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August 22, 1999

Family Planning

Question from New Hampshire, USA:

How dangerous is it to get pregnant and be diabetic? Can it be done safely without harm to the baby? What is the best glucose range to maintain during pregnancy?

Answer:

Pregnancy in a diabetic mother poses risks. How much risk depends on how long a mother has had diabetes and is there any other organ involvement (kidney in particular). The key components to a successful pregnancy are tight glucose control prior to conception (fasting blood sugar less than 100 mg/dl, 1 hour postprandial less than 130 mg/dl, Hgb A1c normal), maintenance of tight control during the pregnancy, fetal assessment with ultrasound, frequent office visits with the obstetrician and use of a team comprised of an obstetrician, an internist/endocrinologist, diabetes nurse educator and a dietitian.

Even with good control of diabetes there is an increased risk of fetal anomalies and complications such as preeclampsia or poor fetal growth. These last two factors may lead to an early delivery.

OWJ