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April 25, 2002

Family Planning

Question from Brooklyn, New York, USA:

I am a 28 year old female who has had type 2 diabetes for three years, and I have been trying to maintain tight control with NPH and Humalog in order to become pregnant. but, if I'm 120 mg/dl [6.7 mmol/L] one to two hours after a meal, I will have lows later. I feel I am in better control when my numbers are high for the first two hours because it decreases my chances of lows later on, and it is difficult for me to eat and monitor my glucose levels at work. Are these highs immediately after a meal dangerous for pregnancy? I am very scared; please help.

Answer:

Ideally, you should not be having high blood glucose values after meals (120 mg/dl [6.7 mmol/L] is great). An occasional elevated blood sugar is not terrible, but if it is frequent, that may represent risk to a developing embryo. If you are developing hypoglycemia, you probably should talk to your endocrinologist about your insulin dosing and the type of insulin that your are using. Maybe a combination of Lantus (insulin glargine) with Humalog would be better for you, or even starting on an insulin pump. Try and get these issues straightened out before you conceive.

OWJ