I am 37 weeks pregnant and have been monitoring gestational diabetes for three weeks. My glucose levels are usually low, but, sometimes, I am very surprised by high ones, usually morning and before I go to bed. I exercise regularly (three times per day, and I eat from a strict diet. I get very discouraged when they are high because I am working so hard to keep them low.

How does drinking water affect glucose levels? How does stress affect glucose levels? Is one high level per day going to affect my unborn baby? I only test three days per week because my doctors say I’m doing okay, but what about those high scores? How do I know I’m not getting them on the days I don’t test? I am supposed to measure less than 5.3 mmol/L [95.4 mg/dl] after two hours of fasting and less than 7.8 mmol/L [140.4 mg/dl] one hour after a big meal. My high results are only one to two decimal points above what they should be, i.e., sometimes a 5.6-5.9 mmol/L [100.8-106.6 mg/dl] after two hours of fasting. Should I be worried?

Water will not affect your blood sugar level, but you should be drinking adequately to avoid dehydration. If you feel excessively thirsty and are urinating more frequently than you would expect with pregnancy, then you should check your blood sugar. Six to eight tall glasses of water a day is commonly recommended during pregnancy.

Stress can cause changes in blood sugar, but with gestational diabetes this should not be a problem.

One high level per day at this point in gestation is probably not going to have a significant effect on the fetus. A blood sugar of less than 5.3 mmol/L [95.4 mg/dl] at two hours after a meal is strict. I usually recommend less than 6.7 mmol/L [120 mg/dl] at two hours or less than 7.2 mmol/L [130 mg/dl] at one hour after a meal. Fasting blood sugar should be less than 5.8 mmol/L [105 mg/dl]. However, if you have persistently elevated blood sugar values, then insulin may be required. For gestational diabetes, this is a temporary measure, and your blood sugar control will return to normal after the pregnancy is over. You may want to review your glucose parameters with your endocrinologist or obstetrician.

OWJ