Pregnancy and Women With Type 2 Diabetes

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Type 2 diabetes, a disease that affects millions of Americans, doesn’t have to be a barrier to starting a family. Whether you are able maintain your blood sugar (glucose) levels within normal ranges through healthy lifestyle habits or you have to take medications, your body’s needs will change once you’re pregnant. It’s expected. But by working closely with your doctor or nurse practitioner, you’ll be able to do what is right for you—and your developing baby.

Type 2 Diabetes vs. Gestational Diabetes

With both type 2 and gestational diabetes, your body doesn’t produce enough insulin or you do produce insulin, but your body can’t use it properly. However, only pregnant women get gestational diabetes. Gestational diabetes is caused by hormones that help the babies grow and develop, and then it goes away once the women are no longer pregnant. Type 2 diabetes can affect both men and women, and it doesn’t go away. 

Both gestational and type 2 diabetes may be controlled through lifestyle habits, such as eating a healthy diet and exercising, or with pills or insulin injections. These treatments are personalized, depending on how severe the diabetes is. Pregnant women who have type 2 diabetes usually have to change their treatments during their pregnancy, to accommodate the growing baby.

Risks for Both You and Baby

If you have type 2 diabetes before you became pregnant or you’re planning to become pregnant, there may be some risks to you or your baby, depending on how severe your diabetes is and how well your blood sugars are controlled. For the baby the risks include:

  • Being larger than usual at birth
  • Birth defects
  • Having high blood sugar levels at birth
  • Being born prematurely
  • Experiencing complications associated with being born prematurely

Complications mothers may experience include:

  • Difficulty delivering because of the baby’s large size
  • Cesarean section for delivery
  • Difficulty controlling blood sugar levels
  • Diabetic complications, such as with vision or kidneys
  • Preeclampsia, which involves high blood pressure and high protein in the urine
  • Infections including bladder and vaginal infections

Lowering the Risks

While these risks do exist, there are things you can do to help lower the chances of them happening. This means working to keep your blood sugar levels as close to normal, with as few spikes or drops, as possible. Speak with your doctor or your nurse practitioner to see what you should be aiming for, what your blood sugar level should be before meals and after. They will also let you know how often they would like to see you for checkups or extra blood tests.

Be sure to tell your healthcare professional about all medications you’re taking—for your diabetes and any other health issues you may have—to make sure they are safe for you and your baby. You may need to switch to some different medications during your pregnancy and if you choose to breastfeed after.

Planning Ahead

If you are still in the planning stages of your pregnancy, it’s a good idea to have a thorough physical exam before you stop using your birth control method. This way, your doctor or nurse practitioner can check your weight and blood pressure, and look to see how stable your diabetes is. They will want to see if there’s been any damage to your eyes, nerves or kidneys, as well, which may have been caused by the diabetes. If your blood sugar levels are unstable, it may be best to try to get them under control before becoming pregnant.

As with all women who are pregnant, lifestyle choices can affect how your pregnancy proceeds. This isn’t a time to lose weight, but your healthcare provider will want to monitor you to make sure you don’t gain more than is right for you. Some women with type 2 diabetes meet with a dietitian who can guide them to a healthy diet that will sustain them throughout the pregnancy, and keep good control of the blood sugar levels at the same time.  

Being pregnant will affect your type 2 diabetes, and your type 2 diabetes will affect your pregnancy. You may have to change your medications, test your blood sugar levels more often, and go for more frequent checkups. Many women have type 2 diabetes and they go on to have healthy, full-term pregnancies. Speak with your doctor about any concerns you may have so you can work together towards a healthy pregnancy.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 5
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