October 28, 2002
Family Planning
Question from Hawaii Volcanoes National Park, Hawaii, USA:
I am a 26 year old who has had type 1 diabetes for five years. My hemoglobin A1c has been under 7% for the last year or so, and I am thinking of becoming pregnant. I have a multitude of autoimmune problems (hypothyroidism, asthma, irritable bowel syndrome, chronic fatigue at times), I am very active, and since I am a research biologist, I hike an average of three miles per day usually carrying a 40 pound pack. Part of me wants to wait three years until after I get my Master’ s degree.
How much does my risk of complications go up each year I have diabetes? Is waiting three years asking for more problems? It is much more important to me have a child than get my degree, but I would like to do both. No doctor has been straight up with me. A gynecologist told me that “I better hurry up because my ovaries are the next thing my immune system will destroy”. I am very stressed as to how I should plan my life.
Answer:
I do not think that waiting a few years is going to make a big difference or significantly increase your risk for complications as long as you have no evidence of vascular disease (hypertension, kidney or eye problems). Just keep your blood sugar in as good control as you can and start taking folic acid (5 mg/day) about a month prior to starting to try to conceive. I would also recommend that you consult with a specialist in high risk pregnancies as you get closer to making that decision.
OWJ
