I was diagnosed with gestational diabetes two months ago. Now, I am 25 weeks along. I am testing my blood sugar levels four times daily. Two hours after meals, my blood sugar levels are less than 120 mg/dl [6.7 mmol/L]. But, my fasting sugar levels are bit high, usually more than 110 mg/dl [6.1 mmol/L]. Does this cause problems for my baby? Do I need to take insulin? For two months, my fasting sugar levels were more.

Your post meal blood sugar values are in the normal range. The fasting values are elevated. In the morning, before breakfast, a reasonable goal is 70 mg/dl [3.9 mmol/L] to 90 mg/dl [5.0 mmol/L]. Before the other meals, your blood glucose should be less than 100 mg/dl [5.6 mmol/L]. There are two possible fixes. One would be some diet adjustment. Speak with your dietitian about the best approach. The other would be to start you on glyburide (an oral hypoglycemic agent). I would also suggest checking your blood glucose prior to each meal in addition to after each meal to see if your blood sugar is elevated at these times as well. I do not think that you need insulin at this time.

OWJ