From Dumont, New Jersey, USA:
I'm 24 years old and have had Type 1 diabetes for over ten years. So far, I have no complications, even though there have been several times in the last ten years where my blood glucose level has not been in tight control, including the past year, although according to my HbA1c's, the past ten years have shown me in fair to good (never excellent) control.
I researched the facts and decided I want to start on the insulin pump and made an appointment with a new endocrinologist (I just moved to a new area) when I found out I was four weeks pregnant. My husband and I had not planned on having children for awhile, at least until I maintained better control, and had been using contraception. As soon as I found out I was pregnant, I started monitoring my blood sugar more often (around 8-12 times a day as opposed to 3 or 4) and, after consulting with my old doctor, (I have yet to see the new one; the appointment's still two weeks away) giving extra insulin if necessary (I use Humalog, which my body seems to need more of it now that I'm pregnant, and Lente, which still seems to be the right amount).
I am worried, though, that during the first four weeks of pregnancy and the few months prior to conception, my blood sugars were not very good and that my baby might not be healthy, because I have heard that those weeks (pre-conception and the first 10 weeks) are the most critical. Is there anything else that I can do to prevent birth defects or is it too late?
Also, has the effect of Humalog on pregnancy been checked yet? I was on Regular for quite a while, but my body seems to respond better to Humalog.
You are correct. The first 8-10 weeks of pregnancy are the most critical since this is when all the organs are developing in the fetus. However, once that time is passed it is still important to maintain good glucose control. You should have several ultrasound examinations during the course of the pregnancy to look for any possible abnormalities (heart defects and spine defects being the most common).
There has not been any published research on the safety of Humalog during the first trimester. However, there was a letter published in the New England Journal of Medicine reporting some cases of abnormalities in mother's using Humalog. However, this could not be directly associated with Humalog.
[Editor's comment: A recent study (Metabolic and immunologic effects of insulin lispro in gestational diabetes by Lois Jovanovic, et al, Diabetes Care 1999 Sep;22(9):1422-7) concludes that Humalog is safe in pregnancy for women with gestational diabetes. JSH]
Original posting 1 Feb 2000
Posted to Family Planning
Last Updated: Tuesday April 06, 2010 15:09:08
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