Baby on Board

I have some exciting news: As of January 2006, there will be another human being in our household.

The last few months have been quite a whirlwind, what with learning the big news, figuring out how to alter my diabetes management and making sure I am doing all I can to protect the little one growing inside me. Pregnancy is a marvel to begin with, but I had no idea what the duo of diabetes and pregnancy would bring. I am amazed and a little scared.

My Blood Glucose Has Never Been So Good!

An A1C of 5.7% and still dropping?—I thought that was a fairytale that would never come true. Low BGs take on a wholenew meaning when you are pregnant. Most striking is the hypoglycemic unawareness. I used to feel shaky at 70, now I get the shakes at 45. The good news is that my pregnancy is going well, at least for the first six months.

Of course, I have been paying more attention lately to the research on diabetes and pregnancy, and I’m struck by how little there is.

Working With the Best

I am fortunate to be working with the best of the best in diabetes and pregnancy, Lois Jovanovic, MD. Recently, she told me of fascinating research that could hold the keys to the mystery of diabetes in general. Amazingly, 25 percent of pregnant women with type 1 diabetes begin to re-create their own insulin during their pregnancy. It is speculated that these women thrive on the mild immunosuppression and the growth hormones produced by the placenta.

Specifically, these women show a rise in C-peptide levels and a drop in their insulin requirements. In studies thus far, their C-peptide rise has been parallel to a rise in pregnancy-related growth factors (prolactin and placental lactogen) and the pregnancy-related immunosuppressive hormones (cortisol and progesterone).

These results suggest that administration of certain hormones in people at the early onset of diabetes may be able to stop the destruction of beta cells and perhaps increase their numbers back to normal levels.

More Research Should Be Done on Diabetes and Pregnancy

But this is just the tip of the iceberg. There is so much to learn about the state of pregnancy and diabetes. There’s just not enough information out there yet.

As we think about diabetes research and our hopes for a cure, let me suggest that we keep our eyes and ears open to the myriad of possibilities.

For women with diabetes who are considering pregnancy, the important thing to know is that you can do it. The key, however, is good glucose control before conception.

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