Diabetes in pregnancy

What is diabetes?

Please see the information videos below:

If you require subtitles, please use the subtitles facility on YouTube.

Planning a baby (pre-conception)

The majority of pregnancies are unplanned, however for those with a pre-existing medical condition, it is important that advice is sought prior to stopping contraception and actively trying for a baby.

All women of childbearing age should be aware of the risks associated with pregnancy and their individual conditions.

There are pre-conception clinics available for women with diabetes to access for advice and support at both Burnley and Blackburn hospitals-this can be via referral from your GP/Practice Nurse/Diabetes Specialist Nurse or you can contact the Lead Midwife for Diabetes to discuss on 07808 364509.

National Institute for Health and Care Excellence (NICE) makes the following recommendations regards planning a pregnancy and diabetes:

• Commence Folic acid 5mgs once every day for at least 3 months before you become pregnant and continue this until 12 weeks pregnant. This significantly reduces the chance of your baby developing any abnormalities around the head and spine (neural tube).
• Aim to achieve an HbA1c of 48mmol/mol (6.5%) where safe and achievable to do so in order to reduce complications as much as possible.
• It is strongly advised not to become pregnant if your HbA1c is 86mmol/mol (10%) or above as this greatly increases the risk of serious complications.
• Ensure you have had a full medication review with either your GP or Diabetes Consultant/Specialist Nurse as some medicines used to treat diabetes and other associated conditions carry a risk for a developing baby and should be stopped or changed prior to becoming pregnant.
• Maintain a healthy weight and active lifestyle-see ‘Diet and lifestyle Advice’ section.

Diabetes UK Information prescription is an excellent tool for patients with diabetes and health professionals regards preparing for pregnancy.

Tommy’s Baby Charity also has an excellent online tool to guide women into preparing for pregnancy.

Antenatal care

We provide specialist care for women with diabetes in pregnancy and therefore have 2 dedicated joint medical clinics every week-one clinic at Burnley General Teaching Hospital and one clinic at Royal Blackburn Teaching Hospital.

Your care is provided by a multidisciplinary team with members from obstetrics, diabetes and dietetics in order to provide the best holistic care for you and your baby. Please see our meet the team section for further details.

You will be asked to check your blood glucose levels 4-7 times a day-we will provide you with a machine and show you how to do this. This is really important to allow us to reduce the risks for you and your baby by ensuring you get the right treatment.

Care is tailored to the individual and we may ask to see you as frequently as 1-2 weekly with phone consultations in between dependent on what treatment you require for your diabetes.

Treatment for diabetes in pregnancy is limited to diet and lifestyle changes (see the ‘Diet and lifestyle advice’ tab), metformin tablets and insulin injections. The team will have a full discussion with you around why a particular treatment is recommended and support you with this.

Click here to see read about what you can expect in line with NICE guidance and offers advice around preparing for pregnancy, the pregnancy journey and postnatal care.

Clinic dates and times:

Burnley General Teaching Hospital, Wednesday mornings 9-5pm

Royal Blackburn Teaching Hospital, Thursday mornings 9-5pm

Care in labour

This is very much dependent on the type of diabetes you have and the treatment for your diabetes.

You will have a full discussion with the team at around 36 weeks pregnant regards the recommended plan for labour and birth.

Please do look at the birth plan section of the NHS choices website for information around birth and pain relief to aid this discussion.  

Postnatal care

Women with pre-existing diabetes usually return to their pre-pregnancy treatment and are followed up by their usual care provider 4-6 weeks after birth.

Women with gestational diabetes stop all treatment after birth.

Gestational diabetes is significant risk for developing type 2 diabetes and therefore it is really important that you attend for a follow up appointment with the GP at 6-12 weeks for a blood test to check that your diabetes has gone away. Your GP should then call you every year to make sure that you have not developed type 2 diabetes.

How can I reduce my risk of developing Type 2 diabetes?

Diabetes UK has an excellent resource around prevention of developing Type 2 diabetes.

Diet and lifestyle advice

Please click on the documents below to access our current dietary advice for pregnant women with diabetes.

Regular exercise is really important, and in particular a 30 minute brisk walk after each meal can make a significant difference to your blood glucose levels, and therefore reduce risk in pregnancy.

You can find more information on the NHS website. 

Your midwife will also be able to signpost you to exercise classes in our local area which are suitable for pregnant/postnatal women.

Useful videos

If you require subtitles, please use the subtitles facility on YouTube.

Tommy’s also have some really good advice around exercise in pregnancy.

Meet the Team

• Dr Sarah Davies - Consultant Obstetrician
• Dr Sarah Loveridge - Consultant Obstetrician
• Dr David Beaumont - Consultant Obstetrician
• Dr Khwaja Nizamuddin - Consultant Physician
• Dr Farheen Raza - Consultant Physician
• Adrian Smith - Diabetes Specialist Nurse
• Kulsum Patel - Diabetes Specialist Nurse
• Sarah Carter - Lead Midwife in Diabetes
• Danielle Waddington/Jane Penketh Deputy Diabetes Specialist Midwives
• Faith Taylor - Specialist Dietitian

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