March 7, 2002
Family Planning
Question from Miami, Florida, USA:
I’m 24 years old, I have had type 1 diabetes for 11 years, I have no complications, and my control has been good for the past several years (My past few hemoglobin A1cs have been 5.6 – 5.7%). After trying for only one month, my husband and I found out that we were pregnant last week. Since we began trying to conceive last month, I have been trying to keep my blood sugars within the prescribed range (80-90 mg/dl [4.4-5 mmol/L]before meals, and 120 mg/dl [6.7 mmol/L] one hour after meals), but although my blood sugars have been good, I’m having trouble staying within this range all the time. My readings are often over 120 mg/dl [6.7 mmol/L], though they are never over 150 mg/dl [8.3 mmol/L]. In the past few days, I think I’ve had a surge in hormones, and my readings are hovering around 115-135 mg/dl [6.4-7.5 mmol/L] almost all the time. How bad is it to have sugars outside of the prescribed range to the extent that I do?
Answer:
The risks are always relative. The greater you exceed the normal values, the greater the risk of problems with development in the fetus. A few elevated values are probably not concerning. Persistently elevated blood glucose might be a problem. However, I would classify your values in the mildly elevated range.
I encourage patients to just do the best they can. You will not always have perfect control. If your blood sugars are steadily increasing, then you need to increase your insulin dose to compensate. Over the course of the pregnancy your baby will be evaluated several times for the presence of any problems.
OWJ
[Editor’s comment: See The Diabetes Monitor: Planning a pregnancy for some additional thoughts.
WWQ]
