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Rybelsus may be one part of treatment, while other people use metformin, SGLT2 inhibitors, DPP-4 inhibitors, insulin, or another GLP-1 medicine

When to contact your provider: Persistent vomiting (more than 12 hours) Severe abdominal pain Signs of pancreatitis (pain radiating to the back, fever, rapid pulse) No weight loss after 8 weeks at the same dose Hypoglycemic symptoms (shakiness, confusion, sweating) if you're on other diabetes medications The 16-week decision point: At 16 weeks (four months), you and your provider should evaluate total weight loss

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"We know that poorly controlled diabetes during pregnancy is associated with both maternal and fetal outcomes in a pregnancy," she said, noting those risks can include miscarriage, birth defect, stillbirth and preeclampsia