I am 32 weeks pregnant, I have gestational diabetes, and I am now on 2.5 mg of glyburide daily. Initially it worked well, but my fasting blood sugar is still borderline (95-100 mg/dl [5.3-5.6 mmol/L]). Any suggestions? Will I be able to breastfeed immediately?

If your fasting blood sugar values are starting to increase, then you could also increase the dose of glyburide [a pill for type 2 diabetes] to 5 mg per day. However, before you do this, have your doctor review your blood sugar results and make a final decision.

You will be able to breast feed after delivery. Most likely, you will not need anything to control your blood sugar once the pregnancy is over. It is important that you have a repeat glucose test around the time of your postpartum visit and maybe even yearly since your risk of developing type 2 diabetes is increased. Early detection may prevent problems down the road.

OWJ

[Editor’s comment: Use of glyburide in gestational diabetes is not part of the approved label for this product. See the discussion about the use of oral hypoglycemic drugs for gestational diabetes at the Diabetes Monitor.

WWQ]