I have had diabetes for 23 years and just became pregnant. I am very concerned at the moment as my blood glucose control has always been erratic, I know this could harm my baby. My husband is very supportive, but I do not want to worry him so have not discussed this with him as yet. Any advice would help.

First of all, I would suggest speaking with your husband about your concerns. You are correct: poor glucose control can have potential effects on the fetus, but not always. With specific blood tests and ultrasound, most defects can be detected or excluded. Early in the pregnancy (first 8-10 weeks) it is important that you strive for tight glucose control. Fasting blood sugar should be less than 5.8 mmol/dl (105 mg/dl) and one hour after each meal should be less than 7.2 mmol/dl (130 mg/dl). Control will not always be perfect, so do the best you can. Your obstetrician will probably consult with an endocrinologist and a specialist in high risk pregnancies to help in your care.

OWJ