What to know about type 2 diabetes in pregnancy

When type 2 diabetes is present during pregnancy, glucose management becomes part of routine antenatal care. Pregnancy can alter insulin needs and how the body responds to food and medicines. Higher glucose may increase pregnancy risks, while treatment that lowers glucose too much can cause hypoglycaemia. The care team may include an obstetric clinician, diabetes clinician, midwife, dietitian and eye or kidney specialists when needed. This is different from diabetes first diagnosed during pregnancy, although both require careful follow-up.

Contact the maternity and diabetes teams early, including before conception when possible. Check glucose at the times advised, keep a record and take prescribed treatment consistently. Do not stop or switch medicines without medical guidance, because some treatments are unsuitable in pregnancy and others may need adjustment. Attend antenatal, eye and kidney reviews, eat regular balanced meals and follow activity advice appropriate to your pregnancy. Keep a plan for treating low glucose and tell close family how to help.

Seek urgent care for severe low-glucose symptoms, fainting, confusion, seizures, difficult breathing, persistent vomiting or inability to keep fluids down. Contact the maternity team promptly for repeated high readings, reduced fetal movement later in pregnancy, severe headache, visual changes, bleeding, contractions or fluid loss. Ask for same-day advice during an illness, because dehydration and infection can change glucose quickly. Keep emergency contact details accessible.

What readings should prompt a call? Which medicines and supplements are suitable? How often do I need eye, kidney and fetal checks? What is my plan for labour, delivery and glucose monitoring after birth?