Care at NUH

Planning for Pregnancy

2024/09/27

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Women with Type 1 Diabetes can experience safe and successful pregnancies with proper care and preparation. 

BEFORE PREGNANCY

Consult your healthcare team about your plans to conceive. Use reliable contraception until you are ready. 

Having Type 1 Diabetes may increase the risk of complications for mother and baby. However, complications can be reduced by
1. Achieving and maintaining a HbA1c of 6.0 to 7.0% before becoming pregnant and
2. Maintaining optimal blood glucose readings throughout the pregnancy.

Work with your healthcare team to achieve optimal blood glucose control before conception. Your healthcare team might recommend using a continuous glucose monitoring sensor or an insulin pump before conception in order to optimize blood glucose levels.

We also recommend the following before conceiving:
1. Be screened for diabetes-related complications (eg. Eyes, kidney, blood pressure)
2. Take folic acid
3. Stop smoking

 

DURING PREGNANCY

You should inform your healthcare team as soon as you are pregnant, so that your condition can be managed carefully by a specialist team.

Expect significant changes in insulin needs and blood glucose levels throughout pregnancy. Regular follow-ups with your diabetes team and obstetrician are crucial. 

Blood glucose targets during pregnancy are more stringent than those for non-pregnant individuals. 

An example of blood glucose targets during pregnancy: 
TimingTarget
Before meals4.4 to 5.5 mmol/L
2h after a meal5.5 to 6.6 mmol/L

Achieving these targets requires regular blood glucose monitoring (up to seven times daily - before and 2 hours after each meal and at bedtime) or the use of a continuous glucose monitoring sensor. Familiarize yourself with flexible insulin dosing principles from our resource page to maintain tight glucose control during pregnancy. 

AFTER DELIVERY

Insulin requirements may decrease substantially after delivery. Breastfeeding is encouraged, but insulin doses may need further reduction to prevent hypoglycaemia. Your healthcare team will work with you for insulin dose adjustments during this period.

Discuss with your doctor the timing for your next pregnancy and appropriate contraception for family planning. 

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