Controlling Your Blood Glucose
Your glucose levels need to be carefully managed and within a specific target range before you become pregnant so that you minimise your chances of developing avoidable complications for you and your developing child during your pregnancy.
Throughout your pregnancy, maintaining glucose levels within this target range is a key factor for the normal growth and development of your baby. Diet, exercise, lifestyle, and accurate glucose monitoring are all important factors in helping you control your blood glucose levels.
The treatments you are prescribed to help control your blood glucose level will depend on the type of diabetes you have and your general health. If you have Type 1 diabetes your body no longer produces insulin itself so insulin injections are an essential part of your diabetes management.
Very few people with Type 2 diabetes are able to control their glucose levels by diet alone so they will also need a combination of insulin, tablets or non-insulin injectable treatments as part of their management plan.
During pregnancy the general recommendation for glucose levels is less than 5.9mmol/L before meals and no higher than 7.8mmol/L, one hour after eating. You will be encouraged to do extra glucose tests to make sure your glucose levels are staying in this range. Avoidance of hypos is very important. Do not be discouraged when your insulin dosages need to be adjusted on a regular basis. Your body’s need for insulin will go up and down throughout your pregnancy.
Another risk with pregnancy is that your warning signs for a hypo may decrease making it harder for you to notice a falling glucose level and treating it before the level goes too low. It is vital that you carry a form of glucose to treat your lows with you at all times during your pregnancy. Quickly correcting the low will result in the best outcome for both you and your baby.
Always discuss your individual target blood glucose range and any problems you have with your diabetes team.
Changing your insulin dose
If you take insulin, it may be necessary to adjust your doses to maintain good control. In particular, meal time insulin can be adjusted depending on the carbohydrate content of your meal. If you are unsure how to do this, your healthcare professional can often help or may refer you to a dietician or suggest that you attend an education course to help you learn about carbohydrates, carbohydrate counting, and insulin dose adjustment.
Insulin doses may also need to be adjusted in other situations, such as before or after exercise or when you are sick.