March 10, 2004
Gestational Diabetes
Question from Houston, Texas. USA:
I am 30 years old. I have PCOS. It took a long time to find out what was wrong and it was a long few years. I thought I was going through menopause at 27, or a mental break down, so putting more insulin into scares me to no end.
After a few years everything stabilized and I was able to get pregnant. My first pregnancy, I had gestational diabetes, controlled totally by diet and exercise. The baby was totally fine. However, during my current pregnancy, diet and exercise aren’t helping, despite my hard work on it. I was not tested for gestational diabetes this time. They had me just start tracking my fasting sugars and sugars one hour after eating, beginning at 12 weeks and on. I was not able to get my fasting sugars below 90 mg/dl [5.0 mmol/L]. Most were around 110 mg/dl [6.1 mmol/L]. All other tests through the day where well below 120 mg/dl [6.7 mmol/L]. Some were even lower than my fasting sugars.
They put me on insulin, 20 units of Lantus to start. It did come down a little to 100 mg/dl [5.6 mmol/L]. I was told to cut cheese out my evening snack of turkey, cheese, and milk, and, at same time, increase my insulin to 30 units. I did as they suggested and it dropped to around 95 mg/d 5.3 mmol/L] average for fasting sugars; the rest of the day was low, 100 mg/dl [5.5 mmol/L] an hour after eating. The 95 mg/dl [5.3 mmol/L] wasn’t good enough so they upped it again to 38 units, which took my fasting insulin back to more than 100 mg/dl [5.5 mmol/L]. Then, I was told it was because of hot dog wieners and the fat in wieners for evening snacks, so they told me to increase the dosage to 48 units.
Since I have PCOS/insulin resistance, is continually increasing my insulin really the answer? Is it really because of the fat in wieners like they say? Should they try a dose of 34, before increasing it again? At night, after snack/insulin dose I test at X number and seem to drop only one point per hour. I don’t notice me dropping and then climbing like they say. I am very frustrated. Could someone explain this?
Answer:
It is common for women with gestational diabetes, whether or not they also have PCOS, to require large doses of insulin. On occasion, I have treated patients with over 100 units/day. It is all a matter of insulin resistance. To overcome this, you just need more insulin. Once you deliver the baby, this excess insulin requirement will drop significantly.
OWJ
