PATIENT EDUCATION
Diabetes & Pregnancy
Pregnancy changes insulin requirements and glucose targets. Care differs for pre-existing Type 1 or Type 2 diabetes and for gestational diabetes diagnosed during pregnancy, but both benefit from coordinated specialist follow-up.
Select a topic below to view more information.
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Planning Pregnancy With Diabetes
What you'll notice or feel
- You have Type 1 or Type 2 diabetes and are considering pregnancy.
- You want to know whether current medicines are suitable.
- There may be concerns about glucose targets, folic acid, eyes or kidneys before conception.
Common causes
- Pregnancy increases the importance of glucose optimisation before conception.
- Some medicines used for diabetes, blood pressure or cholesterol may need review.
- Retinal and kidney status can influence pregnancy planning.
What it could be
- A need for structured preconception diabetes care.
Initial self-care
- Arrange preconception review before stopping contraception if possible.
- Do not stop insulin.
- Review all prescription and non-prescription medicines.
- Start pregnancy-specific folic acid only according to your clinician’s advice.
When to see a doctor urgently
- Very high glucose with ketones, vomiting or dehydration.
- Severe hypoglycaemia or loss of consciousness.
When to see a doctor
- You are planning pregnancy within the next few months.
- Pregnancy occurs unexpectedly while taking diabetes or related medicines.
Gestational Diabetes Screening
What you'll notice or feel
- Usually no symptoms.
- High glucose found during pregnancy screening.
- Sometimes increased thirst or urination, though these can also occur normally in pregnancy.
Common causes
- Pregnancy hormones increase insulin resistance.
- Some women cannot produce enough extra insulin to maintain normal glucose levels.
- Risk is higher with previous gestational diabetes, family history and overweight, among other factors.
What it could be
- Gestational diabetes, usually diagnosed by pregnancy-specific glucose testing.
- Previously unrecognised diabetes if hyperglycaemia is detected early or is marked.
Initial self-care
- Attend recommended pregnancy glucose screening.
- If diagnosed, begin the monitoring and nutrition plan promptly.
- Do not blame yourself; pregnancy-related insulin resistance is biological.
When to see a doctor urgently
- Severe vomiting, dehydration or marked hyperglycaemia.
- Reduced fetal movement or other obstetric emergency symptoms require immediate maternity assessment.
When to see a doctor
- A screening test is abnormal.
- You had gestational diabetes in a previous pregnancy.
- You have high-risk features and are unsure when testing is due.
Glucose Monitoring During Pregnancy
What you'll notice or feel
- More frequent finger-prick or CGM checks than before pregnancy.
- Glucose targets may be tighter than outside pregnancy.
- Insulin needs can change quickly as pregnancy progresses.
Common causes
- Placental hormones progressively change insulin sensitivity.
- Morning sickness and altered meals can complicate insulin dosing.
- Insulin requirements may fall or rise depending on pregnancy stage and illness.
What it could be
- Expected pregnancy-related changes requiring active dose adjustment.
- A need for closer review if glucose frequently falls outside target.
Initial self-care
- Keep glucose records available for the diabetes and maternity team.
- Treat low glucose promptly according to your plan.
- Do not make large medication changes without advice unless following a pre-agreed adjustment plan.
- Stay hydrated.
When to see a doctor urgently
- Repeated severe hypoglycaemia.
- High glucose with ketones, vomiting or difficult breathing.
- Any urgent obstetric concern such as heavy bleeding or reduced fetal movement.
When to see a doctor
- Readings are repeatedly above or below target.
- Insulin doses are changing rapidly.
- Vomiting makes it difficult to eat or take treatment safely.
Medicines and Insulin in Pregnancy
What you'll notice or feel
- Questions about whether a medicine is safe in pregnancy.
- Need for new or increasing insulin.
- Concern about injections or hypoglycaemia.
Common causes
- Pregnancy alters drug choices and insulin requirements.
- Some non-diabetes medicines also need review.
What it could be
- A need for medication reconciliation with both endocrine and obstetric teams.
Initial self-care
- Never stop insulin in Type 1 diabetes.
- Bring every medicine and supplement to review.
- Use only medicines specifically recommended for pregnancy.
- Learn how to recognise and treat hypoglycaemia.
When to see a doctor urgently
- Severe hypoglycaemia, vomiting with ketones or inability to take essential treatment.
When to see a doctor
- Pregnancy is confirmed.
- A new medicine is suggested by another clinician.
- Side effects or repeated low glucose are occurring.
After Delivery
What you'll notice or feel
- Insulin needs may change rapidly after birth.
- Gestational diabetes often resolves, but future Type 2 diabetes risk remains higher.
- Breastfeeding, sleep disruption and irregular meals can affect glucose.
Common causes
- Placental hormone levels fall quickly after delivery.
- Long-term insulin resistance may persist after gestational diabetes.
What it could be
- Postpartum treatment needs differ depending on pre-existing versus gestational diabetes.
Initial self-care
- Follow the postpartum medication plan given by your team.
- Attend recommended postpartum glucose testing after gestational diabetes.
- Continue healthy weight, nutrition and activity habits.
- Plan glucose review before future pregnancies.
When to see a doctor urgently
- Severe low or high glucose, dehydration or postpartum emergency symptoms.
When to see a doctor
- Postpartum glucose testing is due.
- Insulin needs remain unstable.
- You are planning another pregnancy.
YOUR CONSULTATION
What to Expect at Your Visit
- Clarification of whether diabetes predates pregnancy or was first detected during pregnancy.
- Review of glucose/HbA1c, medicines, kidney and eye status where appropriate.
- A pregnancy-specific glucose target and monitoring plan is agreed with the maternity team.
- Nutrition and insulin/medication adjustments are individualised.
- Pre-existing diabetes often requires closer retinal, renal and fetal monitoring.
- After delivery, treatment is reassessed and postpartum diabetes screening is arranged when gestational diabetes was present.
* IMPORTANT: A Note Before You Go
Diabetes in pregnancy should be managed jointly with obstetric/maternity care. Do not wait for a routine endocrine appointment if you have urgent pregnancy symptoms.
This page provides general educational information and cannot replace an individual medical assessment. If symptoms are persistent, worsening or concerning, arrange appropriate medical review.
NEED AN ASSESSMENT?
Arrange an Endocrinology Consultation
For non-emergency assessment or follow-up, appointments are booked through the hospital’s central appointment desk on 0422 432 4433. For severe or rapidly worsening symptoms, seek urgent medical care rather than waiting for a routine appointment.