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July 31, 2003

Family Planning

Question from Long Beach, California, USA:

I am a 39 year old female with type 2 diabetes, and I just found out that I am pregnant. My doctor took me off the oral hypoglycemic agents and put me on insulin twice per day. My general practitioner is ready to terminate the pregnancy, but I am not, so I was referred to a high risk obstetrician next week. I do have two healthy children and need to think of their needs.What are the chances of my having this baby? What are the risks to me and the baby?

Answer:

As long as you do not have any complications of diabetes such as kidney or eye disease, the risk to you of pregnancy is not greatly increased. Your age and the diabetes do increase your risk of developing preeclampsia.

Depending on your glucose control in the early part of pregnancy, the fetus is at some increased risk of structural abnormalities such as heart or spine defects. However, close examination with ultrasound should rule out these problems. Separately, because of your age there is increased risk of genetic abnormalities.

None of these risks are absolute, and none are necessarily indications for termination. That choice is up to you. When you meet with the high risk specialist, these issues will be discussed in more detail.

OWJ

[Editor’s comment: See Planning a pregnancy, at the Diabetes Monitor, for some additional thoughts.

WWQ]