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June 27, 2004

Gestational Diabetes

Question from Burbank, California, USA:

I am 30 years old and seven months pregnant. My blood glucose level at the last test was 141 mg/dl [7.8 mmol/L]. I am being tested for diabetes next week. I am confused at why my level was so high when my entire life I have struggled to keep my blood sugar level up. As long as I can remember, I have had to eat way more than others and have experienced feelings of hypoglycemia, although I was never diagnosed with it. After eating, I feel great. The low blood sugar is fixed easily with food. Have I given myself diabetes without knowing it by allowing myself to have low-blood sugar for so many years? Or, could I be confused about the differences between hypoglycemia and diabetes? When I drank the glucose drink before drawing my blood, within about 15 minutes I was shaky and my heart was beating fast. I knew it would make me sick because I have learned my body and know I need healthy food for breakfast. I am 5'6" and my pre-pregnancy weight was 118 pounds. Besides an irregular heartbeat that doctors can't diagnose, I have never had any health problems. Could my funny blood sugar have created an irregular heartbeat?

Answer:

Pregnancy causes significant changes in how your body manages glucose. There are several hormones that increase your resistance to glucose. The purpose is to allow sugar to be delivered to the growing fetus. Sometimes there is too much insulin resistance and this results in the condition of gestational diabetes. Even though in the past you may have had symptoms of hypoglycemia, without objectively checking a blood glucose during one of those episodes, it is difficult to make a true diagnosis. Your symptoms after drinking the glucose solution are common. It is a big sugar load (similar to drinking a can of soda in one or two minutes). I do not have a good explanation for your irregular heart beat other than perhaps a stress response.

OWJ