Questions?

Pregnancy
1

hi, this is kind of awkward since im in my teens and not planning to have a child for a while, but i did have the talk about having kids with my doctors at my last visit and i have a few questions that i didnt get to ask. so i was wondering if anyone could help me out? i like to keep myself informed about diabetes, and it'll be an advantage to know for when i am ready to have children.

  1. could having constant high blood sugars cause a miscarriage?
  2. would my child have diabetes? (ive been told it skips generations)
  3. would insulin injections affect the baby in anyway? 
  4. in general how much does diabetes affect pregnancy?
2

Hi Hailey,

Is there any reason you were talking about this with your doctor? Did you bring it up to him? Is it because you are sexually active? Just curious...

Anway, I think they are good questions to ask regardless, and you are right its good to be informed and prepared.

1. This is probably a good question for your doctor. I am not really sure about that answer.

2. I have asked this question myself, my doctor told me that it is probably unlikely that my child will develop diabetes but, there is testing to be done after you have a child to see if your baby does have the genetics to develop it.

3. Another good question for your doctor but, in my experience I don't believe insulin affects the baby, you can become insulin resistant toward the end of pregnancy. But, High Blood Sugars are the main culprit because they can cause your baby to become rather large.

4. Diabetes in pregnancy can be different for everyone so that is hard to say. In my pregnancy, I had no complications of anything diabetic related. The only thing I had an issue with was insulin resistance in my 3rd trimester.

Many people have a lot of lows in the first trimester, but I didn't. Some people can develop high blood pressure, rapid development of retinopathy, swelling in the legs, erratic blood sugars,  But Some of these things can become a problem even in a non diabetic woman.

3

Dear Hailey,

Thanks a lot for your questions.

Couples of them really drag me into the matter for such a long time.So,

1.I'd be very grateful if anyone could explain me if my diabetescould affect the child being diabetec?I mean, my diabetes is a threat for the kid being diabetec?

2.If not after birth, so afterwards could the kid become diabetes because of mom being diabetes?

Thanks in advance for detailed answers.

4

Hi Hailey and Irada (I tried to answer your question as well in #2)!

All very good questions.  I will tell you what I know from the research I've done and the books I've read.  I agree with Gina, these are all great questions for your doctor and I would absolutely ask the next time you go in to see them.  I was diagnosed at 15 and had all the same questions!  Being able to get pregnant and have a healthy baby was a major concern of mine, even then!  It's just always been my dream to be a Mom, so I understand where you're coming from.  I highly recommend the book, "Balancing Pregnancy with Pre-Existing Diabetes: Healthy Mom, Healthy Baby" by Cheryl Alkon.  Cheryl is a type 1 diabetic and her book literally breaks down all aspects of pregnancy with diabetes for you.  Great read and really informative!

1.  Having constant high blood sugars could possibly lead to a miscarriage.  In the book I mentioned above it states this, "If blood glucose levels are high during conception and thereafter, the embryo does not form correctly and there is an increased rate of a blighted ovum."  A blighted ovum just describes a pregnancy in which the embryo didn't develop properly or stopped growing early.  Dr. Tamara Takoudes is quoted in the book as saying, "Type 1 and type 2 diabetes increases the risk of miscarriage, especially with poor or less-than-optimal glycemic control, due to unknown causes.  The best remedy for this is diligent and compulsive control prior to conception.  Once conception has happened, better control is good, but the horse is out of the barn already."  Therefore the key is good blood sugar control early on before pregnancy!  The book says that if your A1c is within the recommended preconception range, you are at no higher risk for miscarriage than an average woman.  Although it's believed that on average, 10-20% of all pregnancies end in miscarriage.  So just take care of yourself now, and then you'll have no need to worry!

2.  I've HEAVILY researched this subject!  I was terrified that my baby would be born with diabetes and I could not imagine having to stick a beautiful little baby with needles and lancets.  Here is the breakdown of your child's risk for diabetes:

-If neither parent has diabetes, the child has a 1/100 or 10% chance of having type 1 diabetes.

