Things to do before you become pregnant or as soon as you learn you are pregnant

Preconception care should start from adolescence, and your healthcare team may talk to you about it at each visit. It is really important to use some form of contraception until you decide you want to become pregnant. If you have diabetes and are thinking of getting pregnant it is vital that you ask your diabetes care team for pregnancy planning advice. They will talk to you about all of the following items, but it is a good idea for you to know what tests and treatment to expect, and what you can do to get your pregnancy off to a healthy start.

Blood glucose

You can increase your chances of delivering a healthy baby by keeping your blood glucose in good control before conception and throughout your pregnancy. The first eight weeks are particularly important for the physical development of your baby. Poor control of blood glucose during conception and through the first eight weeks greatly increases the chances that your baby will develop problems.

Have your eyes checked

Especially if you already have any eye problems (retinopathy). Pregnancy can place extra pressure on the small vessels in your eyes, so if you have advanced retinopathy that has not been treated, make sure it's treated before you become pregnant.

Check your medications

Some medicines which are used in the treatment of someone with diabetes should NOT be taken by pregnant women.

If you are prescribed a statin, angiotensin-converting enzyme (ACE) inhibitor or angiotensin-11 receptor antagonist you must tell your doctor if you plan to become pregnant or have found out that you are pregnant, as these may damage your baby’s development.

If you are taking tablets for Type 2 diabetes, you may have to stop taking certain ones because they may harm your baby. If you are switched to insulin injections to control your blood glucose, you can usually return to tablets after pregnancy.
Your doctor will tell you whether or not you need to change your medicine.

Cut out alcohol

Drinking alcohol during pregnancy can harm your baby. It also affects your blood glucose levels and can increase your risk of hypos. 'Less is best' when it comes to alcohol and, ideally, stop drinking altogether until after your baby is born.

Eat right

Follow the general guidelines for healthy eating and read the booklets about diet to learn more about the role food plays in keeping your blood glucose balanced.

Stop smoking

Smoking while pregnant can harm your baby. The effects it has on your child can last well into childhood and can be permanent. The potential problems caused by diabetes can make smoking even more unhealthy for you. Your GP, midwife or consultant can recommend ways to stop smoking.

Begin taking folic acid tablets

Doctors now recommend that all women planning a pregnancy take the vitamin folic acid before conception and for the first 12 weeks of pregnancy. This vitamin helps prevent spinal cord problems (including spina bifida) from developing in your baby. All women with diabetes are advised to take 5mg of folic acid, which is only available on prescription. Discuss with your diabetes care team.

Reviewed September 2011