I am 31 weeks pregnant, I have gestational diabetes, and my doctor told me to call if my blood sugar was over 120 mg/dl [6.7 mmol/L], two hours after any meal. It has been as high as 146 mg/dl [8.1 mmol/L] one hour after a meal, but will drop to 119 mg/dl [6.6 mmol/L] or less within 30 minutes. This is following the morning meal with the prescribed carbohydrate restricted diet. Is this acceptable? Can this rapid fluctuation harm my baby or cause the baby to grow very large?

This is why I recommend checking blood sugars at one hour rather than two hours after meals. You have mild insulin resistance in that you eat and your blood sugar goes up significantly, but eventually the insulin you produce does work to bring your sugar down to normal. Even mild elevations in blood sugar can cause excess growth in the baby, if the elevations are persistent. You may benefit from some insulin.

Another option might be to try an oral hypoglycemic agent named glyburide. Recent research suggests that it may be safe and effective for gestational diabetes. Discuss this with your doctor.

OWJ

[Editor’s comment: Use of glyburide in gestational diabetes is controversial. See the discussion about the use of oral hypoglycemic drugs for gestational diabetes at the Diabetes Monitor.

WWQ]