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June 26, 2002

Family Planning

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Question from Australia:

I am a pregnant woman with type 2 diabetes, and I am wondering if my disease will hurt my unborn child. If so, how or can I change/improve the effect?

Answer:

From: DTeam Staff

Since you have preexisting type 2 diabetes, there are potential risks to the baby. In summary, high blood sugars in the early part of pregnancy can result in fetal abnormalities (heart and spine defects in particular). Poor control in the latter part of pregnancy can result in a large baby and difficulties with delivery.

Therefore, it is important to be in good control prior to conception and during the first 8-10 weeks of pregnancy to minimize the risk of structural abnormalities and maintain this throughout the pregnancy. You should also start on a folic acid supplement before conception to reduce the risk of neural tube defects. Based on some recent recommendations I have increased the dose in mothers at high risk (those with diabetes or a previous history of a baby with spina bifida) to 5 mg each day. The spine is fully formed by day 28 of development so you can stop taking the supplement after about six weeks from the last period.

OWJ