My 18 year old daughter has type 1 diabetes. She is also 13 weeks pregnant. Her most recent A1c was 9.3 %. Do you think an insulin pump may be beneficial to her? Will Medicaid pay for it? We have not been able to control her glucose level since before she became pregnant and now it is really out of whack. We are concerned about her health as well as the baby’s.

I think switching to a pump is worth a try if you are having trouble controlling blood sugars with multiple injections. Your daughter’s hemoglobin A1c is very high. This does place the fetus at increased risk for abnormalities (heart defects, spina bifida, etc.). However, the odds are still in her favor of having a normal baby. At this point in the pregnancy, she is out of the embryonic phase so all the fetal structures are present. It is now a matter of some good ultrasound examinations to evaluate the fetal anatomy. You need to call the Medicaid office in your area to see if they will pay for a pump. I would strongly recommend that your daughter consult with a high-risk pregnancy specialist to participate in her prenatal care.

OWJ
Additional comments from David S. Holtzman, Esq.:

It sounds to me that this person is not receiving the physician care that she needs. That is the prerequisite issue that needs to be addressed. The first step for your daughter is to receive appropriate treatment and medical advice from a physician who specializes in diabetes. If and when she advises that a insulin pump is the preferred treatment option, then the patient, with the support of the physician, can seek approval from Medicaid for use of a pump.

DSH