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July 25, 2001

Gestational Diabetes

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?

Answer:

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.

OWJ