If you have diabetes, you should frequently visit the maternity clinic for follow-up appintments for the entire duration of your pregnancy. In early pregnancy, insulin sensitivity may increase and insulin requirements may decrease, which can increase the risk of hypoglycaemia. Pregnancy-related nausea, vomiting, and irregular eating patterns may further increase this risk.
The need for insulin begins to increase from weeks 16-20 of the pregnancy onwards. The increase in the amount of insulin is due to pregnancy hormones, as a result of which insulin is no longer as effective. The need for insulin is greatest during weeks 32–36 of the pregnancy. As the end of the pregnancy approaches, the follow-up visits take place more frequently.
During pregnancy, glucose targets are stricter than usual. The goal is to achieve a fasting glucose level below 5.3 mmol/L, a glucose level below 7.8 mmol/L one hour after meals, and a glucose level below 6.7 mmol/L two hours after meals, provided that these targets can be achieved without significant hypoglycaemia.
If you have diabetes and are pregnant
For people with type 1 diabetes, continuous glucose monitoring is recommended throughout pregnancy. Continuous glucose monitoring is used to assess fasting and postprandial glucose levels as well as the overall 24-hour glucose profile. The goal is for glucose levels to remain within the pregnancy-specific target range of 3.5–7.8 mmol/L for more than 70% of the time.
The use of an automated insulin pump is recommended during pregnancy for people with type 1 diabetes. Ideally, the automated insulin pump should be started already when planning a pregnancy, but it can also be initiated during pregnancy. The system settings are adjusted throughout pregnancy in collaboration with the diabetes care team.
Your blood sugar should not be too high during pregnancy as it will result in your baby growing adversely big. Healthy eating and exercise are an important part of the treatment. Regular meals, high-quality sources of carbohydrates, and adequate fibre intake help smooth postprandial glucose fluctuations and make it easier to achieve glucose targets.
If you have type 1 diabetes. You should learn – if they are not yet familiar with it – or recap how to measure the blood ketone level and interpret the results. Ketoacidosis, a form of acidosis resulting from insulin deficiency, may occur when the blood sugar level is lower than normal during the pregnancy.
If you have type 2 diabetes, your pregnancy will be closely monitored in specialized healthcare. The targets for fasting and postprandial glucose levels are the same as those for type 1 diabetes. Glucose monitoring can be carried out either through continuous glucose monitoring or with finger-prick blood glucose measurements, depending on individual needs. Blood sugar is managed with metformin tablets and, if needed, insulin.