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Management of blood sugar during pregnancy

The need for insulin changes during pregnancy.

If you have diabetes, you should frequently visit the maternity clinic for follow-up appintments for the entire duration of your pregnancy. Typically, blood sugar is low early in the pregnancy. If you have pregnancy nausea, you should be cautious with your insulin dose and choose foods that you like.

The need for insulin begins to increase from weeks 20–24 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 28–32 of the pregnancy. As the end of the pregnancy approaches, the follow-up visits take place more frequently, on a weekly basis.

Target for the blood sugar levels is 3.5–5.5 mmol/l before meals and 5.5–7.8 mmol/l after meals throughout the pregnancy.

If you have diabetes and are pregnant

In addition to your regular self-measurements, you should always check your blood sugar:

  • two hours after each main meal,

  • 90 minutes after each meal from week 24 onwards,

  • and 60 minutes after each meal from week 26 onwards.

The glucose sensing used in connection with MDI or pump therapy is very useful during pregnancy and breastfeeding.

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. The quality and quantity of carbohydrates and food (long-lasting carbohydrates and fibres) reduce the increasing need for insulin.

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. The monitoring and treatment during pregnancy follows the same principles as a person with type 1 diabetes. The weight, blood sugar and blood pressure targets are the same. Blood sugar is managed with metformin tablets and, if needed, insulin.

Updated 30.9.2023