A friend of mine has a 13-year-old daughter who has type 2 diabetes with erratic sugar levels that are hard to regulate. She uses insulin. She also smokes cigarettes, drinks occasionally and has used drugs in the past. We just found out she is pregnant. What are the risks to her and the baby? What can we expect for possible complications for the teen mom and the unborn baby?

Your friend’s daughter has more issues to deal with than just diabetes. With respect to diabetes, she should see her endocrinologist to help her improve her glucose control. This will probably have the most direct benefit to the pregnancy. I would guess that she is probably beyond the first trimester, which is the time that a developing embryo is most sensitive to hyperglycemia. Thus, a good ultrasound examination is important to rule out any structural defects in the fetus. In addition, the ultrasound evaluation will also determine if the baby is growing well. This is where the smoking and drinking may affect the baby. This young girl should be encouraged to stop both of those activities. For someone this young and pregnant, along with her other problems, parental guidance and support is very important and may have more of an impact than social services.

OWJ