December 27, 2004
Gestational Diabetes
Question from Oxfordshire, England:
I had gestational diabetes in my last pregnancy and was injecting insulin from 33 weeks until giving birth at 37 weeks. After the birth, I wasn’t offered any tests, just told that the gestational diabetes should disappear. Ten months later, I found I am pregnant again. I had an early scan at seven weeks and was given a meter to test my blood glucose levels before food daily. I tested these for a week and the levels ranged from 6.4 to 9.9 mmol/L [115 to 178 mg/dl]. When I returned to the consultant, he said I had gestational diabetes again and has started me on insulin again. Do you think my baby would be at risk of birth defects as a result of my early high levels or do you think my levels weren’t high enough to be a danger? Also, are my levels indicative of pre-existing diabetes since my last pregnancy?
Answer:
Your blood glucose values are elevated and will require some management. It may be worthwhile to do a formal glucose test to confirm a diagnosis. It is possible that you had diabetes prior to conception. Measuring a hemoglobin A1c may give some indication that your blood sugars have been increased for some period of time. The risk to the baby is relative depending on how high the blood glucose is and for how long. I would definitely recommend periodic ultrasound evaluation for anatomy and growth. The odds are still well in your favor of the baby being fine.
OWJ
