November 5, 1999
Question from Wisconsin, USA:
I am 28 years old, and was diagnosed with diabetes when I was 12. My Hb1Ac’s typically run about 7.5, and I am not on an insulin pump yet. My husband and I have recently been discussing starting a family. My biggest concern is my blood pressure. I am currently on Cardizem, Vasotec and Lasix [3 medications for blood pressure control]. I worry about being taken off of these medications, as my blood pressure is in very good control. I also wonder what would happen if doctors could not find a combination that would work for me. I had been on Captopril before the Vasotec and it did not work well for me. Also, how might this affect a baby?
Changes in your blood pressure medications will have to be made. Vasotec is not safe in pregnancy and Lasix is not recommended either. Cardizem is probably safe, but I have more experience with verapamil which acts in an identical fashion. You should discuss possible medication choices with your obstetrician and diabetologist together.
In addition, I would recommend improving your glucose control prior to conception. Try and bring the hemoglobin A1c into the normal range. Also, you should start on a folic acid supplement by starting prenatal vitamins which can be supplied by your obstetrician.