This leaflet is aimed at teenagers and women of childbearing age who have diabetes

Childbearing age begins when menstruation (having periods) starts, which is usually during the teenage years, and continues until the menopause.

The average age of menopause is 50 years.

If you are not sure whether you have completed the menopause:

• women under 50 years need to have no periods for two years
• women aged 50 years and over need to have no periods for one year.

Until then, if you are sexually active and are not planning a pregnancy, you should use effective contraception.

Teenagers and women of childbearing age who have diabetes should avoid unplanned pregnancy and use effective contraception.

Your GP, practice nurse or family planning service can advise on the most suitable method of contraception for you.

Thinking about getting pregnant?

Most women with diabetes have normal pregnancies and healthy babies.

However, having diabetes can increase the risk of serious complications for both you and your baby.

We know that the first six weeks of pregnancy are the most important for your baby's development. Some people do not realise they are pregnant at this stage.

Planning your pregnancy is therefore very important. You should not consider stopping contraception until you have discussed this with either the diabetes team or your GP.

The earlier you start planning, the better. Ideally, you should begin discussions six to 12 months before trying for a pregnancy.

Risks and complications

For women with diabetes who do not plan their pregnancy, the risk of a serious complication, such as stillbirth, a serious heart defect or another birth defect, is about one in 10.

Reassuringly, if you plan your pregnancy and optimise your diabetes before becoming pregnant, the risk of serious complications reduces to around one in 50, which is closer to that of women without diabetes.

Your HbA1c

Your HbA1c target before pregnancy is 48 mmol/mol or less, if this can be achieved without having serious hypos.

There is no evidence to suggest that hypos affect the developing embryo. However, they can present a risk to the mother.

Blood glucose targets to achieve this HbA1c are:

• before breakfast: 5 to 7 mmol/L
• before other meals: 4 to 7 mmol/L.

This might seem quite daunting.

You should consider attending a structured education course, such as MINT1E (for Type 1 diabetes) or XPERT (for Type 2 diabetes), if you have not already done so.

High-strength folic acid

A prescription-strength dose of folic acid 5mg should be taken daily for at least three months before conception and for three months afterwards.

You will need to obtain this from your GP, as shop-bought supplements are not strong enough.

Folic acid reduces the risk of neural tube defects, such as spina bifida.

Medication review

Some medications, particularly those used to treat high cholesterol and high blood pressure, are not suitable during pregnancy.

If you are taking any of these medications, discuss this with your doctor before conception.

Weight management

A healthy weight improves the chances of becoming pregnant and having a healthy pregnancy.

You can ask to see a Diabetes Specialist Dietitian for support with dietary choices and weight loss.

Your target body mass index (BMI) is between 19 and 25 kg/m².

You can calculate your BMI using the NHS website.

Smoking and alcohol

Smoking and drinking alcohol can harm your baby.

Ask for support to stop smoking and drinking alcohol before you become pregnant.

Useful resources

Family Planning Association

Website: Family Planning Association

Telephone: 0300 123 7123

Medway Sexual Health

4 Clover Street
Chatham
ME4 4DT

Telephone: 0300 123 1678

Diabetes UK

Website: Diabetes UK

Go Folic

Website: Go Folic

Explore the benefits of folic acid and how it supports a healthy pregnancy.

Pregnant with Diabetes app

Available from Apple App Store and Google Play.

The app includes information about diabetes and pregnancy planning.