Managing diabetes during labour
Your own blood glucose levels in the time leading up to the birth have an important effect on your baby’s blood glucose levels. The higher your blood glucose is, the higher the glucose supply will be to your baby before birth. The extra glucose stimulates the baby’s pancreas to make more insulin.
At birth, your glucose supply to your baby suddenly stops, but your baby may continue to produce excess insulin for several hours and even up to one or two days after birth. This can cause hypoglycaemia in the baby. If you have blood glucose levels close to the recommended range during labour, this lowers the risk of your baby having low blood glucose levels at birth.
When an induction or caesarean section is planned, your diabetes in pregnancy team will discuss with you a plan for managing your diabetes. This will include adjustment of your insulin doses/pump rates or changing the way insulin will be delivered.
When you are in labour, your blood glucose levels will usually be monitored hourly and the amount of insulin you are being given will be adjusted to keep your blood glucose in the normal range.
An intravenous (IV) insulin infusion and IV glucose (sugar) are often used throughout labour, which allow small amounts of insulin and glucose to run into your blood continuously. Alternatively, rapid-acting insulin injections every two to four hours may be used during labour to manage your blood glucose levels.
If you use an insulin pump, you may be able to continue using it, but with changes to your basal rates and smaller bolus doses. This will only be the case if this can be managed safely at the hospital where you will deliver your baby and blood glucose levels can be kept within the target range.