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May 22, 2006

Gestational Diabetes, Type 2

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Question from Chattanooga, Tennessee, USA:

I’m so scared. I am 26, 28 weeks pregnant and was diagnosed with gestational diabetes at 27 weeks. My three hour test numbers were: fasting 114 mg/dl [6.3 mmol/L]; one hour 213 mg/dl [11.8 mmol/L]; two hours 228 mg/dl [12.7 mmol/L]; and three hours 135 mg/dl [7.5 mmol/L]. I know these numbers are bad.

What really scares me is that my son, who is almost four, was 12 pounds, 3 ounces at birth. My husband was also a 12 pound baby and his other three kids from a previous marriage were 9, 10, and 12 pounds. I have always assumed that my son’s birth weight was due to genetics, but since being diagnosed with gestational diabetes this time, I worry that I had undiagnosed gestational diabetes during my first pregnancy (my one hour test result was 95 mg/dl [5.3 mmol/L] then). I started my first pregnancy 10 pounds overweight and gained 65 pounds. Between pregnancies, I gained an additional 25 pounds.

Since I am now questioning my health during my first pregnancy, I am afraid that I may have had diabetes before getting pregnant this time. With all my risk factors (obesity, previous large baby, family history), why wasn’t I tested early in pregnancy this time? I am afraid my baby will have birth defects if I already had diabetes. How realistic are my fears?

Also, I am trying to control my blood sugar with diet, but I don’t think it’s working. My fasting level has been around 120 mg/dl [6.7 mmol/L], and two hours after meals my numbers are around 102 to 118 mg/dl [5.7 to 6.6 mmol/L] with a 150 mg/dl [8.3 mmol/L] reading one time. I am so fearful of the baby being hurt because of my condition and of the possibility of having to take insulin. I’m deathly afraid of needles and they make me dizzy, faint, and nauseous. I am sinking into depression because I’m afraid that I have regular diabetes and that I will have to prick and poke myself every day for the rest of my life. I have completely changed my eating habits. Am I possibly too late?

Answer:

From: DTeam Staff

It is possible that you had gestational diabetes during your first pregnancy with such a large baby. Now that your doctor has made the formal diagnosis, it is important that you control your blood sugars as tightly as possible to prevent excessive growth of the baby., This may entail taking insulin. I want to encourage you that lots of pregnant women do this and you are just a capable as they are. If this is truly just gestational diabetes, then you are not at significantly increased risk for birth defects compared to the general population. One way to help determine this would be to request a hemoglobin A1c test from your doctor. This test gives a general impression of how good your glucose control has been over the past few months. In other words, if it is normal, then it is unlikely that you had pre-existing diabetes. However, a follow-up glucose test will be necessary after you deliver to confirm whether or not you have diabetes.

OWJ