November 5, 2000
Family Planning
Question from Oviedo, Florida, USA:
What are the risks of pregnancy at an older age after long-term diabetes? I recently turned 37, have had type 1 since the age of 12, and hypothyroidism since the age of 11. I only married three years ago, and. five months later, I went into DKA [diabetic ketoacidosis]. It has taken me years to get back to anywhere near normal blood sugar numbers since then (doctors said I would have died within 12 hours if I hadn’t reached the hospital when I did). I’ve also had a large fibroid tumor the past two years that is scheduled to be removed. (I did not want surgery with blood sugars out of control.)
I went on an insulin pump three months ago. While it has helped with the lows, I’m nowhere near the tight control necessary for pregnancy. My hemoglobin A1c levels are now around 7.5%, and I’m trying for 6.5%. I have never had it that low. I understand the effects of high blood sugar on a fetus. Is it too late to consider pregnancy? Either way, getting blood sugar numbers close to normal is a good thing!
Answer:
As long as you go into the pregnancy with good blood sugar control and you do not have evidence of other organ damage (eyes and kidneys), then pregnancy is worth considering. Age does carry with it the increased risk of chromosomal abnormalities, but this is not related to the diabetes. If you are planning on a pregnancy, then you should also start a folic acid supplement. You can get this from your obstetrician.
OWJ
