Type 2 Diabetes-Pregnancy

Overview of Type 2 Diabetes and Pregnancy.

Type 2 diabetes and pregnancy can be managed and a healthy baby may be expected.  It takes work and planning but if the sugar is controlled prior to conception and kept regulated during the pregnancy for most women with Type 2 diabetes the chances are  that all will be fine for her and the baby.

Someone with Type 2 diabetes who is planning a pregnancy needs to think of the impact of the pregnancy on their diabetes situation, the effect of the diabetes on the baby and then what happens blood sugars during pregnancy.

A woman with diabetes can have damage to the eyes, kidneys, nerves and circulation.  Diabetic changes in the eyes and kidneys can in a small percentage of patients become worse during pregnancy, more so if there is already a lot of damage present. Nerve damage and circulation problems tend to hold steady.  Women with Type 2 diabetes may have high blood pressure or cholesterol.  Some blood pressure medicines (ACE or ARB drugs) and cholesterol lowering statin drugs should not be used during pregnancy.

For the baby the critical period is the first six to eight weeks when all the vital organs are being formed.  If the sugars are not well controlled there is an increased risk of a congenital malformation.  If the sugars stay high for the rest of the pregnancy its as if the baby uses the sugar to make fat, the baby may be large and more difficult to deliver for both mother and baby.  The baby that has got used to having lots of sugar may have a low blood sugar after birth. I have never seen a baby born with diabetes because the mother had Type 2 diabetes.

If the mother is taking oral hypoglycaemic drugs most centres suggest switching to insulin.   This is because in later pregnancy the hormones from the placenta block how insulin works so much more insulin is needed to control blood sugar.  After about 14 weeks of pregnancy the amount of insulin usually just keeps increasing to nearly twice what was needed prior to conception.  After delivery the amount of insulin required drops right back down to prepregnancy needs immediately and some women can go back to diet or oral hypoglycaemic drugs to control their sugars.

Having a baby is exciting, having diabetes and being pregnant adds a worry but if the sugars are controlled especially during the first eight weeks and then for the rest of the pregnancy the chances are that the mom will get through it just fine and the baby will be healthy.