Diabetic diagnosed at 9 years of age delivers normal infant through planned pregnancy after delivery of infant with multiple anomalies and osteogenesis imperfecta.

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  • 多発奇形を伴った骨形成不全のある児を出産後計画妊娠により正常児を得た９歳発症糖尿病の１例

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Abstract

Our report concerns a housewife diagnosed as diabetic at 9 years of age. Through planned pregnancy, she bore a normal, healthy infant after having given birth to one suffering from multiple anomalies and osteogenesis imperfecta congenita, most probably due to the mother's poor diabetic control.<BR>Insulin therapy was begun when the woman's diabetes was first diagnosed. Blood glucose control with 50 to 80 units of insulin was poor. At the age of 23, she came to the Diabetes Center in April 1981, in the 11th week of her first pregnancy. Her fasting blood glucose was 196mg/dl and HbA1 was 11.6%. Despite 14 years of diabetes, she had diabetic retinopathy of Scott's Ia in her right eye only and no diabetic nephropathy. She was immediately admitted to the Center, and underwent strict diet therapy and insulin injections four times daily. Her blood glucose control improved to where it was almost satisfactory after she was discharged. A girl was born spontaneously in the 38th week of gestation, but the infant died within 30 minutes due to multiple anomalies, osteogenesis imperfecta, and nonspontaneous respiration.<BR>After the first delivery, the woman normalized her blood glucose through home-monitoring, and conceived a second infant in a planned pregnancy. Her diabetic control was HbA1 8.4-9.4% and she had no diabetic microangiopathy. She gave birth spontaneously to a 2707g girl in the 37th week of gestation. The infant suffered no abnormalities or complications.<BR>Again, this case demonstrates the importance of planned pregnancy in enabling even a diabetic diagnosed at the age of 9 to experience a normal pregnancy and bear a normal infant.

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