I am an 18 year old girl and my boyfriend and I are thinking about children. Is it harmful for women with diabetes to become pregnant? Will I have many complications with it?

It is very good that you are asking these questions before you get pregnant. There are a couple of issues — risk to you and risk to the baby. The risk to you is minimal if you have no complications prior to becoming pregnant. People with diabetes have a greater risk of certain complications that can occur to any pregnant woman such as preeclampsia, which is a condition that can increase the blood pressure, cause fluid retention, and go on to serious problems for mother and baby if not diagnosed and treated. As I mentioned, all women have risks when they become pregnant, and some of these risks are slightly higher in women with diabetes.

It is very important that you have your blood sugars under the very best control possible at least six months before you plan to become pregnant. Insulin requirements may change dramatically during pregnancy (at first you may need less insulin and be more prone to low blood sugars and then your insulin requirements may double or triple during the course of the pregnancy). It is very important to have an endocrinologist familiar with the changes during pregnancy to work with you to adjust your insulin frequently. If you have nausea or vomiting when you become pregnant, it may make it a little harder to control your blood sugars. If the blood sugars are not under excellent control before you get pregnant and during the first trimester when the baby’s organs are forming, there is a slightly increased risk of the baby developing certain birth defects (all developing babies have a slight risk of birth defects, but uncontrolled diabetes in a pregnant woman can increase this risk in her developing baby). The main risk at the end of the pregnancy is that of high blood sugars which can cause the baby to be large and prone to injury at birth and prone to low blood sugar after birth. Again, very careful blood sugar control can minimize the risks both to mother and to baby.

If the mother has any eye problems or kidney problems, this could become worse and you need to discuss this with your doctor before getting pregnant to know your personal risk.

TGL

[Editor’s comment: See Planning a pregnancy , at the Diabetes Monitor, for some additional thoughts.

WWQ]