How can a woman with diabetes plan a pregnancy safely?

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I read your query and understood your concern.

When you are planning a pregnancy, it is important for you and your family to understand how diabetes can affect your pregnancy and how pregnancy can affect your diabetes. Here is what you need to know:

1. Your diet, body weight, and exercise play an important role in managing your blood glucose.
2. There is a risk of low blood sugar (hypoglycaemia), and sometimes you may not feel it coming. We need to monitor this closely during pregnancy.
3. Nausea and vomiting in pregnancy can affect your blood sugar control, so we need to adjust your plan if this happens.
4. There is an increased risk of having a baby who is larger than usual for their gestational age. This can increase the chances of birth trauma, the need for labour induction, and assisted or caesarean deliveries.
5. It is important to check your eyes for diabetic retinopathy before and during pregnancy.
6. We also need to assess your kidney function before you get pregnant.
7. Keeping your blood glucose under control during labour and birth is very important. Early feeding of your baby can help reduce the risk of low blood sugar in your newborn.
8. Your baby may have health issues in the first 28 days and could need admission to a neonatal unit.
9. There is a long-term risk of your child developing obesity, diabetes, or other health problems later in life.
10. We will also agree on individual targets for checking your blood sugar at home, taking into account the risk of low blood sugar.

If you have type 1 diabetes, your blood glucose targets before and during pregnancy should ideally be:

1. Fasting plasma glucose between 5 mmol/litre and 7 mmol/litre when you wake up.
2. Plasma glucose between 4 mmol/litre and 7 mmol/litre before meals, at other times of the day.

For the preconception period, we aim to keep your HbA1c (glycated hemoglobin) level below 48 mmol/mol (6.5 %), as long as this can be achieved without causing dangerously low blood sugar. Even if you cannot reach this target immediately, any reduction in HbA1c will help reduce the risk of congenital problems in your baby.

If your HbA1c is above 86 mmol/mol (10 %), I would strongly advise you to wait before getting pregnant, because the risks are higher for both you and your baby. If you are considering contraception before trying to conceive, one of the best options is Levonorgestrel.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.