Hyperglycaemia and pregnancy

Hyperglycaemia happens when your glucose levels get too high. If left untreated, this can increase your risk of complications related to diabetes. But taking care of yourself and monitoring your glucose levels can help reduce the risk.

On this page

What is hyperglycaemia?

Symptoms of hyperglycaemia

If you have hyperglycaemia or you are feeling unwell

Causes of hyperglycaemia 

How to prevent hyperglycaemia 

Diabetic ketoacidosis (DKA) 

Symptoms of diabetic ketoacidosis

Preventing diabetic ketoacidosis

When to get medical help

Where to get more information

What is hyperglycaemia?

Hyperglycaemia happens when your glucose levels get too high. If you have diabetes, your healthcare team should give you targets for your blood glucose levels. Hyperglycaemia is when your levels rise above this range.

If you have diabetes, you are also at risk of your glucose dropping too low (hypoglycaemia).

It's important to be able to recognise and treat hyperglycaemia. This is because it can lead to serious health problems if it isn’t treated. But if you follow your treatment plan and monitor your glucose levels often, you can reduce the risk of hyperglycaemia.

Your glucose level may go up and down from day to day during pregnancy. You may need to make some changes to your diet, lifestyle and medication to manage this.

If you’re finding it difficult to manage your glucose levels, talk to your healthcare team for help and support. You could also look for peer support from other women and birthing people going through the same thing. Diabetes UK provides local peer support groups.

You will have extra care throughout your pregnancy and you can contact your healthcare team at any time if you have any concerns.

Symptoms of hyperglycaemia

Symptoms of hyperglycaemia include:

• increased thirst and a dry mouth
• needing to pee more often
• feeling tired.

In some cases, if sugars are high for a longer period of time, symptoms might include:

• blurred vision
• unintentional weight loss
• recurrent infections, such as thrush, bladder infections (cystitis) and skin infections.

Unfortunately, some of these – such as needing to pee more often and feeling tired – are also common pregnancy symptoms. But if you ever have any concerns about your symptoms, it’s always best to mention them to your healthcare team, to be on the safe side.

If you have hyperglycaemia or you are feeling unwell

If you have any form of diabetes, you should always get urgent medical advice if:

•  you have hyperglycaemia that you cannot manage or
•  you are feeling unwell (even if it’s just a cold).

Causes of hyperglycaemia

Hyperglycaemia is most common in people with diabetes. It can sometimes be triggered by:

• food, such as eating too many foods that are high in sugar or have a high GI value
• not taking your recommended dose of insulin
• not injecting your insulin early enough before eating (insulin should usually be injected at least 15 minutes before eating. If this isn’t possible, it may contribute to high glucose levels)
• missing a dose of your diabetes medication or missing an insulin dose
• overtreating an episode of hypoglycaemia
• a change or reduction in exercise (find out more about diet and exercise with type 1 and 2 diabetes).
• taking certain medicines, such as steroids
• an illness, such as a cold.

Feeling stressed? Find out more about type 1 and 2 diabetes and your emotional health.

How to prevent hyperglycaemia

There are ways to reduce the risk of hyperglycaemia:

• Be careful with what you eat. Cut down on foods that are high in sugar or have a high GI level.
• Stick to the treatment plan as agreed with your care team, and contact them if this isn’t bringing your glucose levels down.
• Stay active. Find out more about diet and exercise with type 1 and 2 diabetes.
• Monitor your glucose level often.

Diabetic ketoacidosis (DKA)

Diabetic ketoacidosis (DKA) is a serious problem that can happen if you have diabetes and your body doesn’t have enough insulin. This causes substances called ketones to build up in the body. It can be life-threatening if not spotted and treated quickly.

In pregnancy, you are more likely to develop DKA if you:

• have an infection, such as the flu or a urinary tract infection
• are not following your treatment plan, e.g., you miss a dose of medication such as insulin
• have an injury or just had surgery
• are taking certain medicines such as steroid medication.

If you’re worried about DKA, speak to your healthcare team, who can give you personalised tips on reducing your risks.

Symptoms of diabetic ketoacidosis

Signs of DKA include:

• needing to pee more than usual
• feeling very thirsty
• being sick
• stomach pain
• diarrhoea
• breath that smells fruity (like pear drop sweets or nail varnish remover)
• deep or fast breathing
• feeling very tired or sleepy
• blurred vision
• confusion
• fainting.

Because you may get confused or pass out, it’s important that the people around you know about these symptoms and what they should do if you need help.

Symptoms tend to develop over 24 hours, but can come on faster.

When to get medical help

DKA is a life-threatening emergency and needs to be treated in hospital.

Call 999 or go to your nearest hospital straight away if you think you have DKA, especially if you have a high level of ketones in your blood (above 3mmol/l in your blood, or 2mmol/L in your pee).

Contact your healthcare team or call NHS 111 immediately if your ketones are over 1.6mmol/L, or over 0.6mmol/L if you feel unwell. When in doubt, always seek urgent advice to be on the safe side.

Preventing diabetic ketoacidosis

Checking your glucose regularly will give you the chance to treat any increase quickly and reduce your chances of getting DKA. If you have a continuous glucose sensor, you can set an alarm so you get an alert if your levels are high.

People with type 1 diabetes are at higher risk of DKA, although anyone with diabetes can get it. If you have type 1 diabetes, you should be given ketone testing strips and a monitor at the start of your pregnancy. You should check the ketone levels in your blood if your glucose is too high or if you are unwell.  

If you have type 2 diabetes, you won’t be given a ketone testing kit when pregnant, because DKA is not common in type 2 diabetes. However, pregnancy does increase the risk of DKA. So contact your healthcare team right away if you are unwell at any time during your pregnancy or if you have hyperglycaemia.

Where to get more information

The charity Diabetes UK provides support and advice for anyone with diabetes and their families. You can also call their helpline on 0345 123 2399 (9am to 6pm, Monday to Friday), or email [email protected]  

Learn how diet and exercise can help manage your blood glucose levels during pregnancy.