I am 28 year old who has had type 1 diabetes for 20 years, I am 17 weeks pregnant, and I am having a lot of low sugar values (28-50 mg/dl [1.6-2.8 mmol/L]). My doctor says that this is better than having high sugar levels and cannot harm the fetus because it is for such short period. Is that true ?

To some extent, the baby can support itself if the mother has low blood sugar. However, the fetal reserve for glucose production is limited. Therefore, I would try to prevent these episodes of low glucose. In fact, in my patients if repeated hypoglycemic events are a problem and the pregnancy is past the first 10 weeks, then I will loosen up the control guidelines a little bit. I will accept more frequent episodes of high blood sugars since in the short term these may be better tolerated by the mother, particularly if she is requiring aggressive resuscitation from hypoglycemia. The downside is the risk of excessive growth of the baby.

OWJ