Diabetes complications during pregnancy
Your doctor will advise you to have a baseline screening for all diabetes complications before pregnancy. If you have any complications, they should be assessed and stabilised before you fall pregnant. They will also need to be closely monitored throughout your pregnancy.
Some of the complications of long-term diabetes can be made worse by pregnancy, such as renal damage (kidneys) and retinopathy (eyes).
Diabetes complications affecting the kidneys increase the chance that your blood pressure will become a problem in the second half of pregnancy (usually after 26 weeks). Even minor kidney problems (such as low levels of protein in the urine) can increase the risk of developing high blood pressure in pregnancy.
If you have any problems with your kidneys during pregnancy your baby’s growth will need to be monitored carefully. If you have no signs of kidney problems or only very mild problems before pregnancy, it is unlikely that a pregnancy will have any long-term effects on your kidney function. If you already have diabetes related kidney disease, pregnancy may cause your kidney function to worsen.
Rapid improvements in blood glucose levels can increase the risk of developing eye problems or make any existing eye complications worse. Gradually reducing your HbA1c before you fall pregnant can reduce the risk of these problems occurring.
If you have eye problems that become worse during pregnancy, laser treatment is safe if you need it. Any eye problems that may have developed during pregnancy tend to improve after the birth, usually by the time the baby is three to four months old. You will need to have your eyes checked regularly throughout the pregnancy and then again a couple of months after your baby is born.
If you have autonomic nerve damage, you may experience more problems with low blood pressure during pregnancy. Delayed stomach emptying can also cause vomiting that can persist throughout the pregnancy, which can be stressful and make it difficult to maintain good nutrition. This can lead to significant problems so you should discuss with your doctor how autonomic nerve damage may affect your pregnancy.
Diabetes complications and pregnancy
If you have diabetes complications it is particularly important to have specialised management of your diabetes during pregnancy. It is best for your pregnancy to be managed in a major hospital which has a lot of obstetric and diabetes medical support as well as the best facilities for babies if they are born early or have any problems when they are born.