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February 3, 2006

Complications, Pregnancy

Question from Seattle, Washington, USA:

I have type 1 diabetes and PCOS. I was told that I could never get pregnant. I just turned 36 and I found out I'm pregnant. My blood sugars are out of control ranging from 65 to 500 mg/dl (3.6 to 27.8 mmol/L]. I just had blood tests done and my creatinine was 2.5. I spill a lot of protein in my urine. I'm scared, not only for myself, but for my baby. Is it possible to carry this baby to term or should I just expect a miscarriage? I'm about nine weeks along. What should my blood sugars be? Should I check my sugars more than six times a day? Should I give myself extra insulin each time my sugars are high? I am desperately scared to death. I'm so afraid of having this baby, which may have tons of health problems; I feel sick. Any advice would be greatly appreciated.

Answer:

You need to meet with your doctor as soon as possible. You should be under the care of a high risk pregnancy specialist as well as an endocrinologist. You blood sugars can be controlled with insulin, but it will take some work. You will require multiple daily injections along with frequent blood glucose testing before and after each meal. I am concerned about your creatinine level. This suggests some kidney damage which can have implications for the pregnancy. You are at increased risk of poor fetal growth, pre-term delivery and early onset of preeclampsia. I doubt you will get to full term, but with close monitoring, you may reach a gestational age where you can deliver a healthy baby. You will need a lot of attention throughout your pregnancy.

OWJ