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Diabetes in Pregnancy

Specialized care for women with any type of diabetes in pregnancy.
About
The Diabetes in Pregnancy Service provides specialized and personalized care for women with type 1, type 2 diabetes, gestational diabetes, and women who are risk of developing diabetes during pregnancy.

With a physician referral our team sees women before pregnancy, during pregnancy and after the baby is born. 

Our Goal
Our goal is the help pregnant women with diabetes to have normal blood glucose (blood sugar) levels and lower the risk of diabetes related complications.

Our Diabetes Team

Each woman's care is special and different.  You are the key player in the management of your diabetes and your diabetes team at BC Women's is here to help.

Our diabetes team which includes endocrinologists (diabetes doctors), nurse educators, dietitians, physiotherapists and a social worker works closely with you (the patient) and the other health care providers (e.g. family physicians, midwives, obstetricians).

The diabetes health care team will help you:

  • Learn about and become confident in managing your diabetes
  • Have fewer diabetes-related complications for you and your baby.
Appointments

Please note: Incomplete referral forms will not be processed

Please arrive 15 minutes prior to your appointment to allow for parking and registration.  Parking on the lot is meter parking paid by exact change, credit card or pay by phone.


  • Upon arriving at BC Women's Hospital (main entrance 93), report directly to the Diabetes Clinic desk # 7.
  • You are welcome to bring a family member or friend with you.
  • You can eat before your appointment and bring snacks with you.

Please bring:

  • Any supplements, vitamins, and/or medications you are currently taking
  • A food record of everything you ate and drank 2 days before your appointment
  • If you have a glucose meter, please bring it along with your blood sugar records.

At your first appointment you will meet the nurse and dietitian.  This appointment will take a minimum of 2 hours.


The nurse will talk with you about diabetes in pregnancy.  The information given will depend on the type of diabetes you have.


The dietitian will discuss with you a healthy diet for pregnancy that will also help you control your blood sugar and have a healthy weight gain. 


Some things that will be discussed with you in the appointment:

  • your role on the team
  • what you need to know before you get pregnant (if you have type 1 or type 2 diabetes)
  • the effect of pregnancy on blood sugar
  • the risk to the baby from high blood sugar
  • how to manage your condition - diet, activity, blood sugar testing, urine testing, and insulin (if needed).

You will have a chance to ask questions, and will receive written information so that you do not have to worry about remembering everything.

First Follow Up

At the first follow-up clinic appointment, you will see the endocrinologist, nurse, dietitian, physiotherapist and social worker (if needed). This appointment will take a minimum of 90 minutes.


Endocrinologist:

  • Assesses health, pregnancy and diabetes management
  • Advises on diabetes management.  This may include insulin if needed
  • Discusses exams or tests that may be required

Dietitian:

  • Assesses blood sugars, ketones, weight and hunger
  • Changes are made to the your eating plan as needed
  • Answers any food related questions
  • Discusses insulin (if needed)

Nurse:

  • Reviews blood glucose tesing
  • Teaches insulin (if needed)
  • Answers any meter questions

Physiotherapist:

  • Reviews activity and exercise plan
  • Suggests exercises that may prevent injury and/or discomfort


Social Worker (if needed):

  • Provides psychosocial assessment, counseling and support, focused on reason for referral 
  • Develops a safe pregnancy and parenting support plan with pregnant women and a bridge to community resources
  • Collaborates with the health care team

Regular Follow-up clinic appointments

Your endocrinologist will advise you on how often you need to come to the clinic.  Generally clinic visits are scheduled every 1 to 3 weeks.  At these visits you will always see the endocrinologist and may also see other members of the diabetes team.


Labour and Delivery

Planning for labour and delivery is individual for all women, including those with diabetes in pregnancy.

If you have GDM, you may even go past your due date as you wait for labour to start, as long as you and the baby are healthy. If you have type 1 or type 2 diabetes, it is most likely that you will have your baby a week or two before your due date for the safety of the baby.

Some women may have an induction of labour if there is a concern about the health of the mother or baby. Other women may have a planned caesarean birth, depending on their individual situation. You will always be involved in the decision-making, and have a chance to have your questions answered. The team will help you with advanced planning as much as possible.

During labour, your blood sugar will be watched closely, and the nurses will keep in contact with the diabetes doctor as needed. Your care after delivery will depend on what type of diabetes you have.

Postpartum

If you have GDM, you will have a blood sugar test before breakfast the day after the baby's birth to make sure that the diabetes has gone away. It is important to discuss diet, activity, infant feeding, future pregnancies, and the risk of type 2 diabetes with the team before you go home. A very small number of women still have high blood sugar after delivery and will need follow-up with the diabetes doctor.

If you have type 1 you may not need insulin for the first day or two after delivery, and will need it again when your blood sugar start to go up. If you have type 2 you may need some kind of diabetes medication. You and your doctor will make these decisions. The team will discuss diet, activity, infant feeding, future pregnancies, and future diabetes management with you.

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SOURCE: Diabetes in Pregnancy ( )
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