September 9, 2000
Family Planning
Question from Bahrain:
My wife is 33 years old and was diagnosed with type 2 diabetes two years ago. We are planning to have our second baby, and she was advised to switch from oral tablets to 70/30 insulin (12 units a day). We do not have access to good doctors here. Her sugar levels with 12 units of insulin are 114 mg/dl [6.3 mmol/L] fasting and 189 mg/dl [10.5 mmol/L] two hours after meals. The doctor says that the normal blood sugar levels we should aim for are less than 140 mg/dl [7.8 mmol/L] for fasting and less than 200 mg/dl [11.1 mmol/L] two hours after meals so we can go ahead with the pregnancy. However, after reading questions here and on the net, we find that the target should always be less than 140 mg/dl [7.8 mmol/L]. Please advise.
Answer:
To reduce the risks of pregnancy as much as possible, a woman with diabetes should have her glucose control as near normal as possible prior to conception. I recommend a fasting blood sugar between 80 and 100 mg/dl [4.4 and 5.6 mmol/L], a one-hour after meal less than 130 mg/dl [7.2 mmol/], or a two-hour after meal less than 120 mg/dl [6.7 mmol/L]. You may want to speak with your doctor about using Regular and NPH insulin separately rather than the 70/30 mix. This would give your wife more flexibility in dosing.
OWJ
