8 Most Common Questions about Pregnancy and Diabetes:
1. Can I get pregnant now that I have diabetes?
Yes, you can, because diabetes does not affect fertility. However, it is wise to inform your doctor of your wish in good time so that you can make preparations together.
2. I have type 1 diabetes and I want to become pregnant. Will my baby get diabetes too?
The chance that the child will also develop diabetes is greater than normal. Until the age of 35, the chance increases gradually, to a percentage between 3 and 8%. The chance is smaller when the mother has diabetes than when the father has diabetes. It saves about half. However, the younger the father was when he was diagnosed with diabetes, the greater the chance.
3. What preparations are necessary before becoming pregnant?
It is important that medication that lowers blood sugar levels is stopped in time and that you are ‘transferred’ to insulin treatment. Most medications are not good for the baby, and insulin generally allows patients to be better regulated, which in turn is important for the baby’s development and growth. Furthermore, your eyes and kidneys need to be closely monitored. They will also be advised to take a tablet of folic acid daily, and other medications used, such as those to treat high blood pressure, hypercholesterolemia, or other conditions, will be critically examined. Finally, extra check-up appointments will be made with the internist, gynecologist, and diabetes nurse.
4. I have diabetes and got pregnant unexpectedly. Is that bad?
No, it’s not bad, but it’s not optimal either. Contact your doctor and diabetes nurse as soon as possible so that blood sugar regulation and other checks can be carried out as quickly as possible and any adjustments can be made in the short term.
5. I have diabetes and I hope to become pregnant. Do I have to undergo an HbA1c test?
Yes, and therefore it is wise to discuss a pregnancy wish with your doctor in good time. The blood sugar regulation must be in good order so that the baby’s development can proceed undisturbed. High blood sugar levels can negatively influence development. Therefore, a low HbA1c (< 7%) and normal blood sugar levels will be sought in advance.
6. How should I regulate my diabetes during my pregnancy?
Try to keep the blood sugar level between 4 and 6 mmol/l before every meal and below 6.7 mmol after every meal (2 hours after the meal). Ideally, the blood sugar level should be < 5.3 mmol/l. An HbA1c lower than 7% should also be aimed for. You will see that you will need to inject more and more insulin during pregnancy to keep the blood sugar level in line. You should also have regular check-ups with your internist, gynecologist, and/or diabetes nurse.
7. I have to inject more and more insulin, it can’t go on like this, can it?
Normally, more and more insulin has to be injected during pregnancy. This is because the placenta/mothercreas releases hormones through and for the growth of the baby. These hormones have an opposite effect to insulin, so more insulin is needed. The largest need for insulin is around the 33rd week of pregnancy after that less is needed. Be careful, because if you don’t spray less then you will get hypo’s again.
8. I also get medication for my blood pressure. Is it allowed during pregnancy?
Most patients with diabetes receive so-called ACE inhibitors or AT2 antagonists for the treatment of hypertension. These drugs are bad for the baby, and should not be taken during pregnancy. Nevertheless, blood pressure must remain well regulated during pregnancy. Fortunately, other drugs can be used, such as the so-called calcium antagonists, the beta-blocker labetolol, and alpha-methyldopa. It is best if the medication is stopped before fertilization. Otherwise, it should be stopped as soon as possible after fertilization.
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