Unplanned Pregnancy with Type 2 Diabetes

An unplanned pregnancy with Type 2 diabetes can increase the risk of pregnancy-related complications.

Diabetic women are already at increased risk of maternal, fetal, and neonatal anomalies and an unplanned pregnancy further increases the risk. Here we’ve discussed some safe ways to manage an unplanned pregnancy with diabetes.

The American Diabetes Association states that type 2 diabetes is the most prevalent type of disease. This type of diabetes results from improper insulin utilization by the body. Insulin resistance is the main underlying problem of type 2 diabetic patients.

In type 2 diabetes, blood sugar levels are high because there is not enough insulin to maintain normal levels. A healthy lifestyle with proper diet adjustments can help to control type 2 diabetes. However, some people might still need medications or insulin to maintain normal blood glucose levels.

There are certain things to take into account to lower potential hazards and safeguard the health of both you and your unborn child if you have type 2 diabetes.

Risk or complications of having T2DM when pregnant

An unplanned pregnancy along with Type 2 diabetes can lead to poor management of blood sugar levels. This can be harmful to both the mother and the unborn child

Birth Defects:

During the first two months of pregnancy, the baby’s organs develop frequently before a woman is aware that she is pregnant.

Uncontrolled blood sugar can have an impact on those organs as they develop and result in significant birth problems in the developing baby, including brain, spine, and heart defects [ref].

A very large infant:

Poorly managed diabetes can lead to a large body size. The newborn becomes very huge due to “overfeeding”.

An extra-large baby can make labor difficult for both the mother and the baby, in addition to providing discomfort to the mother throughout the final trimesters of pregnancy.

To deliver the child, the mother might require a C-Section. Because of pressure on the shoulder during delivery, the infant may be born with nerve injury.

The C-section (Cesarean Section):

C-section is the surgical delivery of the baby through the mother’s abdomen.

Women with uncontrolled diabetes are more likely to require a C-section to deliver the baby. Recovery from childbirth is often slower with C-section deliveries.

Preeclampsia (High Blood Pressure):

Preeclampsia may occur in pregnant women who have high blood pressure, protein in their urine, and frequently persistent swelling in their fingers and toes.

It’s a significant issue that requires proper monitoring. Both the mother and the unborn child may suffer consequences from high blood pressure.

It could result in the baby being born early and could also make the mother experience seizures or a stroke (a blood clot or bleeding in the brain that can cause brain damage) when she is giving birth. Women with type 2 diabetes are more likely than non-diabetic women to have high blood pressure.

Infant Birth (Preterm) [ref] 

The baby may experience issues as a result of being born too soon, including breathing difficulties, cardiac issues, brain bleeding, digestive issues, and eyesight issues.

Compared to women without diabetes, women with type 2 diabetes are more likely to give birth early.

Reduced Blood Sugar (Hypoglycemia):

When taking insulin or other diabetic treatments, people with diabetes run the risk of having excessively low blood sugar. When left untreated, low blood sugar can be extremely dangerous and even fatal.

Hypoglycemia can be avoided by closely monitoring your blood sugar levels and treating low sugar levels as soon as possible.

If a woman’s diabetes was poorly managed while she was pregnant, her infant may experience low blood sugar very shortly after birth. The infant’s blood sugar levels should be monitored for several hours after birth.

A stillbirth or miscarriage:

A miscarriage is a pregnancy loss that occurs before 20 weeks. The term “stillbirth” refers to the baby’s death in the womb at 20 weeks.

Stillbirths and miscarriages can occur for a variety of causes. A woman who has uncontrolled diabetes is more likely to miscarry or give birth to a stillborn child [ref].

How to handle T2DM after pregnancy?

Your diabetes team will review your diabetes management after your baby is born. These factors help in diabetes management after birth:

• Your diabetes treatment prior to pregnancy.
• Your blood glucose levels in the days following birth.
• Whether or not you are breastfeeding.

Managing diabetes after birth

If you used to treat your diabetes with diet and/or metformin before becoming pregnant, you are likely to do so again.

If you began taking insulin while you were pregnant, it will probably be stopped as soon as you give birth. However, you might need to resume insulin use or begin taking metformin depending on your blood glucose levels.

If you were taking insulin before being pregnant, you probably need to keep doing so. Your doctor will assess the type of insulin, the number of injections, and the amounts you require.

If you need insulin after giving birth, the doses will be lower than they were throughout pregnancy, and you’ll need frequent checks, particularly in the first month.

Metformin and insulin are the only medications that are safe to take while nursing. When you stop breastfeeding, your doctor might prescribe you additional diabetic drugs.

After your kid is born, you’ll still need to perform routine blood glucose checks. After birth, your blood glucose targets will be higher than they were throughout pregnancy.

While you are establishing breastfeeding and a new habit with your infant, this helps to lower the chance of hypos. At this point, it is typically advised to maintain blood glucose levels between 5 and 10 mmol/L [ref].

When you first bring a new baby home, especially in the first few weeks, you will be kept busy caring for your baby. You may discover that your diabetes is not being managed as well as you would like as a result of this new routine and disturbed sleep.

Managing Diabetes During Pregnancy

Keep the following in mind to ensure your health and safety and the health and safety of your infant:

• Remember to take your insulin or prescription medication as directed.
• To be able to care for yourself and your baby safely, avoid hypos.
• In order to better control your diabetes, check your blood sugar levels at least four times every day.
• Make appointments with your diabetes healthcare providers so they can continue to assist you in managing your diabetes even after the birth of your child [ref].
• If you’re overweight during pregnancy, eating a healthy diet and increasing your physical activity will help you achieve a healthy weight.
• Diabetes increases your risk of developing other serious health conditions such as heart disease, so eating a healthy lifestyle is even more important.

Summary of Maternal and Fetal Complications of Unplanned Pregnancy with Type 2 Diabetes: