Type 2 Diabetes and Pregnancy

Women with type 2 diabetes can have a healthy pregnancy if blood glucose levels are managed. It is important to manage your glucose levels well prior to pregnancy. 

If hyperglycemia (high blood glucose) is present in the first 8 weeks of pregnancy, there is a risk for congenital malformations. Later in pregnancy, hyperglycemia may result in a large baby, making delivery more difficult and increasing the risk for a caesarian section.  

Type 2 diabetes: Care during pregnancy

Women with type 2 diabetes may experience changes to the eyes and kidneys during pregnancy, especially if some damage was already present. Changes to the kidneys may also occur in a small percentage of women if damage was already present prior to pregnancy, so blood work may be done to monitor your kidney function.

Certain blood pressure medications (ARBs and ACEs) and cholesterol lowering statins are not recommended during pregnancy, so speak to your doctor about alternatives to these medications when pregnant. The recommendation for folic acid is 1mg, 3 months prior to conception until 3 months post conception.

Insulin resistance (when insulin is not working properly) increases throughout pregnancy and usually begins by about 14 weeks. Most women who are on oral hypoglycemic agents (OHA’s) will be changed to insulin to optimize blood glucose levels.

Blood glucose targets

Targets for blood glucose levels are: less than 5.3mmol/L before meals, less than 7.8mmol/L 1hr after meals and less than 6.7mmol/L 2hrs after meals.  Since glucose levels are lower, the goal for your HbA1c is 6.5% or less (6.1% or less, if possible).

Regular activity is beneficial to manage blood glucose levels, weight gain and help increase energy levels.  Speak with your doctor if there may be activity limitations.

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