Hypoglycaemia

Hypoglycaemia during pregnancy is a major danger to women with diabetes, and can result in significant harm (eg motor vehicle accidents). The risk to the fetus is less clear, but there are concerns about the potential impact of more severe or prolonged maternal hypoglycaemia.

Women with type 1 diabetes are particularly at risk of hypoglycaemia, especially in the first trimester when insulin sensitivity increases. Other risk factors for severe hypoglycaemia are:

• previous severe hypoglycaemia
• hypoglycaemic unawareness
• long duration of diabetes
• low HbA1c
• fluctuating blood glucose concentrations
• excessive use of supplemental (correction) bolus doses of insulin.

For management of hypoglycaemia, see Hypoglycaemia in patients with diabetes.