-If the mother has type 1 diabetes and the child is born before the mother is 25, the child has a 1/25 chance of having type 1 diabetes.

-If the mother has type 1 diabetes and the child is born after the mother is 25, the child has a 1/100 chance of having type 1 diabetes.  (Meaning that your child would have the same odds of having type 1 as a child with non-diabetic parents.)

-If the father has type 1 diabetes, the child has a 1/17 chance of having type 1 diabetes.

-If both parents have type 1 diabetes, the child has a 1/4-1/10 chance of having type 1 diabetes.

Sorry, I know that some of those numbers are scary, but it's still good to know.  I've met plenty of diabetics with happy, healthy children.  As far as the likelihood of the child developing diabetes down the line, it's always a possibility.  I'm not sure of the exact odds, but as with all of these questions, I'd ask your doctor and see what kind of knowledge they have on the subject.

3.  Insulin injections should not affect the baby in any way.  The only way that an insulin injection could impact the baby is if you were to frequently miss injections, making your blood sugars consistantly high.  In that case, with CONSISTANT high blood sugars (an occasional one is expected, no one is perfect!) you put yourself at risk for miscarriage, as well as put your baby at risk for birth defects or other problems.  So as long as you take your insulin appropriately and as directed by your doctor, it shouldn't affect the baby at all!

4.  In general, diabetes greatly impacts a pregnancy.  If you're diabetic and pregnant it tends to be more work than a normal woman who is pregnant.  Most doctors will send you to a high risk OB/GYN.  You'll have more doctors visits, both with your OB and your endocrinologist.  You'll have to monitor your blood sugars extremely closely and continue to give yourself insulin, count your carbs, watch what you eat, etc.  The most important thing though is that we can have easy, normal pregnancies just like anyone else!  It might be a bit more work, but if in the end we walk away with a healthy baby, it's all worth it!  There are a lot of different aspects to pregnancy with diabetes, entire books are dedicated to the subject!  So I would just recommend picking one up, such as the one I suggested earlier, and reading it, even if you're not planning to have a baby any time soon!  I know it really eased my fears and helped me understand exactly what to expect.

I hope this helps and answers your questions!  Please let me know if there are any additional questions you have or if you need clarification on anything!

5

I never wanted to have kids because I worried they would inheirit my diabetes or I'd have diabetic complications.  Wish I'd known the truth sooner.  If you take decent control of your diabetes, your  pregnancy is no more dangerous to you and your child as any other.    

As a type 1 mom you have to test more often and adjust your insulin almost daily in the final months, but I was able to work full-time up to the end, take an expectant moms' exercise class, and have fun with friends (my halloween costume when I was 8 months pregnant was "Attack of the Killer Tomatoes" with me dressed as a tomato of course).  

Type 1 diabetes doesn't have a very strong genetic link in most families.  The ADA site has the same info Leah shared.  Basically kids will have a 1-8% chance of developing diabetes if their mom has it and a 6-12% chance of developing it if the dad has diabetes.   I've had diabetes since age 4 and gave birth when I was 32, so my son has a 2% chance of developing diabetes.  I have still worried at different times that he has diabetes, but statistically it is unlikely.   www.diabetes.org/.../genetics-of-diabetes.html

Insulin injections can't hurt your baby.  My son would jump in my tummy when I put a new pump infusion set in but my doctor reassured me the needle was nowhere near the uterus.  

When you're pregnant any normal mom does everything she can to be healthy.  I did well aiming for a non-diabetic blood sugar of 80 and testing often so I didn't have lows (low blood sugars can cause brain or neurological damage to a fetus).  I carb counted carefully and at more vegetables.  Most of all, I just trusted my instincts in managing my diabetes and my pregnancy.  I knew my diabetes was in good shape and ignored any yahoo who said in a worried voice, "Have you seen Steele Magnolias?"   =)

6

hi Gina, no i'm defiantly not sexually active, i was only talked about pregnancy with my doctor because i have irregular periods and suggested going on birth control. my doctor proceeded to tell me about pregnancy and planing for my future and stuff like that and how i might be wanting to start to think about having kids in a short number of years.  that got me thinking about my future, and worrying about if i even wanted to put myself through the stress of having kids. (i love children, but i wouldnt want my child to have to suffer through living with diabetes like i do). Thanks for your information though:)

and to leah & jenn, thanks for understanding my position, and for all of the insightful information, it made me feel a lot better about ever becoming pregnant. when i plan on having a child (or becoming sexually active) i will definitely check out those books to get me more informed. those answers were awesome! and i feel less worried about planning for my future and having my dreams of a mom coming true:)!

