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January 22, 2001

Gestational Diabetes

Question from Tracy, California, USA:

I am seven months pregnant and was diagnosed with gestational diabetes at 29 weeks. I have had asthma for 10 years and I was put on an inhaled steroid about a year ago, and my doctor switched me to a different inhaled medication as it's considered more safe in pregnancy. I did not have gestational diabetes with my first pregnancy when I was not taking steroids. Can inhaled steroids somehow be related to gestational diabetes? Is it reasonable to consult with my asthma doctor in order to try cutting steroid intake?

Answer:

Steroids can cause insulin resistance. However, this is usually associated with higher doses and systemic levels such as seen with oral prednisone. In theory, inhaled steroids do not result in a high blood concentration. Therefore, this should not contribute significantly to the gestational diabetes. A consultation with your asthma doctor is reasonable, because it would be good to have you on as few medications as possible.

OWJ