February 8, 2001
Gestational Diabetes
Question from New York, New York, USA:
About two weeks ago, I found out I have borderline gestational diabetes, and I’m currently about 30 weeks pregnant. I have been following the diet, and my numbers are pretty much in controlled. However, one day when I drank some orange juice before I went to bed, I had a high fasting of 94 mg/dl [5.2 mmol/L] the next morning. I then skipped breakfast, and when I measured two hours after lunch, the number was 140 mg/dl [7.8 mmol/L]. I tested with a urine strip later in the afternoon, and I was spilling a lot of glucose (color indicated more than 1000 mg/dl) in my urine. I was panicked, but I ate normally for my snack and dinner and the two-hour after dinner number was within limits, about 100 mg/dl [5.6 mmol/L]. I have been following the restricted diet ever since (that was three days ago), and my numbers are fine. I noticed that the baby was very active when I was having high blood glucose, but was much quieter when my blood glucose was under control. Does this “roller-coaster” harm the growth of the fetus and its production of insulin?
Answer:
An occasional elevated blood sugar is not a problem. Your fasting blood sugar is fine and the 140 mg/dl [7.8 mmol/L] is not bad. Also, it is common for pregnant women to spill glucose in their urine. This does not accurately reflect blood glucose levels. However, if you have persistent elevation in blood sugars (fasting and/or postprandial), then insulin may be added to your treatment regimen. I use the following guidelines: Fasting should be less than 105 mg/dl [5.8 mmol/L] (preferably 60-90 mg/dl [3.3-5 mmol/L] ) and the one-hour postprandial should be less than 130 mg/dl [7.2 mmol/L], and two-hour postprandial should be less than 120 mg/dl [6.7 mmol/L].
OWJ
