My 25 year old married sister has diabetes, is three months pregnant, and the doctors attending on her advise termination of pregnancy. Is there no way out at all? During the period of pregnancy, is there a way to keep diabetes under control? Can the pregnancy be continued for a safe delivery? Will the child get diabetes?

The diabetes aspects of her pregnancy can be continued safely as long as there is a specialist in managing diabetes in pregnancy consulting on her case. The goal is to maintain blood glucose values as close to normal as possible (fasting between 70 and 90 mg/dl (4-5 mmol/L)) and a one hour post meal less than 130 mg/dl (7.2 mmol/L). These values will not be achieved all the time, but she must do her best. Insulin is the best way of controlling blood glucose, and your sister should be checking her blood sugar values just before and one hour after each meal. The fetus should also be evaluated by ultrasound for possible abnormalities related to diabetes. The child will not get diabetes because the mother has diabetes. Since the cause of diabetes is complex, I cannot say that the child will not develop diabetes later in life (most likely not).

Termination is not absolutely necessary. However, if there is evidence of a severe abnormality such as a neural tube defect or heart defect, then this may be a consideration.

OWJ