Type 2 diabetes living in pregnancy

Overview

Type 2 diabetes is a condition where the body does not use insulin properly, leading to high blood sugar. When you have type 2 diabetes and become pregnant, it means you need to manage your blood sugar carefully to keep you and your baby healthy.

Yes, type 2 diabetes is becoming more common in women of childbearing age, so more pregnancies are affected.

It affects women who already have type 2 diabetes and become pregnant. It is more common in women who are overweight, have a family history of diabetes, or are from certain ethnic backgrounds.

Symptoms

Common symptoms

• Increased thirst and hunger
• Urinating more often than usual
• Feeling very tired
• Blurred vision

Causes

Main causes

• Type 2 diabetes is caused by the body’s cells not responding well to insulin, a hormone that controls blood sugar.
• In pregnancy, hormones can make insulin work less effectively, which can raise blood sugar.

Risk factors

• Being overweight or obese before pregnancy
• Having a family history of type 2 diabetes
• Being over 25 years old
• Having had gestational diabetes in a previous pregnancy
• Belonging to certain ethnic groups (e.g., South Asian, African-Caribbean)

When to see a doctor

See a doctor urgently if:

• If you have blood sugar readings that are very high or very low and you cannot correct them
• If you have signs of diabetic ketoacidosis (see emergency symptoms)
• If you have severe abdominal pain or vaginal bleeding

Book a routine appointment if:

• You should see your diabetes care team regularly throughout your pregnancy, as often as they recommend.
• Attend all prenatal check-ups to monitor your health and your baby's growth.

Diagnosis

If you already have type 2 diabetes, you will be under the care of a diabetes specialist before and during pregnancy. If you have not been diagnosed but have risk factors, your doctor may recommend a blood test early in pregnancy.

Tests that may be done

• HbA1c test: measures average blood sugar over the past 2-3 months
• Fasting blood glucose test
• Oral glucose tolerance test (if needed to confirm diagnosis)
• Blood sugar monitoring at home (finger-prick tests)

What to expect at your appointment

Your healthcare provider will check your blood sugar levels often and adjust your treatment plan as needed. You will have ultrasound scans to check your baby's growth and development.

Treatment

The goal of treatment is to keep your blood sugar in a target range to protect you and your baby. Treatment usually includes healthy eating, physical activity, and medication adjustments. Many women need insulin during pregnancy, even if they took pills before.

Self-care at home

• Check your blood sugar levels at home as often as your doctor advises.
• Follow a healthy meal plan that includes vegetables, whole grains, and lean proteins, and limit sugary foods and drinks.
• Stay active with safe exercises like walking or swimming, but talk to your doctor first.
• Take your medications exactly as prescribed.

Medical treatments

Your doctor may prescribe insulin injections to help control blood sugar. Some women may use other injectable medications, but oral diabetes pills are usually not recommended during pregnancy. Your doctor will determine the best treatment for you.

Living with this condition

Living with type 2 diabetes in pregnancy means checking your blood sugar several times a day, planning meals and snacks, and staying active. You will need to adjust your routine as your pregnancy progresses.

Lifestyle tips

• Eat a balanced diet with regular meals and snacks to keep blood sugar stable.
• Stay physically active – aim for at least 30 minutes of moderate exercise most days, with your doctor's OK.
• Get enough rest and manage stress through relaxation techniques.

Diet and exercise

Work with a dietitian to create a meal plan that fits your needs. Focus on low-glycemic foods (like whole grains, legumes, non-starchy vegetables) and lean proteins. Avoid sugary drinks and snacks. Exercise, such as walking or swimming, can help lower blood sugar and improve mood.

Mental health and emotional wellbeing

Managing diabetes during pregnancy can be stressful and may cause anxiety or worry about your baby's health. It is normal to feel overwhelmed at times. Talk to your healthcare team or a mental health professional if you need support.

Prevention

If you already have type 2 diabetes, you cannot prevent the condition, but you can reduce the risk of complications by managing your blood sugar carefully before and during pregnancy. For women at high risk, lifestyle changes can sometimes prevent or delay type 2 diabetes.

Vaccines

Your doctor may recommend the flu vaccine and the whooping cough (pertussis) vaccine during pregnancy to protect you and your baby.

Screening programmes

If you have risk factors, your doctor may test your blood sugar early in pregnancy. All women are screened for gestational diabetes around 24-28 weeks, but if you have type 2 diabetes, you are already diagnosed.

Complications

If left untreated

• High blood sugar can cause the baby to grow too large (macrosomia), which can lead to difficult delivery.
• The baby may be born with low blood sugar (hypoglycemia) after birth.
• Increased risk of preeclampsia (high blood pressure and protein in urine) in the mother.
• Higher chance of miscarriage or stillbirth.

Long-term outlook

With careful management and good blood sugar control, most women with type 2 diabetes have a healthy pregnancy and give birth to healthy babies. Your healthcare team will work closely with you to give you the best possible outcome.

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