Pregnancy and Type 2 Diabetes


Women with diabetes—type 1 or type 2—are able to have a smooth and safe pregnancy and delivery. But still, they have to take several precautions before and during pregnancy. According to Diabetes Canada, uncontrolled blood sugars can cause birth defects, a larger baby with high blood sugar which can cause problems during delivery and nerve damage in the baby. Also, women with poor diabetes management have a higher risk of having a miscarriage or stillbirth. Other health issues such as preeclampsia from high blood pressure are often higher in women with diabetes. Hypoglycemia—low blood sugar—can be fatal if not treated quickly and affects both mother and child. Expectant mothers with diabetes are also more likely to have a C-section.

Early pregnancy

The early weeks in the pregnancy, even before you realize you’re pregnant, are critical for women with diabetes. After seven weeks, around the time women find out they’re pregnant, the baby’s organs are fully formed. High blood sugar levels and ketones pass through the placenta and to the baby and increase the risks of birth defects. So, if you’re planning a pregnancy, consult with your doctor on blood sugar and blood pressure target ranges to ensure a safe early pregnancy. Have your doctor assess your A1C and chances of experiencing other diabetes-related complications such as kidney, eye, nerve and heart damage.

During pregnancy

During pregnancy, you need to ask your doctor about your use of diabetes medication. For people with type 2 diabetes who take oral medication, your doctor may have you switch to insulin because oral medication hasn’t yet shown to be safe to use during pregnancy. Also, Diabetes Canada recommends that you receive care by a diabetes care team, including diabetes educators (nurse and dietitian), obstetrical care provider and physician/nurse practitioner, with expertise in diabetes and pregnancy to minimize the risks to you and your baby.

Food and exercise

You and your doctor or nutritionist will also need to develop a safe dietary plan for you and the baby. Sure, you’re eating for two and will need to increase your calorie intake per day to gain weight throughout your pregnancy, but make sure your diet consists of vegetables, fruits, lean meats, dairy, poultry, fish, whole-grains and legumes. Talk to your nutritionist, certified diabetes educator and doctor on how much weight you should gain over the course of your pregnancy and how much of each food group you should eat per day to keep your blood sugar and pressure under control. Work with them to determine a manageable exercise regimen as well.

Labor and post-labor

When it’s time to welcome your new little one into the world, your healthcare team will monitor your blood glucose levels closely to make sure you have a safe delivery. At this time, have your doctors reassess your health to determine the safest time for delivery or what your target blood sugar levels should be when labor occurs.

After labor, you may experience some blood sugar swings or have better blood sugar control. No worries here—check your blood sugar often and talk with your doctor about resuming or adjusting your diabetes medications. Be sure to discuss the effects your medication could have on breastfeeding and passage onto your baby.

Breastfeeding and weight loss

If you’re breastfeeding, continue to monitor your blood sugar closely, as it can cause fluctuations in blood sugar, including possible hypoglycemia. So, keep a snack nearby. Breastfeeding can also help you lose the baby weight. But, as always, you should aim for the healthiest weight for your body. Work with your diabetes educator and nutritionist on developing a diet plan for safe breastfeeding. Breastfeeding can also lower the risk of diabetes in your baby.

Quick pregnancy health checklist

At your next doctor’s visit, discuss:

  • Target blood sugar and blood pressure levels
  • Risks of developing nerve, eye, kidney and foot problems
  • Risks of developing heart disease
  • Risks of birth defects
  • Ideal diet and exercise regimen
  • How much weight you should gain
  • Plan for a smooth delivery
  • If you should adjust your diabetes medications or if you should take them at all
  • How any medication will affect the development of your child

Written By T'ara Smith, MS, Nutrition Education, Posted , Updated 09/01/23

T’ara was diagnosed with type 2 diabetes in July 2017 at the age of 25. Since her diagnosis, she focused her academic studies and career on diabetes awareness and living a full life with it. She’s excited to have joined the Beyond Type 1 team to continue her work. Two years later, T'ara discovered she'd been misdiagnosed with type 2 and actually has latent autoimmune diabetes in adults (LADA). Outside the office, T’ara enjoys going to the movies, visiting parks with her dog, listening to BTS and cooking awesome healthy meals. T’ara holds an MS in Nutrition Education from American University.