Managing Type 2 Diabetes and Pregnancy
Pregnancy can be a wonderful time full of hopes, dreams and excitement for the future. But if you have an existing health issue is can also be fraught with fear.
Managing type 2 diabetes is even more crucial during pregnancy than it is when you aren’t expecting a baby.
Even those who keep great control of their diabetes can find those pregnancy hormones and cravings can play havoc with their diabetes and appetite. It’s really vital to carefully manage your diabetes during pregnancy and afterwards as your body returns to its pre-pregnancy state.
The Right Healthcare Team
Firstly, it’s really important to make sure the team caring for you during pregnancy are fully aware of your history. It’s not enough to assume your notes will carry this information — be a diabetes bore and remind everyone you come into contact with that you have type 2.
Sadly, overworked and tired staff don’t always have the time to do anything but skim through your notes. As an example, the day after I had my baby a very solemn doctor came to tell me my blood glucose levels post C-section showed I might have type 2 diabetes.
He was embarrassed when I pointed out the meds on my nightstand and the big red sticker on my notes and told him I had been diagnosed three years previously!
What to Do in the Early Weeks of Pregnancy
When choosing who is going to care for you, assemble a team made up ideally of the following:
- A doctor who specializes in caring for pregnant women with diabetes.
- An obstetrician who handles high-risk pregnancies, and has experience of dealing with pregnant women with diabetes.
- A pediatrician (children’s doctor) or neonatologist (doctor for newborn babies) who knows and can treat special problems that can happen in babies of women with diabetes.
If possible, it would be ideal to also meet with a registered dietitian who can help you plan your meals and snacks as your needs change during and after pregnancy, and a diabetes educator who can help you manage your diabetes during pregnancy.
If this is not possible due to your location or financial situation, make the most of online resources. The American Diabetes Association, for instance, has lots of useful information and of course you can read articles and chat to other people experiencing similar situations on NLO.
Eating for Two Is Not an Option
A fundamental principle is to remember that no woman, diabetic or not, should “eat for two.”
In diabetic moms-to-be this can create a real issue if the pounds pile on during pregnancy. Blood sugar levels will go awry and birth can be significantly more difficult if you are overweight, especially if you end up requiring an assisted or surgical delivery.
Yes, you do need to put some weight on, but your pre-natal team will be able to guide you as to how much and, crucially, when.
If you are already overweight it’s vital to try and stick to the recommended weight gain parameters.
It’s more important to improve the quality of the food you eat, rather than the quantity. You will be feeding your baby as well as yourself and what you eat now could impact your child’s health for the rest of their life.
It’s hard to prepare healthy food when your body is craving ice cream, but just think of the life you are nurturing before reaching for the spoon over the salad tongs.
If prenatal sickness and nausea is an issue, figure out your best time of day when your stomach is most settled and use that to prepare a week’s worth of healthy food to freeze or refrigerate.
If you are simply too tired to prepare a meal, get your partner, a friend or family member to help out. Even the worst cook in the world can throw together a nutritious salad.
You could cheat and buy ready-made salads, but ensure you wash any leaves thoroughly before consuming. Don’t think that honey mustard pasta salad is necessarily a healthy choice — check fats, carbs and sugars to make sure your salad is not largely empty calories.
If you are at the vomiting stage of pregnancy you are going to roll your eyes at my next suggestion to get some exercise.
Actually, a walk in the fresh air or a refreshing swim might leave you feeling better and it will certainly be good for you, baby and your shared blood sugar levels.
You should always mention your pregnancy and your diabetes to anyone running any form of fitness class or session. If you already attend a class and want to continue, go a few minutes early and ask your instructor how to adapt your routine.
If you are new to exercise, check with your doctor before starting any new routine.
Keep Glucose Levels in Check
I’ve mentioned monitoring glucose levels — it’s especially important during pregnancy to regularly check levels and to check that any diabetes medication you have been taking is suitable for pregnancy.
Many oral medications are either not suitable, or there is some doubt about their safety during pregnancy, so you may be switched to insulin during pregnancy and possibly for a short while afterwards.
Don’t panic about this even if you are scared of needles. I sobbed during my consultation with the diabetic nurse showing me how to inject for the first time during pregnancy and then felt embarrassed when she pointed out she’d already completed my injection and I hadn’t felt a thing. Those needles are really fine!
So to sum up, a pregnancy for a mom-to-be with type 2 diabetes might not automatically prove to be high risk, but the key to keep it as low-risk as possible is to consult the experts, eat well, exercise and make sure that everyone caring for you knows about your condition.