There are potential issues for the birth parent and fetus if an individual has type 2 diabetes. These issues include an increased risk of eye and kidney problems and preeclampsia. Therefore, people with type 2 diabetes must work closely with their healthcare team throughout pregnancy. Specialists can help someone have a healthy pregnancy.

Type 2 diabetes is a chronic health condition where the body cannot respond to insulin properly. Because insulin is a hormone that plays a major role in regulating blood sugar levels, people with type 2 diabetes can have higher than typical blood sugar levels. As a result, they are more likely to develop various health complications.

If a person has high blood sugar leading up to the time of conception, this can increase the risk of birth abnormalities, stillbirth, and preterm birth. It can also increase the risk of a baby weighing too much, experiencing neonatal complications, or both.

Among pregnant people with diabetes, high blood sugar levels can increase the risk of having preeclampsia and the need to deliver the baby early. However, a team of healthcare professionals can design an individualized treatment plan that minimizes potential risks while maximizing the likelihood of delivering a healthy baby.

This article looks at type 2 diabetes and pregnancy, including how a person can prepare for pregnancy and avoid some potential risks.

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When someone with type 2 diabetes is considering getting pregnant, they should first aim to get their blood sugar levels stable and in the target range. A healthcare team can help pregnant people achieve that and maintain optimal health.

If a person is already pregnant and has preexisting type 2 diabetes, they will also benefit from having a healthcare team. The team may consist of the following:

  • medical doctors and specialists who are experts in diabetes care, for example, an endocrinologist
  • a registered dietitian who can help plan meals
  • an obstetrician who has experience in caring for pregnant people with diabetes
  • a nurse who can help with prenatal and postnatal care
  • a diabetes educator who can help manage all aspects relating to diabetes
  • a midwife who can help provide care during labor and post-delivery

The first few weeks of pregnancy are crucial for fetal development. Ideally, a person should talk with the team several months before trying to conceive.

This is because if someone’s average blood sugar level over the past few months is 10% or more, there is an increased risk of having a baby with a heart, kidney, brain, or spinal cord abnormality. If this level — which doctors call the A1C measurement — is 6.5% or less, the person is no longer at an increased risk.

To monitor and manage this risk, pregnant individuals should have regular checkups to discuss and assess:

  • blood sugar levels and management, including exercises
  • diet and weight gain
  • any diabetes complications, such as kidney, eye disease, or neuropathy
  • existing health conditions
  • current diabetes and other medications
  • blood pressure, cholesterol levels, and other health measures

By working closely with the healthcare team and carefully managing blood sugar levels, it is possible to reduce the risks relating to type 2 diabetes during pregnancy.

If someone develops diabetes during pregnancy, doctors call it gestational diabetes.

Learn more about gestational diabetes.

If someone with type 2 diabetes plans to become pregnant, managing their blood sugar levels is important. A person’s healthcare team can best advise on achievable blood sugar targets.

Health experts have defined the following as typical targets for adults:

  • Before meals: 80 to 130 milligrams per deciliter (mg/dL) before meals
  • Two hours after the start of a meal: less than 180 mg/dL

However, these target levels change during pregnancy:

  • Before a meal: 95 mg/dL or less
  • One hour after a meal: 140 mg/dL or less
  • Two hours after a meal: 120 mg/dL or less

That said, these targets may differ by age, any additional health problems, and other factors.

If a person is yet to consult a dietitian, they should consider scheduling an appointment before getting pregnant.

A dietitian can help the person understand the type of diet they should follow and offer suggestions on how to make more optimal food choices. Together, the person and dietitian can create a suitable meal plan, as some people need to add extra calories, protein, and other nutrients during pregnancy.

Generally, eating a nutritious, balanced diet is essential for type 2 diabetes management. A balanced diet should provide the necessary vitamins, minerals, and fiber for the parent and the developing fetus. A plan can include:

  • lean meat with a low fat content
  • fish, but avoiding raw fish preparations and those with a high level of mercury
  • fruits and vegetables
  • whole grains

Learn more about eating a balanced diet when pregnant.

It is also important to discuss expected weight gain during pregnancy with a person’s healthcare team. If individuals are a typical weight for their height, they should aim to gain no more than 25–35 pounds. However, everyone is different and should follow a doctor’s recommendations.

Without careful management, type 2 diabetes can cause various health issues for the pregnant individual and developing fetus.

Pregnant person

Pregnancy can worsen some of the health problems of diabetes, such as eye and kidney problems, particularly if the person’s blood sugar levels are too high.

There may be an increased risk of developing preeclampsia, where someone’s blood pressure becomes dangerously high during the second half of pregnancy. The individual can also have too much protein in their urine.

Preeclampsia can lead to serious health complications for the pregnant person and fetus. The only cure is to give birth, so the pregnant individual may need to deliver early.

Fetus

High blood sugar levels can harm a developing fetus during the first 8 weeks of pregnancy. It can increase their risk of being born with congenital heart, brain, or spine anomalies.

Other risks include:

  • the baby being born too early, which doctors call preterm birth
  • having a large baby, necessitating cesarean delivery
  • neonatal complications, including breathing difficulties or low blood sugar for the baby

When the birth parent has high blood sugar, it also makes pregnancy loss or stillbirth more likely.

If someone has type 2 diabetes, they should discuss plans for pregnancy with a doctor. This is because, without proper management, type 2 diabetes can have serious health implications for the birth parent and developing fetus.

A team of healthcare professionals, including endocrinologists and obstetricians, can help them create an individualized treatment plan to help minimize any potential risks. The plan may detail ideal blood sugar levels, diet recommendations, and appropriate weight gain during pregnancy.