My wife, who has had type 1 diabetes almost 30 years, is well controlled (hemoglobin A1c: 6.5% ) on an insulin pump, and we would love to have our own child but don’t want to put her life or health in danger. We are getting mixed answers from her doctors. What dangers are posed to a woman with type 1 diabetes if she becomes pregnant?

First of all, I would suggest that you peruse this website because we have addressed this question before, and there is a lot of information already here about diabetes and pregnancy.

In brief, the main determinant of risk is how her overall condition is at this time. If she does not have any retinal problems, kidney damage or hypertension, then the risk of complications during the pregnancy is reduced. By maintaining good blood glucose control (as she is already demonstrating) prior to conception and during the early part of pregnancy, the risk of fetal abnormalities is also reduced. I would recommend a thorough evaluation by her endocrinologist before starting to try and conceive. She should also start on a folic acid supplement (5 mg/day) to reduce the risk of spina bifida.

OWJ