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July 27, 2001

Gestational Diabetes

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Question from New Britain, Connecticut, USA:

I am currently 34 weeks pregnant, have gestational diabetes for the second time, and I am concerned because my fasting blood sugars are higher this pregnancies then they were last time. I am about 60 pounds heavier then I should be, and I know that increases my risk of having diabetes for the rest of my life. The diabetes life care folks say that if I can’t maintain fasting blood sugars below 95 mg/dl [5.3 mmol/L], they will put me on Insulin. My fear is that I will never be able to go off insulin and this will cement the fact that I will keep the diabetes after the pregnancy. Is that true?

There are times I go to bed with a glucose reading of 84 mg/dl [4.7 mmol/L] and wake up with a reading of 91 or 95 mg/dl [5.1 or 5.3 mmol/L]. Why is the glucose level increasing if I have had nothing else to eat? Why are my diabetes life care folks telling me to eat protein before I go to bed? Will this lower the blood sugars? I thought any food ingested still affects the glucose levels.

Answer:

From: DTeam Staff

There is always some variation in blood glucose levels. You have a greater degree of insulin resistance in this pregnancy probably as a result of time and excess weight. Even if you are on insulin for the pregnancy, you may not need it after you deliver, but you would have to repeat your glucose test after your baby is born to determine this.

If you still have diabetes, then your glucose control may improve with oral hypoglycemic agents medication, weight loss, proper diet and exercise. Even without eating, your glucose can fluctuate up and down slightly. Protein will provide calories but at a slower rate than if you ate a candy bar before bed. Thus, this should prevent any morning hypoglycemia.

OWJ