November 24, 2002
Gestational Diabetes
Question from Detroit, Michigan, USA:
I am 37 years old, was diagnosed with gestational diabetes when I was 18 weeks pregnant, and, at that time, my fasting glucose was 120 mg/dl [6.7 mmol/L] with an A1c of 5.5%. The doctor gave me two weeks to control it with diet and exercise, but I could not, so she put me on insulin at 20 weeks. I have several questions:
Do you think that I had pre-existing diabetes?
Is it possible that the baby got hurt because of the high blood sugar in the first trimester?
I have trace to small ketones from time to time, particular after I walk for 30-40 minutes. Do you think it will hurt the baby? I did a lot of research over the internet. Some people say that ketones are not going to hurt the baby, but others say they do so I am confused.
Answer:
Your fasting blood sugar was higher than expected, but your hemoglobin A1c is normal. You may have mild glucose intolerance which was present prior to conception.
To be on the safe side. I would recommend a thorough ultrasound examination of the fetal anatomy. In addition, you should be re-tested for diabetes after you deliver.
Urine ketones are a common finding during pregnancy and should not be a problem, particularly if you are keeping your blood sugar under good control.
OWJ
