March 7, 2001
Gestational Diabetes
Question from Sacramento, California, USA:
I am eight weeks pregnant with my third child, and had gestational diabetes during my previous pregnancies which was diet-controlled. My two boys came early and their birth weights were over six pounds.
Because of my history, the nurse suggested a one-hour glucose test at six week weeks — which was 148 mg/dl [8.2 mmol/L]. So, I took the three hour glucose test and had an one abnormal reading at one hour. I am now being sent to the dietitian but currently there are no plans for me to monitor my blood sugars. I am concerned because, at only six weeks, I am now technically diagnosed as “borderline”, and gestational diabetes usually occurs at 24 weeks. Do I have pre-existing diabetes and not know it? I am worried because if I do have pre-existing diabetes, obviously, it is not controlled and in poorly controlled diabetes, there is a huge risk of birth defects. Please clarify what my situation is.
Answer:
One abnormal result on the three-hour test does not make a diagnosis of gestational diabetes. However, your risk is increased, and it will be important to repeat your three-hour test at 24-28 weeks. I doubt that you have preexisting diabetes, and therefore your baby is not at increased risk. One test that might be helpful is a hemoglobin A1c. If it is normal, then you have not had long-standing hyperglycemia. Ask your doctor about this.
OWJ
[Editor’s comment: Since it appears that you already know how to monitor blood sugars, it certainly will not hurt for you to do so, and it might relieve some of your anxiety.
SS]
