My 37-year-old has had Type 1 diabetes for 5 years. She has three children, ages 12,14,16. She divorced their father six years ago. She just recently remarried a man that has no children; at his request she had her tubes untied last year. She is now trying to have more children. Two weeks ago she found out she was pregnant but over the weekend she had a miscarriage. Needless to say her mother and I are worried sick about this. Can you please let us know what you think? What risk are there, if any, for her and the baby?

While it is an unfortunate event, miscarriages are very common. Usually the exact reason is never known. Most commonly miscarriages occur due to genetic abnormalities in the developing fetus. At age 37, this is a more likely cause. However, miscarriages can also occur due to hormonal problems in the mother and other medical conditions such as diabetes. I am often surprised though by patients who come to my office in poor control, but have no problems conceiving and carrying the pregnancy.

Having diabetes poses some risk to the mother. If she has other organ involvement, then pregnancy may worsen her condition. She is also at higher risk of developing a special complication of pregnancy called preeclampsia. Some of the complications in the mother may lead to a need for early delivery of the baby as well. The baby is not necessarily at risk of developing diabetes. Good glucose control prior to conception and during the pregnancy will minimize these risks.

OWJ