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Home > Knowledge & support > Living with type 1 diabetes > Health and wellbeing > Pregnancy
Yes, many women with type 1 have had healthy children.
Pregnancy with type 1 diabetes does take extra planning. It’s important to find out as much information beforehand so that you can prepare.
Only one in 10 people with type 1 diabetes have a close family member with the condition. Your baby is highly unlikely to be born with type 1 diabetes, although there is a genetic condition called neonatal diabetes, which is uncommon. The chance of your baby developing diabetes in the future is dependent upon a number of things.
For women with type 1 diabetes giving birth before the age of 25, the child has a one in 25 chance of developing type 1. For women older than 25, the child has a one in 100 chance – about the same as someone who doesn’t have type 1.
It is worth remembering that most people with type 1 diabetes don’t have relatives with diabetes. Find out more about type 1.
If you’ve decided to try for a baby there are some things to consider:
It is advisable to have regular medical appointments with your Diabetes Care team or GP prior to becoming pregnant. Eye and kidney screening is also recommended.
It’s recommended to have a review of medications you are taking for any other conditions with your GP. If you are taking statins these should be stopped at least three months before conceiving. Likewise, if you are taking blood pressure medication this should be reviewed as some types are not suitable for use in pregnancy.
Some hospitals provide Preconception Clinics. The staff working in this service are trained to advise you on glucose monitoring, insulin dosing and adjustment, healthy lifestyle behaviours and medication reviews to help prepare you for pregnancy.
Taking folic acid supplements is recommended for all pregnancies. Women with diabetes require a higher dose of 5mg due to the potential for neural tube defects. This is available on prescription from your GP and should be taken from three months before conception until 12 weeks into pregnancy.
Pregnancy multivitamins are also recommended, especially Vitamin D.
Try to get your HbA1c below 53 mmol/mol (7%) before you concieve and aim to keep it below 48 mmol/mol (6.5%) during pregnancy if you can do this without getting more episodes of hypoglycaemia.
The first 6-12 weeks are when a baby’s major organs develop, which is why it is important to have tight blood glucose control before becoming pregnant. Having consistently high blood glucose levels in these early weeks of pregnancy can increase the risk of abnormal development, but with careful planning and support this risk is significantly reduced.
Your Diabetes Healthcare Team will be able to support you with keeping your HbA1c in the recommended range.
Technology like continuous glucose monitors (CGM) or flash glucose monitors will help you to keep your blood glucose levels in range. Starting before you get pregnant can help you get used to the technology in advance.
The recommended target range for your glucose is 3.5 – 7.8mmols. Spending 70% or more of the day in this range improves the chance of having a healthy pregnancy.
CGM is available on the NHS for pregnant women, although you should be able to get flash on the NHS, if you prefer. Find out more about accessing technology from the NHS.
Yes, with the right support, information, and preparation.
Like any planning for pregnancy, there are some goals that you can work on about three months before beginning a cycle.
Getting the right insulin to carb ratios, how sensitive you are to insulin and how long your insulin works for all become very much a part of managing your type 1 and optimising IVF treatment.
Your fertility team can advise on how to manage your diabetes to give the IVF the best chance of working.
It’s usually recommended to start the IVF cycle after you’ve optimised your blood glucose levels. Try to get your HbA1c to 48mmol/mol (6.5%) and aim for a time-in-range of at least 70%.
Talk to your Diabetes Healthcare Team about keeping your HbA1c in the ideal range. As for all pregnancies where diabetes is involved, they can advise you on available technology to help keep your blood glucose levels within the tighter range that you need for IVF and pregnancy.
All pregnancies in people with type 1 diabetes come with a risk of developing high blood pressure, but IVF pregnancies tend to have higher incidences of pre-eclampsia.
You will be carefully monitored during antenatal care when undergoing IVF but it’s important to find a team that are willing to listen to concerns that you may have and who are able to talk you through any risks.
Once you’re pregnant, it is important to try to maintain glucose control. This can be difficult, so get support from your Diabetes Healthcare Team, other healthcare professionals, family, and friends.
You may find that pregnancy changes your hypo warning signs. You will also notice that your insulin requirements change from one trimester to the next. Common pregnancy conditions such as hyperemesis and food cravings can impact your glucose management, which is why it is important to contact a joint antenatal-diabetes clinic as soon as you know or suspect that you are pregnant.
From 12 weeks into pregnancy all women with type 1 diabetes are advised to take Aspirin as this reduces the risk of developing high blood pressure. The dose of Aspirin is dependent upon your weight and BMI, which is why it is important to attend an antenatal clinic specifically for women with type 1 diabetes.
Your clinical team will provide you with a schedule of check-ups and tests to monitor you throughout your pregnancy. They will review you regularly to identify the potential for any complications that can be more common pregnancy, including kidney and eye problems.
The growth of your baby also needs to be closely monitored, as variable blood glucose levels can increase the risk of the baby growing to a larger than average size, or to your baby growing more slowly than normal.
Pregnant women are entitled to CGM on the NHS. This can help you keep your blood glucose levels in range more easily. Talk to your Diabetes Healthcare Team about how to get one.
If you fall pregnant unexpectedly, make an appointment with your Diabetes Healthcare Team as soon as possible to help with glucose management and support for you and your pregnancy.
The risk of miscarrying increases if your type 1 diabetes is unmanaged. If your levels are within target range as much as possible, your type 1 diabetes is unlikely to cause a miscarriage.
You have every reason to expect a normal birth. You can carry your baby to full-term and go into labour on your own. Some women are advised to have their baby early because of the effect on their type 1 management or the baby becoming too large.
You can still have a natural birth, although it is slightly more common to have a caesarean section. You will be able to discuss all your options with your obstetrician and plan for your baby’s birth towards the end of your pregnancy.
If your insulin doses changed during your pregnancy, they will go back to pre-pregnancy doses immediately after delivery of the baby. Keep a note of what these were before you became pregnant.
If you want to breastfeed, there’s no reason why you can’t.
Monitor any fluctuations in your blood glucose levels and plan ahead. You’ll probably need to eat more carbohydrate when feeding, especially in the early months. You may find that your milk is slower to ‘come in’, but your midwife or lactation consultant will help you and your baby to get to grips with it.
Talk to your support network, whether it’s a partner, friends, or family, as well as your GP and Diabetes Healthcare Team.
You can also connect online with people with type 1 who are going through pregnancies or have had children already. There are various online communities and resources:
“To anyone with type 1 considering IVF, I would say find your support network – through a diabetes charity, social media, or through people you meet at clinics. They will help you. That is the most valuable thing of all.”
“My baby was healthy and I have a lovely daughter, who’s nine now. By the time of my second pregnancy I had accepted my type 1. That pregnancy was amazing, because I knew so much more.”
“After a few wobbles at the start, I soon learned to embrace and trust CGM wholeheartedly. My trust in the technology, coupled with the amazing knowledge and support of my team at St Thomas’s hospital, gave me the confidence to undertake a pregnancy.”
“Every single day for that pregnancy and since, I have woken up in target. I have had a huge reduction in hypos. I have had to eat less to maintain my diabetes levels and eat what I want, when I want.”
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