Type 1 Diabetes And Pregnancy
Can You Give Birth if You Have Type 1 Diabetes?
Women with type 1 diabetes can have a safe pregnancy and deliver a healthy baby, but in some cases, a vaginal delivery may not be possible. Babies of mothers with type 1 diabetes tend to be larger, increasing the risk of complications during delivery. You may need to have your baby early, possibly through induction at week 37 or 38, or via a Caesarean section (C-section).
Your healthcare team will guide you on what’s best for both you and your baby. It’s recommended that women with type 1 diabetes work closely with their healthcare providers before coming off contraception to reduce risks during pregnancy.
Will Type 1 Diabetes Affect My Baby?
Most women with type 1 diabetes have healthy babies. However, pregnancy hormones can make it more difficult to keep blood sugar levels within the target range. High blood sugar levels during pregnancy can affect your baby’s development, leading to potential complications such as:
- Birth defects
- Larger baby size, increasing the risk of a difficult birth
- Miscarriage or stillbirth
After birth, some babies may need neonatal care for conditions like low blood sugar and jaundice. Babies may also need support with breathing or heart problems.
To minimize risks, inform your diabetes healthcare team as soon as you start planning for a baby. During pregnancy, you’ll have frequent check-ups and extra appointments to monitor your and your baby’s health.
Can Type 1 Diabetes Be Passed from Mother to Baby?
Babies aren’t born with type 1 diabetes, and there’s only a slightly higher risk of your child developing the condition later in life. Many people with type 1 diabetes have no family history of the condition.
Planning for a Pregnancy if You Have Type 1 Diabetes
Planning your pregnancy is key to reducing health risks for you and your baby. Ideally, you should start working with your healthcare team 6-12 months before stopping contraception to prepare for a healthy pregnancy. Your team will help you reach an HbA1c level of 48mmol/mol or lower to protect your baby, as the first 6-8 weeks of pregnancy are critical for organ development.
Your healthcare team may:
- Perform kidney and eye checks
- Prescribe high-dose folic acid (5mg daily)
- Review your medication for pregnancy-safe alternatives
- Discuss using a Continuous Glucose Monitor (CGM) to track blood sugar levels
- Provide advice on diet, physical activity, and, if needed, help to stop smoking or drinking
Managing Blood Sugar Levels During Pregnancy
Keeping your blood sugar levels within the target range is crucial to reducing risks for you and your baby. Pregnancy hormones can make managing blood sugar levels harder, especially due to insulin resistance, which often starts around weeks 16-20. You’ll likely need to adjust your insulin dose, especially before meals, as pregnancy progresses.
Using a CGM can help by alerting you when your glucose levels are too high or too low. Your healthcare team will provide extra support to help you manage these changes.
Risks and Complications During Pregnancy
If you have type 1 diabetes, you’re at higher risk of certain complications during pregnancy, including:
Hypos (low blood sugar)
which may be more frequent and severe, leading to hypo unawareness
Diabetic Ketoacidosis (DKA)
a life-threatening condition where the body uses fat for energy, producing harmful ketones. DKA can occur even when blood sugar levels seem normal during pregnancy.
You’ll also be at risk of high blood pressure, kidney, and eye problems, which may worsen during pregnancy. Your healthcare team will monitor you closely, and you’ll receive regular eye and kidney checks.
Pre-Eclampsia and Type 1 Diabetes
Women with type 1 diabetes are at a higher risk of developing pre-eclampsia, a serious pregnancy complication marked by high blood pressure and protein in the urine. Pre-eclampsia typically occurs after 20 weeks of pregnancy and can pose risks to both the mother and the baby. You’ll be closely monitored for this condition during your routine antenatal visits, and medication may be offered if needed.
Emotional Support During Pregnancy
Managing type 1 diabetes during pregnancy can be overwhelming. It’s important to seek emotional support from your healthcare team, midwife, or a diabetes support group. You can also contact the Diabetes Kenya helpline or join online communities to connect with others going through similar experiences.