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"Can people with diabetes have children safely?"
I am a 31 year old woman with type 1 diabetes and my husband and I want to have a child. Is it safe for me to be pregnant? What should I know about controlling my blood sugar while pregant and other health effect?
There are several major important themes for women who have type 1 diabetes to address prior to becoming pregnant. The best approach is to make certain, if possible, that your pregnancy is well planned so that you have time to discuss optimal medical management with both your endocrinologist and your OB GYN prior to becoming pregnant. First, many of the complications of diabetes, such as eye disease, have the potential to worsen during pregnancy; therefore making sure you are up to date on all of your recommended screening tests and that your diabetes is well controlled prior to the pregnancy is important. Second, control of your blood sugars with insulin is likely to be more labile during pregnancy. Therefore, having a good plan in place with your doctors and nutritionist as to how to deal with this is important. Third, there is a higher risk of congenital malformations of the baby in diabetic mothers, and this risk goes up with poorer diabetes control. In addition to making sure your disease is well controlled prior to getting pregnant, your OB GYN might recommend more extensive surveillance. Fourth, some other medications that you may use for aspects of your diabetes (such as ACE inhibitors for blood pressure control and kidney protection) cannot be used during pregnancy. These medication switches should be made well before you get pregnant. Feel free to discuss these issues in greater detail with both your endocrinologist and your OB GYN!
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