November 6, 2004
Pregnancy
Question from Silver Spring, Maryland, USA:
I am 29 years old and my husband I and are trying to conceive. I have type 2 diabetes and control my blood glucose with four daily injections plus Glucophage pills. My A1c is 6.5%. My doctors say that this is great and it is okay for me to have a child. However, it is difficult for me to keep my blood glucose levels between 80 and 120 mg/dl [4.4 and 6.7 mmol/L]. Most days I can, but some days my blood glucose will rise and I have done everything I am supposed to do. Sometimes it rises to 200 mg/dl [11.1 mmol/L], but always goes down within an hour or so. Will this hurt my baby? Is it okay for me to have a baby because I am a diabetic? My blood glucoses will never ALWAYS be between 80 and 120 mg/dl [4.4 and 6.7 mmol/L]. Please help as I think I may be pregnant and needs answers right away so I won’t miscarry!
Answer:
Your hemoglobin A1c shows overall good control. Your blood sugars will never be perfect (no reflection on your efforts) and an occasional high value is probably not going to have any effect on the fetus. The problems occur in mothers who have persistently elevated blood sugar values. So, do not drive yourself crazy.
Yes, you can have a baby even though you have diabetes. It is important that your pregnancy is managed by an obstetrician with experience with diabetes along with your endocrinologist. The pregnancy does require extra attention in terms of several ultrasound examinations to rule out fetal structural abnormalities and excessive growth. With the glucose control that you demonstrate, you have helped to minimize your risks for problems.
OWJ
