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May 26, 2000

Family Planning

Question from New Delhi, India:

My friend has Type 1 diabetes (insulin dependent). She is now 19 years old and has had diabetes since the age of 9. Would you tell me what precautions she should take in her diet and during the time of her pregnancy in the future?

Answer:

It is important that she be in good glucose control (fasting blood sugar between 60 and 90 mg/dl and 1 hour after meal less than 130 mg/dl) prior to conception and during the pregnancy. The hemoglobin A1c should be in the normal range. These steps will minimize the risk of fetal abnormalities. Diet should be adjusted along with the insulin dosing to help achieve these goals. During pregnancy she should be cared for by an obstetrician and an endocrinologist or an obstetrician with subspecialty certification to management high risk pregnancies.

OWJ