Special Considerations
Folic acid
General advice is that all women with diabetes planning a pregnancy should have 5mg of Folic Acid every day. This should be taken both before conception and for the first 3 months of pregnancy. Green leafy vegetables and enriched breakfast cereals (see packaging for details) are good sources of Folic Acid, but you will need supplements to reach the recommended amount (5mg tablets are available by prescription).
Changing glucose levels
Glucose levels will change during your pregnancy. If your diabetes was previously treated with tablets you will need to look after your diet very carefully to improve your blood glucose control. If you are overweight you may also be pleasantly surprised at the improvements in blood glucose control losing weight can bring. Regular monitoring will show you whether you need to start insulin injections to improve your blood glucose levels.
Stop smoking now
For your own health and the health of your baby stop smoking now! When you have diabetes, smoking carries a particularly high risk of causing angina, heart attack, stroke and circulatory problems. There is also good evidence to show that babies born to mothers who smoke have a higher risk of developing problems such as asthma.
Hypos and pregnancy
Because you are aiming for very strict control, you may find you have more 'hypos' when you are pregnant, although many women find that their pregnancy passes with few problems. No one really knows why 'hypos' occur more frequently during pregnancy but it is best to be prepared. Fortunately, unborn babies do not appear to be harmed by hypos but it is still important to be mindful.
There are several steps you can take to try to avoid 'hypos', including:
- Eat on time - missed or late meals are the most common cause of 'hypos' so don’t get caught hungry.
- Monitor your blood glucose - 'hypos' may indicate that your insulin dose needs adjusting. Your physician or diabetes educator will help you if you are unsure about which insulin to adjust.
- Don't go solo - now is not the time to spend long periods alone. Make sure you are in regular contact with people during the day and that you are not alone overnight.
- Tell your friends - friends, relatives and your children need to know how to recognize a 'hypo' and how to help you. Just in case you have a severe 'hypo' and lose consciousness, your Diabetes Educator can teach your partner how to inject you with glucagon to raise your blood glucose.
- Use your alarm clock - every pregnant woman needs to rest during the day but be careful that you do not sleep through mealtimes. If you need a snooze, set your alarm clock.
- Take care when you drive - if you need to drive check your blood glucose before you head out, carry extra glucose and try not to make a journey before a meal.
Important Notice: Information provided is for general background purposes and is not intended as a substitute for medical diagnosis or treatment by a trained professional. You should always consult your physician about any health care questions you may have, especially before trying a new medication, diet, fitness program, or approach to health care issues.
DOC11709-Rev-A 04/08
