December 30, 2003
Family Planning
Question from Knoxville, Tennessee, USA:
I am a type 1 diabetic with an insulin pump. I try and keep tight control of my diabetes, checking my blood sugar frequently. My A1C is usually 6.0. My husband and I are trying to get pregnant and I could be possibly be about a week to a week and a half pregnant right now, but it is too early to take a home pregnancy test. These past few days my blood sugars have been abnormally difficult to control, and have been elevated to 250-300 mg/dl [13.9-16.7 mmol/L] for no apparent reason. This is very unusual for me. They sometimes get slightly out of whack right before my menstrual cycle is due, but never to this extent. Is it common to have higher blood sugars during the first few weeks of pregnancy due to progesterone and other hormones? I have always heard that low blood sugar is common in early pregnancy, but what about high blood sugars? If high blood sugars are sometimes a sign of early pregnancy in diabetics, what exactly is the cause?
Answer:
Erratic blood sugars (both high and low) tend to occur in early pregnancy. The most likely explanation is changing hormone levels and introduction of some particular placental hormones that increase your resistance to insulin. Why this can happen within the first week of conception is unclear since implantation of the ovum has just barely occurred. Knowing that glucose control will fluctuate, I recommend checking your blood sugars frequently (before and after each meal) and making adjustments accordingly. You should be able to confirm a conception a week or two after your missed period.
OWJ
