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Question:

From Fairview,South Dakota, USA:

I was diagnosed in June of 1970 with type 1 "brittle" juvenile diabetes at the age of 12. I had a general practitioner for a doctor until 1977. Since then, I have been using my OB-GYN for the control of my diabetes.

From 1977 to 1998, I gave birth to 10 children, six boys and four girls. Their birth weight averaged between 6 pounds, 12 ounces to 8 pounds, 6 ounces. In 1988, our stillborn daughter weighed 10 pounds, 6 ounces. I had no other doctors during my pregnancies except the OB-GYN and the pediatrician at birth.

From what I have heard and read, that is not what I was supposed to do. Am I the only type 1 diabetic out there who has given birth to nine living children or is this not unusual? My doctor wants me to go to Mayo Clinic to be studied because he said I am not doing what it says in the diabetes books.

At the present time, I am working at the Veteran's Hospital in Sioux Falls, South Dakota as a nurse's aide, I have no problems with my diabetes except when I work nights and run low blood sugars the next day and have hypoglycemic reactions. I do not test my blood sugars and have rarely done so for 35 years. I do not follow any diet per se. I weigh about 150 pounds and am 5 feet, 4 inches tall. Is this unusual or pretty normal?

Answer:

It is certainly not impossible to have long-standing diabetes, multiple healthy pregnancies and no mention of diabetes complications. However, this would normally be in the setting of excellent blood glucose control. I usually see this tight control in someone who tests their blood glucose frequently, is on an intensive insulin regimen (such as an insulin pump) and receives regular medical care form a diabetes center. So, yes it is unusual that you seem to be quite healthy with very little medical intervention.

What you have been doing seems to have worked fine for you but I would definitely be seen at a diabetes clinic (doctor, educator, dietician) to make sure you are getting the most up-to-date care and prevent future problems. I would also be curious to find out if you truly have type 1 diabetes and an endocrinologist may decide to run these tests. Has your doctor been checking you for complications of diabetes such as eye, kidney, heart and blood vessel disease? Have you had an A1c test that measures the average blood glucose? Since you are having hypoglycemia on a regular basis, a doctor that specializes in diabetes would likely be able to help you fine-tune your insulin regimen and reduce these episodes. Diabetes education and self monitoring of blood glucoses will be an important first step for you in recognizing patterns to try and prevent these reactions.

MN

Additional comments from Dr. Jim Lane:

You have lived with type 1 diabetes for a long time. I am glad you have not had major complications with your diabetes. However, we do not know enough about diabetes-related complications to understand why some people with good control still have complications and those with less than good control avoid them. I would say that with type 1 diabetes, and a doctor that feels uncomfortable treating you for such a condition, it would be reasonable to obtain the opinion of an endocrinologist.

JTL

DTQ-20060420145008
Original posting 30 Apr 2006
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Last Updated: Tuesday April 06, 2010 15:10:08
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