March 12, 2003
Gestational Diabetes
Question from Missouri, USA:
I was diagnosed with gestational diabetes in my fifth month, am in 26th week of my pregnancy, and I take insulin twice per day. My doctor does not know for sure at what stage in pregnancy I developed diabetes or whether I had it at the beginning of my pregnancy. My ultrasounds show everything to be okay.
My fasting levels range 95-107 mg/dl [5.3- 5.9 mmol/L], and my readings two hours after meals range 115-120 mg/dl [6.4-6.7 mmol/L] most of the time, sometimes jumping to 130 mg/dl [7.2 mmol/L]. Is it okay for the sugars to fluctuate once per day over 10 mg/dl [0.6 mmol/L]? Would they be affecting my baby?
Do I need to test for ketones (I was not asked to)? Should be asked to have a hemoglobin A1c done?
Answer:
The fluctuation in your blood sugar values is to be expected but is not excessive. Since you are having some fasting values over 105 mg/dl [5.8 mmol/L] and postprandial values over 120mg/dl [6.7 mmol/L], I would suggest an increase in the insulin dose.
Sometimes it is difficult to determine if you had preexisting diabetes. Therefore, repeating the glucose test after delivery will be useful.
I usually do not recommend checking for urine ketones in someone with gestational diabetes. However, you can discuss this further with your doctor. As long as your blood sugar values are in the normal range and you are eating appropriately, you should not have any problems with ketone formation.
OWJ
