From Rhode Island, USA:
My 22 year old daughter, diagnosed with Type 1 diabetes 11 years ago, is 4 months pregnant. Because of the need for tight control she's experiencing many severe reactions, some resulting in seizures. She's home alone all day since she was 'let go' from her job because her pregnancy interfered with her performance. She'd been hospitalized for a week with high blood sugars and had to miss time from work for frequent doctor appointments.
Several days ago her boyfriend called me at work because he'd been by the house. Her car was there but she didn't answer the door. After getting my house key from another daughter he found her unconscious and having a seizure and called 911. I'm very concerned for her and the baby. Do you have any thoughts or advice?
It sounds like your daughter is a very brittle diabetic. If she is having severe hypoglycemic events, then my approach would be to not go for tight control and allow for higher blood sugar values. This may lead to a large baby, but that can be managed. Frequent visits to the obstetrician and endocrinologist are needed in this situation and hospitalization if blood sugars cannot be managed as an outpatient. Be sure that your daughter is being managed by an appropriate team: obstetrician or perinatologist along with an internist/endocrinologist, dietitian and a nurse specializing in diabetes in pregnancy.
Additional comments from Dr. Quick:Also, if she's not already doing so, I'd suggest she plan to check 8-12 (or even more!) blood sugars daily, and telephone the results daily to an endocrinologist or diabetes nurse educator, to help her continue to revise her program and stabilize her blood sugars.
And everybody should know how to give Glucagon; if she has any more tendency to unconsciousness, it might be wise for her to stay with someone in the same house whenever possible, rather than being alone.
Last Updated: Tuesday April 06, 2010 15:09:02
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