My friend, who was recently diagnosed with type 2 diabetes, is afraid to get pregnant. She has read that if she gets pregnant, she will have to take insulin. If she does take insulin during pregnancy, does that mean she has to be on insulin the rest of her life after pregnancy? She is very scared!

I assume that your friend is currently taking an oral hypoglycemic agent. It is possible that oral medication may carry her through a pregnancy. The more likely scenario is that she will require insulin. Just because she takes insulin during the pregnancy does not necessarily mean that she will need it afterwards. To minimize her risks in pregnancy, I would suggest some weight loss (if she is overweight), diet adjustment to fit her diabetes, and folate supplementation (5 mg/day prior to conception and through the first three months of pregnancy). In addition, she should do her best to bring her glucose into good control prior to attempting a pregnancy. During the pregnancy, she will need to be seen by a specialist in high risk pregnancies (either as a consultant or for total care).

OWJ