Managing healthy glucose levels for pregnancy

These are the recommended targets for planning and during pregnancy. 

You should aim for  glucose of: 

• under 5.3mmol/l before meals 
• under 7.8mmol/l at one hour after eating 
• 6.4mmol/l two hours after meals 

It can be  difficult to achieve these targets during pregnancy because insulin requirements change so you will have regular contact with your diabetes team. 

Planning pregnancy 

If you’re planning pregnancy, the recommended target is HbA1c 48mmol/mol (6.5%). But this can be personalised to your specific needs, especially if you have problems with hypos. 

If your HbA1c is above 90mmol/mol (10%) you should try to avoid pregnancy as such levels significantly increases your risks of having a miscarriage, stillbirth or baby with a developmental abnormality. 

Early in the pregnancy 

At the beginning of the pregnancy, insulin requirements can go down as a result of hormonal changes, and many women have to reduce their insulin doses to avoid hypoglycaemia. 

Later on in the pregnancy 

Later on in pregnancy, insulin requirements increase very significantly and insulin doses may increase rapidly. High glucose levels can cause the baby to put on too much weight, which can lead to difficulties during delivery. 

The recommended targets can be difficult to achieve. No-one achieves them all the time, but the closer you can get, the better it is for your baby. If you’re struggling to hit the recommended targets then you and your diabetes team may want to consider some other options, such as insulin pump use and glucose sensors. Your diabetes team should be able to help you decide an appropriate target, but the most important thing to know is that any improvements you can make to your diabetes will improve the outcome of your pregnancy. 

You should expect to check your glucose levels at least seven times a day during pregnancy. But pregnant women should have access to glucose sensing systems, either Freestyle Libre ‘Flash’ or ’intermittent’ sensors or Continuous Glucose Montitoring Systems (CGMS). Link to monitoring section 

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