Hi Cassy-

   I wanted to go over an article at work before I chimed in, but seeing as my daughter is sick and I don’t know when I’ll go back I’ll go ahead and put my two cents worth in.

  Urogenital abonormalities (such as ambiguous genitalia) is not typically attributed to diabetes. With diabetes the most common birth defects affect cardiovascular, nervous, and gastrointestinal systems along with craniofacial problems (cleft lip/palate) In addition, more of these defects are seen with babies whose mothers have type 1 diabetes rather than gestational diabetes. With type 1 diabetes, the possiblity of poor glycemic control goes throughout the pregnancy, and docs tend to attribute poor glycemic control in the early stages of pregnancy to the vast majority of these defects. With gestational diabetes, poor glycemic control doesn’t happen til later in the pregnancy after most of the systems are well developed- thus less of a chance of anything going wrong.

   I would be very skeptical of the docs saying that her diabetes being out of control in the last month of pregnancy caused the ambiguous genitalia. I don’t see how the docs would be able to link poor glycemic control to virilization of the genitalia- those two endocrine pathways are completely different. Poor control of maternal blood sugars can cause a host of problems with a newborn, but saying it was the cause of ambiguous genitalia? I’d love to hear a doc explain that one- and your friend should ask the doc to give a detailed explanation how such a thing could happen (just in case he’s trying to BS her cause he has no idea what’s going on)

   On the other hand (and this is why I wanted to go over that paper before chiming in) there are maternal factors that could lead to the virilization of genitalia. If they can’t find anything wrong with the child, they should look to the mother to see if the problem lies with some endocrine pathway there. Bah- I want that paper so I can remember what the heck that one condition is called! Anyways- if you are interested in knowing more about what maternal factors can cause virilization, let me know and I’ll let you know once I can get my hands on that paper.

   This coming from a type 1 diabetic with a SWCAH girl. Never once did the docs suggest that my daughter’s genitalia was an effect of my diabetes. Hah- and great glycemic control during pregnancy is every pregnant diabetic’s hope and dream, but it’s harder than heck to actually achieve! Hope that this helps--

Martha