July 25, 2001
Question from Washougal, Washington, USA:
I am 35 years old, 32 weeks pregnant, and I have had gestational diabetes for three weeks which I am trying to control with diet and exercise. My fasting numbers are always below 95 mg/dl [5.3 mmol/L], but I get two to three high numbers a week two hours after lunch (120-130 mg/dl [6.7-7.2 mmol/L] ), and I’m concerned I will be pushed into taking insulin. What are the risks of taking insulin and its effect on the baby versus continuing to have two to three high lunch numbers?
Even mildly elevated blood sugar values can result in large baby. A postprandial blood sugar of 120-130 mg/dl [6.7-7.2 mmol/L] is not bad. You may want to check one hour after meals for a while. If these are persistently greater than 130 mg/dl [7.2 mmol/L], then insulin or possibly glyburide may be considered. Since your fasting blood sugars are normal, you may do well with a single injection of insulin. Insulin does not cross the placenta and thus will not affect the baby other than how it controls your blood sugar level.