I would like your opinion about giving my expectant wife insulin. In her second month, they found sugar. She was 80 mg/dl [4.4 mmol/L] fasting, 149 mg/dl [8.3 mmol/L] after eating. A month later, she had a glucose tolerance test. Again, she was 80 mg/dl [4.4 mmol/L] fasting, but 175 mg/dl [9.7 mmol/L] after consuming glucose. In her fourth month, she was 69 mg/dl [3.8 mmol/L] fasting, 99 mg/dl [5.5 mmol/L] after food. Finally, in her fifth month, she was 74 mg/dl [4.1 mmol/L] fasting, 131 mg/dl [7.3 mmol/L] after food. The doctor has suggested my wife take three units of insulin for the remainder of her pregnancy. Is this safe for the baby?

Your wife’s fasting glucose values are normal and the after meal values are slightly elevated. You have several options. One is to adjust her diet to provide foods that will not excessively increase her glucose values. This could be done in consultation with a nutritionist. The other would be to take a medication called glyburide, which is a pill taken once or twice daily. The third option would be to take insulin. Insulin will not harm the baby since it does not cross the placenta. However, taking insulin will require frequent testing of your wife’s blood glucose so she does not decrease her glucose level too much. I cannot give a recommendation on an appropriate dose of insulin based on the numbers you provided. So, you need to speak further with your doctor.

OWJ