My daughter has type 1 diabetes, In the future, will she be able to have children of her own? She is eight now, but the time will come. I have three children, one with diabetes and the other losing her eyesight related to being born 16 weeks early due to toxemia. My son is in fine health.

We’ve discussed pregnancy in women with diabetes previously. See previous questions about family planning for specifics. In short, women with diabetes can have healthy babies with only slightly increased risks of complications (including toxemia and prematurity) compared to women without diabetes IF they maintain the best possible glucose control both before conception and during pregnancy (when insulin requirements change frequently).

I understand it must be particularly painful to you to have one child who is losing eyesight from being born prematurely and another child who is now doing well, but at risk of eye disease in the future from diabetes (assuming we don’t have a cure in the near future). This is a very personal decision your daughter and her spouse will have to make when the time comes in the future whether or not they want her to become pregnant, knowing she is at slightly increased risk of developing problems which could affect her health and the child’s. Right now, you should try to help her to live as normal a life as possible, and not dwell on all the things that could go wrong, but focus on helping her stay healthy and well adjusted so when the time comes, she will be able to make her own decisions on what to do. There are many, many healthy children living today who were born to women with long standing diabetes since childhood. Fortunately, the outcome is usually very good and the parents are usually thrilled.

In the meantime, I hope that the ophthalmologists will be able to stabilize the vision of your other child and that your family finds the strength to cope with all these problems and help each other.

TGL