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Question:

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 sugar 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?

Answer:

Clearly your daughter is in need of significant attention to get her blood glucose levels into a safe and tolerable range. Is she working with a team of physicians and diabetes educators who specialize in diabetes and pregnancy? I would suggest that she needs do that needed immediately.

Hopefully your daughter is on an insulin regimen that allows her to match the insulin to food, preferable using Humalog because it matches the food peak better and results in fewer lows after meals and in the night. Not knowing her situation, I would be hard pressed to make any specific recommendations except to say that she needs an expert team to work with her on her regimen and she may need to change her living situation to have someone with her much of the time.

Family members and friends need to know how to use Glucagon injection for lows.

One thing to remember, highs are much more dangerous to the baby than low blood glucose levels, except that it is never a good thing for mom or baby if she has a seizure. In my experience, with young ladies who were particularly brittle, we had very good luck using an insulin pump because we could control the basal (background insulin) better.

Finally, I hope your daughter has opted for the COBRA benefit to maintain her health insurance so that she has continuous coverage.

VV

Original posting 14 Apr 1999
Posted to Family Planning and Hypoglycemia

  
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Last Updated: Tuesday April 06, 2010 15:09:02
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