October 28, 2008
Gestational Diabetes
Question from Canada:
I am 31 weeks pregnant. Normal weight before pregnancy was 127 pounds, at 5 feet, 5 inches. I have gained about 20 pounds so far. This is my third pregnancy. I had the one hour glucose test at 18 weeks and my blood sugar was 5.3 mmol/L [95 mg/dl]. I had a second test at 26 weeks with a blood sugar of 5.4 mmol/L [97 mg/dl]. Then, I just had another one hour test with a result of 8.4 mmol/L [151 mg/dl] so the doctor ordered a two hour fasting 75 gram test. I did it and when I asked the laboratory technician what my fasting level was, he said 5.6 mmol/L [101 mg/dl]. Based on what I’ve seen on the Internet, that seems to be high. My doctor will not receive the test results for a couple days. Should I be worried? Should I call him to let him know what my fasting number showed so he can get the test sooner? My obstetrician said not to worry about it, that it is probably nothing, that I shouldn’t even do the two hour fasting test, but I did it any way. My family doctor was the one that ordered it. I am just really worried.
Answer:
The fasting of 5.6 mmol/L [151 mg/dl] is slightly elevated. The normal is less than 5.3 mmol/L [95 mg/dl]. Depending on the rest of the results of the two hour test, additional management can be determined. It is possible that you may only need some adjustment in your diet. Further options would be an oral medication such as glyburide. If the diet and pills do not work, than you may need insulin. However, from what you have stated so far, I doubt that you will require insulin. If, indeed, the diagnosis of gestational diabetes were made, then the risk to the baby at this point would primarily be excessive growth. With good glucose control, fetal growth can be kept within the normal range.
OWJ
