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How To Prepare To Have A Healthy Pregnancy With Type 2 Diabetes

How To Prepare To Have A Healthy Pregnancy With Type 2 Diabetes

Nicole Knight, AHCJ | August 10, 2021 | trying to conceive
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Type 2 diabetes is not only the most common form of diabetes in this country, it’s also on the rise among reproductive-aged women (1). 

If you’re among the millions of individuals with type 2 diabetes, take hope — a healthy pregnancy is still within reach. You’ll just need to be mindful of the risks (including newer ones like COVID-19!) and fine-tune your diet and lifestyle to make sure you have the healthiest possible pregnancy. 

Here we break down everything you need to know about type 2 diabetes and how it may affect your pregnancy and newborn. We wrap up with  tips for a healthy pregnancy from the experts.

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What is type 2 diabetes?

With type 2 diabetes, your body doesn’t use insulin the way it should. Doctors call this insulin resistance (1). 

As a result, your blood glucose (sugar) may reach unhealthy levels in your body. Blood sugar levels that remain out of control are bad for maternal and fetal health, which is why preparing for pregnancy and proper management is so important (1). 

Is gestational diabetes the same as type 2 diabetes?

Gestational diabetes develops in pregnancy, usually around the 24th week, when your body can’t produce enough insulin to maintain healthy blood sugar levels. Blood sugar levels typically go back to normal following delivery (2). 

However, around half of women with gestational diabetes go on to develop type 2 diabetes. You can try to prevent this from happening by returning to a healthy body weight after your bundle of joy is born (2).

What are the risks of diabetes in pregnancy?

There are pregnancy risks for all women, however, diabetes increases the risk for certain things, such as (1):

  • Miscarriage
  • Stillbirth
  • Birth defects
  • Preeclampsia (high blood pressure that may cause dangerous complications)

You’re also more likely to have an extra-large newborn or one with respiratory distress syndrome or high blood sugar, you stand a greater chance of needing a C-section (1).

In addition, diabetes in pregnancy may increase the likelihood of obesity and type 2 diabetes in your offspring later in life (1, 3).

How can I prepare to have a healthy pregnancy with type 2 diabetes?

To help reduce the risks, be proactive and talk to your provider about your plans to get pregnant. Studies show that women with diabetes have healthier pregnancies and fewer complications when their healthcare starts at preconception and continues throughout their pregnancy (3).

Expect your provider to go over (1, 3):

  • Your blood sugar
  • Whether your blood sugar remains in your target range
  • How you are currently maintaining your blood sugar
  • Your medical history and existing health issues
  • Whether you are prone to or already have diabetes complications, such as eye disease, kidney disease, or neuropathy (nerve damage)

Your provider will also review all of the medications you’re taking to make sure they’re pregnancy-safe (1, 3).

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How do you manage type 2 diabetes prior to getting pregnant?

For some, a healthy lifestyle and diet are enough to maintain their blood sugar at an appropriate level. Others might need a combination of lifestyle and nutritional changes along with insulin shots or medication to help keep their glucose levels in a healthy range (1, 3). 

Your provider may recommend changing your diet or losing weight to help stabilize your blood sugar levels before conceiving. Being overweight or obese is associated with type 2 diabetes, as is having polycystic ovary syndrome (PCOS) (1, 4). 

Many women with PCOS have insulin resistance. Both obesity and PCOS can make it more difficult to conceive and have been linked to infertility (1, 4).

Does PCOS cause diabetes?

It’s complicated, but research shows there’s a link. According to the CDC, more than half of women with PCOS go on to develop type 2 diabetes by their 40th birthday (1). 

Similarly, a 2017 study in Denmark showed the risk of developing diabetes was four times greater in women with PCOS compared to women in the control group. The authors found that body mass index (BMI) and fasting blood sugar levels were the chief predictors of whether a PCOS patient would get type 2 diabetes or not, but cautioned that more research is needed to fully understand the link (5). 

What steps can I take to have a healthy pregnancy with type 2 diabetes?

You’ve already taken a major step by researching how to have a healthy pregnancy with type 2 diabetes. Next, work with your healthcare provider to keep your blood sugar as close to your target range as possible before becoming pregnant. 

Consider taking these proactive steps (1):

  • Check your blood sugar levels regularly in consultation with your practitioner. Because pregnancy changes the body’s need for energy, blood sugar levels can seesaw very quickly. Be proactive about understanding how exercise and anything you put in your body affects your blood sugar.
  • Eat a balanced diet. If you’re overweight, try to cut calories to lose some weight before you get pregnant. Losing as little as 10 pounds may improve your blood sugar levels. Talk to a dietitian about a diet rich in fertility foods, and make healthy eating a team effort with your partner.When taking these suggested steps toward a healthy diet, you might also find this article  on whether to avoid carbs helpful as well. 
  • Exercise regularly. Aim for at least 30 minutes of moderate-intensity exercise, such as a brisk walk, at least 5 days a week. Exercise helps regulate your blood sugar by forcing your body to use glucose for energy while you workout and even after your workout is over. It also helps keep your weight in a healthy range. Plus, regular exercise lowers stress, which may make it easier to conceive

It’s also important to take folic acid supplements before and during your pregnancy. This may help prevent neural tube defects in your baby and may lessen the likelihood of ovulatory infertility (1, 3).

How does COVID-19 affect pregnancy with type 2 diabetes?

Pregnant women with diabetes are more vulnerable to the severe effects of COVID-19. For example, a 2020 paper in the journal Diabetes notes that the inflammatory effects of the coronavirus make it more difficult to maintain a healthy blood sugar level despite your best efforts (6, 7).

In diabetes patients sick with COVID-19, researchers observed many cases where a cytokine storm (when the immune system overreacts) was accompanied by an unhealthy surge in blood sugar (6). 

Thus, experts urge women with diabetes to take precautionary measures to avoid getting coronavirus at all (6).

How can I increase my fertility with type 2 diabetes?

Consider talking to your gynecologist or a reproductive endocrinologist about medications to help manage diabetes and supercharge your fertility. Your practitioner may suggest pairing metformin, an insulin-lowering drug, and ovulation-inducing medication with a regime of diet and exercise (8). 

In one study, women treated with metformin and the drug clomiphene were four times more likely to ovulate than those who just took clomiphene. They also experienced higher pregnancy rates (8).

Can supplements boost fertility with type 2 diabetes?

If you’re looking for a natural alternative, multiple studies suggest that inositol might be just as good or better than metformin at improving insulin sensitivity and fertility. However, the research centered on women with PCOS and insulin resistance, not necessarily those with type 2 diabetes — although this may be a distinction without much of a difference (9, 10, 11). 

Of course, before you start shopping for supplements, be sure to discuss natural alternatives with your practitioner as part of a larger conversation about your pregnancy goals. 

Rest assured, even with type 2 diabetes, a healthy pregnancy is still within reach. Careful management of your blood sugar and simple changes to your diet and lifestyle can assist in the journey toward a positive pregnancy test.

References +
How Not to Waste Another Month When Trying to Conceive
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