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I am a diabetic, how can I plan a pregnancy?

Q: I am a 29 year old diabetic taking insulin two or sometime three times for the last 9 years, and married from the last three years. My husband is very co-operative and with a caring nature. I work from 10 to 8 at my shop. I used to take human mixtard insulin 70:30 but now I take humaline R and novaline L, I mean both are mixed (according to my doctor). I want to get pregnant, and I got report past three month blood test which is 10.3 and previous report was 11.6 which is bad. So how much figure do I need to get healthy baby and everything else is normal. I keep checking everytime but most of time my sugar getting down during midnight. I try to control my diabetes. So according to you for healthy child, what should I do? And how do I know that I am able to get pregnant and have healthy baby, please let me know is there any glucowatch has been discovered through which I can know my blood sugar everytime.

A:Please do use contraception till your HbA1c is better than 10.3; ideally it should be just 0.5-1% above the non-diabetic range, and for someone planning a pregnancy it has to be in the ideal range during the entire time from when you are planning to get pregnant till the delivery. How often do you check your sugars? It should be tested before meals (breakfast, lunch, dinner) and at bedtime at least every alternate day, and at 2-3 am every week during this time when you are trying for tight control. You have to make sure the sugars are neither high (ie > 130 premeal) nor too low (< 80 at any time). Once you are pregnant, even more frequent sugar testing will be needed. The mid-night (2-3 am) sugar should preferably be about 100-180: low sugars at this time are particularly disastrous. Right now, since you are having night hypoglycaemia, please urgently reduce your night dose in consultation with your doctor. You have to be able to get in touch with your doctor frequently for dose adjustment during this entire period till your delivery. In addition, I hope you a. walk or get other exercise regularly, b. eat regularly, with no long gaps, c. get your BP checked regularly, and are maintaining it at 120/ 80 mmHg, d. have had your thyroid function tested recently, e. get your annual diabetes checks done religiously: serum lipids, serum creatinine, urine microalbuminuria, retinal examination. All these are particularly important when you re planning a pregnancy.


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