I have been diagnosed with gestational diabetes at 14 weeks. I had an early ultrasound at nine weeks. The baby is fine that is what they said. I wondered if my gestational diabetes would have affected my baby in the earlier weeks. All the four values of GTT were high. Right now, I am controlling it with diet, but my fasting levels are high. My other levels go high sometimes but they are under 140 mg/dl [7.8 mmol/L]. Is my baby safe? What more can I do to reduce fasting levels? I go for a 20 minute walk after breakfast and, in the evening, I walk on a treadmill for around 25 minutes where I burn 100 calories. I feel exhausted after that. Can I continue doing exercise? I am 5 feet and my weight was 160 pounds before getting pregnant. I had put on around 14 pounds in the first trimester. Now, after changing my diet, I have lost two pounds. Is it safe to lose weight?

A diagnosis of diabetes at 14 weeks gestation is suggestive of the possibility that you actually have pre-existing diabetes (type 2). If you are having problems controlling your glucose by diet alone, then an additional agent is necessary. Options are glyburide (an oral hypoglycemic medication) or insulin injections. You should discuss this with your doctor. The baby is probably doing well. However, it is important that a detailed ultrasound is done around 18 weeks gestation to review the anatomy of the baby. In addition, a second ultrasound detailing the heart should be done a little later in the pregnancy if good views are not obtained at the 18 week examination. Babies of mothers with diabetes are at risk for developmental abnormalities, particularly of the spine and heart. The risk is in the first 12 weeks of pregnancy when all the organs and structures of the embryo are developing. The risk is minimized by good glucose control.

Your weight loss is not of great concern. Ideally you should be steadily gaining weight and you will probably pick up those few pounds that you lost with your diet change. Despite the weight loss, the baby will continue to grow.

OWJ