You may need additional care if you have type 2 diabetes during pregnancy. But it’s possible to have a healthy pregnancy and delivery if you have type 2 diabetes.
Type 2 diabetes is the
If you have type 2 diabetes, your blood glucose levels rise because not enough insulin is being made to keep them in a normal range. For some people with type 2 diabetes, lifestyle and diet strategies alone can effectively manage glucose levels. Others may need to take medication or insulin to help maintain appropriate blood glucose levels.
If you have type 2 diabetes, you can still have a healthy pregnancy, but there are some things to consider to reduce possible risks and ensure that you and your baby are healthy.
If you have type 2 diabetes and are considering getting pregnant, talk with your endocrinologist and OB-GYN. You may want to discuss:
- the level of blood sugar management you need
- the presence and likelihood of diabetes complications, such as kidney disease, eye disease, and neuropathy
- your medical history and any other existing health conditions
- what steps you’re currently taking to maintain healthy blood glucose levels
- a review of all your current diabetes medications — and other medications — to be sure they’re safe for pregnancy
Your OB-GYN may recommend that you meet with a maternal-fetal medicine (MFM) specialist. This type of doctor specializes in treating pregnant people with chronic health conditions or high risk pregnancies.
Your doctor might want you to implement some things before you get pregnant. For example, losing weight or changing your diet can help stabilize your glucose levels before conceiving. They will also want to make sure your current diabetes treatment is safe during pregnancy.
Discuss your ideal level of blood sugar management for pregnancy, which may be stricter than typical blood sugar goals.
Depending on your overall health and how well your diabetes is managed, your doctor might recommend you wait to conceive or give you the go-ahead to try.
Talking with your doctors about your diabetes and its potential effects on your future pregnancy can help you decide whether it’s the best time for you to get pregnant.
There aren’t necessarily specific difficulties associated with type 2 diabetes when trying to get pregnant. Other factors may come into play, however, including causes that could have contributed to your diabetes diagnosis.
Overweight and obesity are associated with type 2 diabetes, as is having polycystic ovarian syndrome (PCOS). Both obesity and PCOS can make it more difficult to conceive and have been linked to fertility issues.
Losing weight, eating a balanced diet, exercising regularly, and taking any necessary medications for PCOS can all help increase one’s chances of conceiving.
If you’re having difficulty conceiving, you may want to talk with a fertility specialist or reproductive endocrinologist. The ideal time to do this is after 1 year of trying if you’re under 35 years old or after 6 months of trying if you’re 35 years old or older.
While some people can manage their type 2 diabetes with diet and exercise alone, others take medications to help manage blood sugar. Before you get pregnant, talk with your care team to see whether you can still take them during pregnancy.
Many current diabetes medications have not been established as safe in pregnancy, so you might need to switch to insulin instead.
Insulin helps regulate your blood sugar and, unlike oral diabetes medication, doesn’t cross the placenta, so it’s safe to take during pregnancy.
In fact, insulin is also used in people who develop gestational diabetes during pregnancy.
When you become pregnant, you might need to see your OB-GYN or midwife more often. Your blood sugar will need to be monitored, and your doctor may want to check in with you frequently to see how you’re feeling and to monitor the pregnancy.
An MFM specialist may monitor the health of you and your baby. Often, MFM specialists work with OB-GYNs to care for someone, especially if the person’s chronic condition is well managed.
Eating a healthy, balanced diet is important when you have type 2 diabetes. In fact, for some people, diet and exercise strategies are enough to keep their blood sugar well managed.
When pregnant, it’s especially crucial to make sure your blood sugar is at an appropriate number. It’s also important to make sure you’re eating a well-balanced, nutritious diet.
Talk with your doctors about whether a meal plan is necessary to help you and your baby get essential nutrients while keeping your blood sugar at appropriate levels. They might recommend a nutritionist who specializes in working with prenatal clients.
A healthy prenatal diet is similar to a healthy regular diet, incorporating a lot of different foods and taking care not to overeat. “Eating for two” isn’t necessary, so there’s no need to overeat.
Foods to choose from include:
- fruits and vegetables
- whole grains, beans, and legumes
- lean meats, including chicken
- fish, though you should avoid raw preparations and varieties with high mercury content
- low fat dairy products
Talk with your doctors about the expected weight gain for your pregnancy. Typically, the recommended weight gain is no more than 25 to 30 pounds (11 to 14 kilograms). If you have overweight or obesity, doctors may advise you to remain the same weight you are now.
Each individual is different. Depending on your medical history, your doctors might provide you with more personalized recommendations.
Having type 2 diabetes, especially difficult to manage type 2 diabetes, can increase the risk of certain complications during pregnancy.
Potential risks for you
Some of these complications can include:
- preeclampsia, or high blood pressure during pregnancy, which can have serious effects on you and your baby, possibly causing stroke or blood clots in you and warranting early delivery for the baby
- pregnancy loss, since people with type 1 or type 2 diabetes are at higher risk of miscarriage or stillbirth
- preterm or cesarean delivery
- increased amount of amniotic fluid
Visiting your doctor regularly is important for monitoring the health of you and your baby. If you start having any unusual symptoms, call your doctor immediately.
Potential risks for your babies
If your blood sugar isn’t well managed during pregnancy, it can have significant effects on the developing fetus. Some of these risks include:
- Congenital conditions: Before you even know you’re pregnant, the baby’s organs start to form. Unmanaged blood sugar right around when you conceive can cause birth defects in organs like the heart, brain, and spine.
- Very large baby: When your blood sugar is high, it causes the baby to be “overfed.” This can increase the risk of shoulder injuries during delivery and the likelihood of a cesarean delivery.
- Preterm birth: People with type 1 and type 2 diabetes are more likely to give birth early than those without diabetes. If a baby is born too early, this may increase the risk of health concerns for the baby.
- Neonatal complications: If your blood glucose levels aren’t well managed, the baby has an increased risk of low blood sugar and respiratory problems.
If you have type 2 diabetes and are thinking about becoming pregnant, talk with your OB-GYN and endocrinologist. Be upfront with them about the status of your diabetes, how it affects your health, and if there’s anything you are concerned about.
Managing your type 2 diabetes before you get pregnant is important for you and your baby. Your healthcare team can help you ensure you have a healthy and safe pregnancy and delivery.