The Diabetes in Pregnancy team provides care for women with pre-existing diabetes who are planning pregnancy, during the antenatal period and in the first six weeks after the baby is born. The team also care for women who develop gestational diabetes in pregnancy.
The team consists of a consultant diabetologist, consultant obstetrician, specialist midwife/deputy midwife, specialist nurse and dietitian and midwifery support worker.
The joint diabetic antenatal clinic is held weekly on Tuesday mornings in the Women’s Clinic and the diabetes specialist midwife and specialist nurse run a midwife/nurse-led clinic on Thursday mornings.
Diabetes in pregnancy
- Achieving optimum glucose control improves the chances of having a healthy pregnancy and baby. Aim for HbA1c of 48 mmol/L
- Taking Folic acid 5mg prior to pregnancy and for the first 12 weeks of pregnancy reduces the risk of neural tube defects (spina bifida) This is only available on prescription.
- Early referral to the diabetes pregnancy team is important as soon as a pregnancy is confirmed. Women are offered one to two-weekly contact with the team during pregnancy and extra ultrasound scans to monitor the pregnancy
Gestational diabetes (GDM). Gestational diabetes can develop in pregnancy at around 24 -28 weeks gestation and is diagnosed by a Glucose Tolerance Test (GTT) The Community Midwife screens for risk factors for GDM at booking. If you have had GDM in a previous pregnancy you will be offered a GTT at 14 -16 weeks gestation and if normal again at 24 -26 weeks.
The level of glucose in your blood before and after the GTT will show whether you have gestational diabetes or not. If your GTT result is abnormal you will be referred to the diabetes pregnancy team. The Diabetes Specialist Midwife will contact you to coordinate your care.
The risk of developing gestational diabetes can be reduced by:
- Being physically active 30 mins a day for five days a week i.e. yoga swimming and walking
- Eating healthily – making healthy food choices and eating smaller portions high in fibre low in sugar and fat
- Eating five to seven portions of fruit and vegetables a day
- Avoiding weight gain in pregnancy and losing weight after pregnancy if you are overweight
Diabetes Specialist Midwife. The Diabetes Specialist Midwife provides support and advice on both diabetes and midwifery care throughout pregnancy and the postnatal period. A specialist antenatal diabetes in pregnancy evening class is held monthly in the Women and Children’s Unit. The Diabetes Specialist Midwife can be contacted on 01253 955626.