August 17, 2005
Question from Glasgow, Scotland, United Kingdom:
I was diagnosed with gestational diabetes a week ago, at 18 weeks, and have been monitoring my blood glucose levels four times a day since then. My levels range from a low of 4.4 mmol/L [79 mg/dl] to a high of 9.0 mmol/L [162 mg/dl], although this was on the first day I tested and not long after eating, and it has never been as high since. My daily average, which I simply worked out by adding totals and dividing by 4, is between 6.0 mmol/L and 6.3 mmol/L [108 and 113 mg/dl]. I am controlling these levels with diet and would like your opinion as to whether these levels are acceptable and, therefore, if I am likely to be able to continue managing by diet alone.
Overall, your glucose values are acceptable. However, an average of the day’s values is not the best way to determine glucose control. It is important to look at the fasting and pre-meal values and the one or two hour post-meal values individually. On the average, you may be doing well, but if there are frequent high peaks or low valleys, then, in fact, your control is not very smooth and could result in some problems. Your diet appears to be working well but you should be within the following parameters: fasting 3.8 to 5.0 mmol/L [68 to 90 mg/dl]; pre-meal, less than 5.6 mmol/L [101 mg/dl]; and one hour after a meal, less than 7.2 mmol/L [130 mg/dl] (or less than 6.7 mmol/L [121 mg/dl] at two hours). If these values are being exceeded frequently, then you need to consult further with your physician.