Type 2 diabetes is the most common form of diabetes, according to the American Diabetes Association. In this form of diabetes, the body doesn’t utilize insulin correctly. This is called insulin resistance.
Blood glucose levels rise because there’s not enough insulin being made to keep levels normal. For some people with type 2 diabetes, this can be managed with healthy lifestyle and diet changes, but others might need 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.
Before getting pregnant
If you’re considering getting pregnant, talk with your endocrinologist as well as your OB-GYN. Be honest and discuss:
- the level of blood sugar control you require
- 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 currently take to maintain healthy blood glucose levels
- a review of all your current diabetes medications — and other medications — to make sure they’re safe for pregnancy
Your OB-GYN might recommend that you meet with a maternal-fetal medicine specialist (MFM), a doctor that specializes in mothers with chronic health conditions or high-risk pregnancies.
Your doctor might want you to implement some things before you get pregnant. Losing weight or changing your diet can help stabilize your glucose levels before conceiving. They’ll also want to make sure your current diabetes treatment is safe during pregnancy.
Depending on your overall health and how well your diabetes is controlled, your doctor might recommend you wait to conceive or give you the go-ahead to try.
Having an honest conversation with your doctors about your diabetes and its potential effects on your future pregnancy will enable both of you to decide whether it’s an optimal time to get pregnant. You should also discuss your ideal level of blood sugar control for pregnancy, which can be stricter than typical blood sugar goals.
While trying 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.
Being overweight or obese is 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 infertility.
Losing weight, eating a healthy diet and exercising regularly, and taking any necessary medications for PCOS can all help increase your chances of conceiving.
If you’re having trouble conceiving, you may want to see a fertility specialist or reproductive endocrinologist. The ideal time to do this is after one year of trying if you’re under age 35 or after six months of trying if you’re 35 or older.
Medications and pregnancy
While some people can control their type 2 diabetes with diet and exercise, others take medications to help control blood sugar. Before you get pregnant, talk with your medical team or midwife to see whether you can still take them during pregnancy.
Many current diabetes medications haven’t been established as safe in pregnancy, so you might be switched to insulin instead.
Insulin helps control 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 women who develop gestational diabetes during pregnancy.
Once you’re pregnant
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 will work with general OB-GYNs to care for someone, especially if the person’s chronic condition is well managed.
Diet and weight gain considerations
Eating a healthy diet is important when you have type 2 diabetes. In fact, for some people, healthy diet and exercise is enough to keep their blood sugar under control.
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 the 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 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 and dietitian about expected weight gain for your pregnancy. Typically, if you begin pregnancy at a normal weight for your height, the expected weight gain is between 25 and 35 pounds. Women who are considered obese are generally suggested to gain 15 to 25 pounds.
Each individual is different, and depending on your medical history, your doctors might provide you with more personalized recommendations.
Risks and complications linked to pregnancy with type 2 diabetes
Having type 2 diabetes, especially uncontrolled type 2 diabetes, can put you at risk for certain complications during pregnancy. 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 warrant early delivery for the baby
- pregnancy loss, since women with type 1 or type 2 diabetes are at higher risk of miscarriage or stillbirth
- preterm or cesarean delivery
- increased amount of amniotic fluid
Seeing your doctor regularly is important to monitor the health of you and your baby. If you start having any symptoms that’re out of the ordinary, call your doctor immediately.
Risks for babies
If your blood sugar isn’t well-controlled during pregnancy, it can have significant effects on the developing fetus. Some of these risks include:
- Birth defects. Before you even know you’re pregnant, the baby’s organs start to form. Uncontrolled 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 risks of shoulder injuries during delivery and increases the likelihood of a cesarean delivery, or C-section.
- Preterm birth. Women with type 1 and type 2 diabetes are more likely to give birth early than women without diabetes. If a baby is born too early, this can increase the risk of health issues.
- Neonatal complications. If your blood glucose levels aren’t controlled, the baby is at increased risk for low blood sugar and respiratory problems.
If you have type 2 diabetes and are thinking about becoming pregnant, talk with your obstetrician and endocrinologist. Be upfront with them about the status of your diabetes, how it affects your health, and if there’s anything you struggle with presently.
Getting your type 2 diabetes under control 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 birth.
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