From Las Vegas, Nevada, USA:
I am 16 years old and have had Type 1 diabetes for 5.5 years. I recently found out that I am pregnant. Can you please give me as much information as possible about this? I have heard a lot of good news about the pump. Will this help and, if so, does most insurance cover it?
Probably one of the most significant factors contributing to successful pregnancy outcome is preconceptual glucose control. Basically the closer that fasting and postprandial blood sugar values are to normal (I use less than 105 mg/dl fasting, and less than 130 mg/dl at 1 hour postprandial as guidelines) the greater the likelihood that the risk of congenital abnormalities will be minimized. Since you are already pregnant, this is a goal to shoot for and will still have some benefit to the pregnancy. However, do not drive yourself crazy over an occasional elevated blood glucose value. Similarly, your hemoglobin A1c should also be in the normal range. Check with your doctor's office to find out what the normal values are (usually less than 6 to 7% depending on the assay).
The more times you check your blood sugar the more information can be gained about your glucose control. However, you have to be practical. At a minimum I would recommend checking a fasting, before lunch, before dinner and bedtime blood sugar. If you want to check at 1hour after meals this would also be useful but not necessary after each meal.
Depending on your blood sugar control and any other problems, you should be seeing your obstetrician once a week to maybe once every two weeks.
Your overall medical condition is important. As long as your blood pressure is normal and you have no evidence of kidney disease then the risk to the pregnancy is minimized. It is important that you work with a diabetes team (an obstetrician, an internist or endocrinologist with expertise in diabetes during pregnancy, and a dietitian). This group usually will have established contacts with other useful specialists such as an ophthalmologist.
A insulin pump can be a useful tool, but injections can achieve very good control of blood glucose. You will have to check with your insurance company on coverage.
Original posting 21 Mar 1998
Posted to Family Planning
Last Updated: Tuesday April 06, 2010 15:08:54
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