As the incidence of Type 2 diabetes is now taking off at such a pace we are also seeing increasing numbers of Type 2 diabetes in pregnant women. The issues regarding blood glucose control and adverse pregnancy outcomes are similar to those in Type 1 diabetes. That is to say it is the high blood glucose regardless of the cause is the central trigger of pregnancy related problems. The consensus is thus to establish as near normal diabetes control before and during pregnancy by whatever means, diet or medication.
More specifically regarding medication, insulin has traditionally been the treatment of choice. This has been the case until recently because the safety of oral hypoglycaemic agents have not been sufficiently accepted in pregnancy. There are now a number of positive published studies with both sulphonylureas but particularly with Metformin in women with Type 2 diabetes in pregnancy. These support the continued prescriptions of oral medication during pregnancy with the introduction of insulin in addition when necessary.