Can You Have A Safe Pregnancy If You Have Type 2 Diabetes?

For women diagnosed with type-2 diabetes, the thought of having a baby can be concerning because of the risk of complications. While it’s true that diabetes does pose certain pregnancy risks, you can have a completely safe and healthy pregnancy with adequate planning and awareness. This requires working closely with your doctors and adopting lifestyle changes that can improve your chances of conceiving and of having a safe pregnancy. 

First Steps for Pregnancy With Type 2 Diabetes

When you have type 2 diabetes, pregnancy planning needs to begin before you even get pregnant. The most important prerequisite is to get your blood sugar levels under control, keeping them in the recommended range for between three to six months before trying to conceive. Of course, blood sugar levels will also need to be kept stable and within this healthy range for the entire duration of your pregnancy too. To start planning for pregnancy, speak to your doctors, including specialists like endocrinologists and obstetricians. Your doctors may make the following recommendations before you conceive:

Diabetes Medication Changes – If you are on any medications other than insulin, you may be advised to switch to other medications that are considered as safe during pregnancy. Insulin is regarded as safe during pregnancy and is even used to treat gestational diabetes (diabetes that develops during pregnancy).

Treatment For Other Conditions – Medications used to treat other conditions like hypertension may also be changed. as some of these medications are not recommended when conceiving or pregnant. Additionally, you may require treatment to protect against the risk of some diabetes complications that can arise during pregnancy. 

Multi-specialty Care – Your doctors may recommend further consultation with specialists including high-risk obstetricians, registered dietitians, and diabetes educators, among other specialists. 

After your health care providers have assessed your health thoroughly, they may advise you to wait before conceiving or could give you a go-ahead. It’s important that you adhere to their recommendations as this will not only affect your health and safety, but also the health of your baby. 

Next Steps For Pregnancy With Type 2 Diabetes

In addition to the management of blood sugar levels and diabetes, you will also have to take other precautions, especially with regard to factors that could have contributed to the development of type 2 diabetes. Both obesity or being overweight and a diagnosis of polycystic ovarian syndrome (PCOS) are linked to an increased risk of developing diabetes. Both conditions are also associated with difficulty conceiving and fertility problems. 

This means that if you are overweight or suffer from PCOS, you also need to try to lose weight gradually with a healthy diabetes and diet and a regular exercise routine. With PCOS, your doctor may also prescribe certain medications to improve your chances of getting pregnant. 

If you still have trouble conceiving even after a year of trying and are under the age of 35, you should consult a fertility specialist for further help. Women over the age of 35 should only wait for six months before seeking help. 

Having A Safe Pregnancy With Diabetes

Once you get pregnant, you will need more frequent prenatal visits than women without diabetes, as your doctors will want to monitor both your blood sugar levels and your pregnancy. They will recommend treatment modifications and care accordingly. The recommendation that is most critical to ensuring a safe and healthy pregnancy when you have diabetes is diet and weight management. For many women, simply eating healthy and exercising helps to keep a check on blood sugar levels. 

Adequate and balanced nutrition takes on added importance during pregnancy because your nutrition also impacts foetal growth and development. Ask your doctor and dietitian for advice on meal planning so that you can get the nutrients that you and your baby need, while also keeping blood sugar levels under control. Typically, a prenatal diet is not very different from your regular healthy diet, including a variety of foods to ensure balanced nutrition. Avoid overeating, as you don’t really need to ‘eat for two’, and gaining excess weight will increase the risk of complications. 

To keep your diet healthy and nutritious, you can focus on the following foods:

• Fresh fruits and vegetables
• Legumes, beans, and whole grains
• Nuts and seeds
• Lean meats and fish (well-cooked and avoid varieties of fish that have higher levels or mercury)
• Low fat dairy foods

You should also discuss expected weight gain during pregnancy with your doctors as this will help with diet planning and weight management. Although every woman is unique and your doctors will be best equipped to give you personalized advice, most women who are at a healthy body weight at the time of conception can expect to gain roughly 11.5 to 16 kilos, while women who were obese at conception should gain just 5 to 9 kilos.  

Pregnancy Risks Linked To Type 2 Diabetes

Although the risk of complications is low when diabetes is managed effectively, as per the recommendations of your doctors, it is important to be aware of the risks. Some possible complications include:

• Preeclampsia or hypertension in pregnancy, which can threaten the health of you and your baby – with regular prenatal testing the condition can be easily detected and treated
• Preterm or Caesarean delivery
• Miscarriage or stillbirth
• Polyhydramnios or excessive amounts of amniotic fluid around the foetus

When blood sugar levels are poorly controlled from the outset of pregnancy, it increases the risk of certain complications that can affect your baby.

• Foetal organ development begins before you can even confirm your pregnancy. This means that if blood sugar levels were not controlled at the time of conception, there is a higher risk of birth defects in your baby. 
• When blood sugar levels are not kept under control before and during pregnancy, babies can grow larger than normal, weighing up to 4 kilos or more. This raises the risk of birth trauma including shoulder injury or bone fractures and nerve damage in the baby.  It there raises the likelihood of a Caesarean delivery.
• Poorly controlled blood sugar levels during pregnancy can also increase the risk of respiratory problems and low blood sugar in the baby.

As is the case with preventing any diabetes complication, early management and care are critical to ensuring the health and safety of your pregnancy. Most women with type 2 diabetes can have safe and complication free pregnancies by working closely with their doctors before and during pregnancy.

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