7

Hi Hailey, Nice Name! In your teens and while going through puberty you will probably have a lot of high blood sugars. There was a long time when i didn't test and didn't care. My A1C's were in the 12s and even 13's at one point. However, I was never hospitilized and I never had ketones. Once I got into my late teens probably about 19 I started checking more and my A1c's got into the low 10s and high 9s. As I got older I got more responsible and started caring. It's good that you are already thinking about this stuff - it keeps you ahead of the game. I have 2 cousins w/ type 1 (it runs on the female side of my Cherokee Blood line). 1 is a teenage now and doesn't take care of herself at all. She has been hospitalized more times than i can count. Her doctors have already told her she has really affected her body and her chances of having a healthy pregnancy when she gets older are getting slimmer by the day. My other cousin is a yr older than me and was also not good at taking care of herself. Now she is married and has a bad kidney and iron problems. The doctor told her she shouldn't try. When I got serious w/ my boyfriend in my late 20s and knew that it would probably lead to marriage I asked my doctor for help. We started a plan to get my A1c down. We left DC and moved to Chicago, got engaged and married. I had a new great DR who told me my A1c was 8 and I needed it to be at 6 for alteast 9 months before I even thought about trying. That took about 18 months to achieve. Then after my wedding - 11 months married my A1c was 6.4 (.4 higher than she wanted but o well ) I got pregnant and had a healthy 5.10 pound baby boy. SO IT IS POSSIBLE even if as a teen you have a period of constant highs.  However, if you are pregnant and you have constant highs and a high A1c your risk for miscarriage or a baby w/ heart/ brain and other issues is EXTREMELY high! I know an irresponsible girl that got pregnant w/ an A1c of 12.9 she lost the baby at 11 weeks.

2. The skipping generations thing depends on what caused your diabetes. They are finding out there are so many different genetic reasons causing different type's of diabetes it is getting harder and harder to tell. (I work in Bio. Research). The most common Type 1 diabetes that is just caused by a gene that is triggered by something (i/e stress, flu, etc. ) does not just "skip a generation". Meaning your grandkids are not guaranteed to a have a higher risk. Since you are a FEMALE the odds of you passing the gene on a lower than if you were a male. You can look up the exact statistics on the JDRF web page that goes into more details about what age you were diagnose, male/ female , age of pregnancy etc. But basically if you do not have an abnormal family mutation ( ex) my Friend Hannah - all of her siblings, have it, her father has it and her fathers siblings - that is mutated extremem gene ) but in most cases just 1 or maybe a few cousins (if you have any minority blood your odds are higher of family members w/ it) so to my point :

easy answer to ? # 2. If mother is type 1, child has a 7% chance of getting type 1 as opposed to a 4% chance of a baby born to a non Type 1 mom or dad. ( Very slim odds )

3. When your pregnant hopefully you will be on the pump. It's way better for control. As for the "needle" hurting the baby NO WAY. Normal insulin injections are not an issue at all. Although, your belly will be tight and your more likely to take shots in the bottom , arms or legs. The more insulin you take the more it can possibly increase the size of the baby.

4. Diabetes affects pregnancy 100% just like it affects your day every day. If you want a healthy baby you have to check your blood sugars atleast 8 times a day although most T1's I know tested minimum 13 times a day. You are watched by your doctor much more. Your labor is watched more, your meds are watched more, your weight etc. If you start a healthy life style and good control early it just becomes routine. It's not easy, but it's worth it in the end.