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July 29, 2000

Family Planning, Hypoglycemia

Question from Ohio, USA:

My wife is 30 years old and has type 1 diabetes. She's a black belt in Tae Kwon Do and is in excellent physical condition. She had a miscarriage six years ago and now we are trying again and are now well into the fifth month. For the most part, she has been good about her blood sugars, keeping them within range. However, she has had about five episodes of low blood sugar (low to mid 30's mg/dl [1.6 mmol/L]). It's been hard to predict when her tendency to be high or low will change. They haven't been prolonged episodes, but I'm worried about the possibility of fetal abnormalities. We've already lost one child and I guess I'm a little paranoid about this one. What kind of danger are we looking at here? How low and how often is too much?

Answer:

Low blood sugars will not cause fetal abnormalities. However, the fetus does have a limited response to hypoglycemia (does not have as much glycogen reserve in the liver as adults). Therefore, it your wife is prone to hypoglycemic events, I would suggest not striving for as strict control of blood sugar as is possible. In the fifth month of pregnancy, there is no risk of congenital abnormalities due to elevated blood sugars. Talk with your physician about this further.

OWJ