Type 2 Diabetes and Pregnancy
Almost 90% of diabetes cases among Canadians are type 2. In Type 2 diabetes, the body cannot use insulin effectively – a hormone produced by the pancreas that supports the body to use glucose obtained from the carbohydrates. In Type 2 diabetes, as the body cannot use insulin, the glucose stays in the blood. If not managed effectively, diabetes can progressively worsen. Pregnancy further complicates the condition by demanding higher insulin than normal, resulting in fluctuating blood glucose levels.
Studies of women with Type 2 diabetes during pregnancy show that they are at an increased risk of complications, such as miscarriage or a baby born with malformation, as compared to those who do not have Type 2 diabetes. Pregnant women with Type 2 diabetes thus need extra care. Fortunately, with diligent self-care and medical guidance, the chances of a successful pregnancy and a healthy baby are as good as any other expectant woman. The key to deal with Type 2 diabetes during pregnancy is to maintain blood sugar levels throughout the nine months.
Here are a few details about Type 2 diabetes and pregnancy and a few tips for a healthy pregnancy.
Table of Contents
Type 2 Diabetes Symptoms
Pregnant women with Type 2 diabetes mostly do not have apparent diabetes symptoms. However, when present, the symptoms can be:
- Excessive fatigue
- Extreme thirst
- Increased frequency and volume of urination
Type 2 Diabetes and Pregnancy Treatment
While some women can control Type 2 diabetes with diet and exercise, others require medications. If on medications, consult your doctor to know if you can continue them during pregnancy. Oral medications are not considered safe during pregnancy, and the doctor may switch you on insulin. Insulin controls blood sugar and unlike oral medications, cannot cross the placenta. It is thus safe to take insulin during pregnancy.
Type 2 Diabetes and Pregnancy Risks and Complication
Blood sugar that is not controlled in a pregnant woman with Type 2 diabetes could cause the following problems for the baby and the woman:
Preeclampsia (High Blood Pressure)
Women with Type 2 diabetes are at risk of high blood pressure more often than those without it. If a woman has hypertension, swelling in toes and fingers, and protein in the urine, she may have preeclampsia. This condition requires close monitoring and management by the treating doctor. Preeclampsia can cause a stroke or seizure in the woman during delivery or labor. It can also result in preterm labor and delivery.
Hypoglycemia (Low Blood Sugar Levels)
Women who take medications to control blood sugar may develop levels that are too low, which can be severe or fatal if not managed quickly. Avoid hypoglycemia by watching and treating blood sugar early. Uncontrolled diabetes causes hypoglycemia in the baby after delivery. So, the baby’s blood sugar level is monitored for several hours after birth.
Cesarean section or C-section is a surgery performed to deliver the baby through the mother’s abdomen. A woman with fluctuating or uncontrolled blood sugar levels has a higher chance of needing a Cesarean section. This surgery takes longer for the woman to recover from the delivery.
Stillbirth or Miscarriage
Stillbirth is a loss of pregnancy after 20 weeks, while miscarriage means that before 20 weeks. Although they can happen for many reasons, a woman with diabetes has a higher chance of stillbirth or miscarriage.
Women with Type 2 diabetes are likely to deliver earlier than those without it. Being born too early or preterm birth can cause problems in the baby, such as bleeding into the brain and breathing, heart, vision, or intestinal problems.
An Extra Large Baby
Fluctuating blood sugar levels of the mother during pregnancy increases the baby’s blood sugar. The baby is “overfed” and overgrows. A large baby causes discomfort during the last trimester of the pregnancy, as well as problems during delivery. For instance, the baby’s shoulder gets stuck during delivery, resulting in nerve damage because of pressure. It also increases the risk of getting a C-Section to deliver the baby.
The organs of the baby develop during the first months of pregnancy, even before the woman might know she is pregnant. Fluctuating blood sugar levels may affect the organs while being formed, causing congenital disabilities in the baby, such as the spine, heart, and brain.
Tips for Pregnant Women with Diabetes
Before planning a pregnancy, see your doctor. The doctor will assess the effect of diabetes on your body and change medications if required. If you are overweight, the doctor may recommend diet and tips that will help you lose weight.
In general, some common tips include:
- See the doctor often: A woman with diabetes will need to visit the doctor’s office more frequently to ensure that the glucose levels are maintained, as a preventative for any other issues that may arise.
- Eat healthy foods: The doctor and a dietitian will suggest choosing high-fibre food, including lots of vegetables, steering clear of sweetened beverages, and swapping out starchy foods with healthy ones, such as whole grains. These foods will help in keeping blood glucose levels in control.
- Monitor blood glucose levels: As pregnancy changes the body’s needs, blood sugar levels can fluctuate rapidly. So, monitor blood sugar levels frequently, as advised by the doctor. It is also essential to exercise, adjust insulin and food intake, based on your levels.
- Exercise: Exercising is another excellent way of keeping blood sugar levels under control. After checking with the doctor, exercise regularly. Carry out 30 minutes of moderate-intensity exercise at least five days a week, such as swimming or brisk walking.
If you have Type 2 diabetes and planning to get pregnant, it is essential to get blood glucose levels in check. During pregnancy, visit your doctor as advised and follow all the precautions for safe and healthy delivery.