I want to know about early pregnancy for a teenager with diabetes. What are the risks? What do you suggest? I am looking for information for my sister to give to my 10 or 11 year old niece.

Your question is very broad. I would strongly suggest that you peruse this web site for more detailed information provided in the answers to previous questions along this line. However, I can give a brief summary. The key to a successful pregnancy in a woman with diabetes is good glucose control both before and during the pregnancy. The first eight to ten weeks are when the developing embryo is most susceptible to the effects of hyperglycemia resulting in abnormalities. Heart and spine defects are classically associated with uncontrolled diabetes, but any organ system is at risk. Therefore, she should work with her endocrinologist to bring her hemoglobin A1c into the normal range prior to conception. Folic acid supplementation may also reduce the risk of spina bifida. An additional risk factor is the presence of any organ damage in the mother (kidneys in particular, especially if there is associated hypertension). Thus, she should have her eyes and kidneys examined periodically prior to conception.

During the course of the pregnancy, she will have several ultrasound examinations to look for fetal abnormalities and to make sure the baby is growing appropriately. In the later part of the pregnancy, she will have serial testing for fetal well-being. Historically, babies frequently died during the third trimester. However, with close surveillance, this risk has been reduced to that of someone without diabetes.

With care from an endocrinologist and a high risk pregnancy specialist (perinatologist), women with diabetes can have good pregnancy outcomes.

OWJ