A 42 year-old woman with type 1 diabetes for 22 years was married recently, and she and her husband have decided to have a child. Neither had children previously. The woman has hypertension treated with an angiotensin converting enzyme (ACE) inhibitor and a diuretic with maintenance of blood pressure at 120/80 mm Hg. She recently had a 24 hour urine test, and the results showed a total protein of 3 grams (normal, <80 mg) and creatinine clearance of 70 mL/minute (normal, 88-128 mL/minute). Her glycated hemoglobin (HbA1c) is 6.7% (normal, <5.7%).
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