I Am Diabetic and Pregnant: How Should I Monitor My Pregnancy?

During the pregnancy

• Controlling your diabetes though monitoring blood sugar levels, eating a balanced diet and proper insulin treatment are necessary to ensure a good outcome for your pregnancy.
• From the first days of pregnancy, and preferably even before conception, your blood sugar must be as close to normal as possible.
• Regular self monitoring is essential to maintain your blood sugars in the recommended range and to allow you to determine how much insulin you should use.
• With regards to your diet, the magic words are balance, variety and quantity. Consulting a dietician will help you attain a healthy and balanced diet and will give you specific dietary advice regarding diabetes during pregnancy. This advice will include the food that you should limit as well as those foods that are good for you. The dietician can also advise you about the amount of food you should consume during meals and snacks.
• If you are a type 1 diabetic, you may have to modify your insulin schedule in order to have a basal-bolus insulin therapy, which combines at least 4 injections of two different kinds of insulin: slow-acting insulin to cover your needs between meals and fast-acting insulin at mealtimes.
• If you are a type 2 diabetic, your treatment with tablets for the diabetes will be stopped and replaced by treatment with insulin. In order to obtain the best glycaemic control possible, your treatment will be divided into three or four injections over 24 hours. To help you carry out and adapt this treatment, a short hospital stay may be required. The treatment with insulin may, most often, be stopped after the delivery of your baby.
• The glycaemic balance changes throughout pregnancy. It will be necessary to adapt your insulin doses regularly.
• You will require close supervision by your physician during the pregnancy. This may seem restrictive, but it is also reassuring — your good health, as well as the health of your baby, depends on it. Do not hesitate to ask for an extra appointment at the slightest sign of something abnormal: greater fatigue, fever, exaggerated thirst, etc.

After the delivery

• If your blood sugar control has been good during the pregnancy, your baby will be at no higher risk than any other child at delivery.
• If you wish to breastfeed and you have type 2 diabetes, the insulin treatment must be continued throughout the time that you are breastfeeding. It will be stopped when breastfeeding has ended and you can resume your oral anti-diabetic treatment.