
April 15, 2005
Hyperglycemia and DKA, Pregnancy
Question from Trece Martires City, Cavite, Philippines:
I’m 29 years old, married and have type 1 diabetes. I just had a miscarriage last month during the sixth week of my pregnancy. Before the miscarriage, I had a spotting/bleeding and the next day a much heavier bleeding occurred that lead to a complete abortion. During my pregnancy, my fasting blood sugar ranged from 140 to 200 mg/dl [7.8 to 11.1 mmol/L] with 30 units of Humulin NPH Insulin. My question is: did my diabetes have a great effect in my pregnancy? How? Do I still have the chance to get pregnant again?
Answer:
Although I cannot say for sure, I doubt that your glucose control had anything to do with your miscarriage. I am always amazed that some women wildly out of control can conceive and carry a pregnancy. There are many reasons for early pregnancy loss (which unfortunately happens to be quite common). Certainly, very high blood sugars can increase the risk of fetal abnormalities which might lead to a miscarriage but, in your case, I cannot confirm this. I would encourage you to work on your glucose control prior to trying for another pregnancy. The closer to normal you are, the less likely the developing fetus will have any problems. I would also suggest that you ask your doctor to give you extra folate to take before conception and during the first eight weeks of the pregnancy. An extra 4 mg/day will help reduce the risk of spina bifida.
OWJ