you information about a healthy lifestyle and ask you to make changes, such as being more active or losing weight. Leading a healthy lifestyle can help you to reduce your risk of developing diabetes in the future.

You will be asked to have your blood glucose tested six weeks after the birth, to make sure that it has gone back to its pre-pregnancy levels. If the results of this test are normal, you will be asked to have regular checks in the future to monitor your blood glucose levels. This is because, having had gestational diabetes, you're more at risk of developing diabetes in the future than other women.

This includes type 1 or type 2 diabetes and diabetes in pregnancy if you have another baby. You can reduce the likelihood of this by eating the right foods, being active and the right weight for your height.

If your test result shows that you still have raised blood glucose levels, you will be asked to have further tests to see whether you have type 1 or type 2 diabetes. If tests confirm this, your doctor will discuss your treatment options with you.

Further information

Sources

  • Gestational diabetes. Diabetes UK. www.diabetes.org.uk, accessed 21 March 2008
  • Recommendations for the management of pregnant women with diabetes (including gestational diabetes). Diabetes UK. www.diabetes.org.uk, accessed 21 March 2008
  • Diabetes in pregnancy: management of diabetes and its complications from pre-conception to the postnatal period. National Institute for Health and Clinical Excellence (NICE), 2008. www.nice.org.uk
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Related topics

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: May 2009

 

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