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What precautions do diabetic women have to take before conceiving?

Q: My wife had a trace of diabetes in her first pregnancy. She started taking insulin during pregnancy and by the grace of god the delivery was OK and the baby was normal. She had a caesarean operation. Presently she is taking medicine to control her sugar and cholesterol levels daily. Now we are planning for a second child. What precautions do we need to take? Doctors says that we need to start giving her insulin injections from the first day of pregnancy till her delivery, is it true? Please advise as we will be trying soon.

A:This is a very important question being faced by all the young diabetic women. My advise to all such women is as follows: 1. You have to plan your pregnancy in advance. 2. Three months prior to getting pregnant blood glucose has to be controlled i.e., Fasting between 80-120 and 2 hour PP < 140 mg/dl. A1C levels have to be < 7%. If not so postpone your pregnancy. 3. Get assessment of diabetic complication specially eye examination and kidney status. 4. Safety of oral medications in DM is not proven so if blood glucose is not controlled with diet and exercise insulin has to be taken and a very tight control of blood glucose levels has to be maintained. 5. Best person to look after pregnant diabetic women is Endocrinologist/ qualified Diabetologist.

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