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March 4, 2001

Family Planning

Question from Atlanta, Georgia, USA:

I am 30 years old and have had diabetes for 22 years. I am in good control, have no complications, and have been using and insulin pump for three years. My husband and I have been trying to get pregnant for several months. I have been extremely vigilant about my blood sugars keeping them in normal range. A couple of days ago, I had a problem with my pump. My blood sugar was 90 mg/dl [5 mmol/L]when I went to bed, but when I woke up it was 442 mg/dl [24.6 mmol/L], and I had moderate ketones. I treated it right away and brought it down in a few hours. Yesterday, I found out that I am five weeks pregnant. The ketones happened on the 24th day of the pregnancy. Since this is a critical time in embryo development, I very worried. My doctor doesn't seem to have an answer. Other than this incident, my blood sugars have been nearly perfect. How worried should I be? Is there anything I can do?

Answer:

One episode of hyperglycemia is probably not of major significance. However, even though it is too early to evaluate the fetus, your good control will significantly reduce the risk of fetal abnormalities The best thing you can do is keep up the good work. As the pregnancy progress additional evaluation will be done.

OWJ