February 14, 2003
Gestational Diabetes
Question from Detroit, Michigan, USA:
I was diagnosed with gestational diabetes when I was 18 weeks pregnant, and was put on insulin at 20 weeks. My insulin dose requirement increased gradually from 20 weeks until 36 weeks. Right now I am at 37 weeks, and my insulin dose requirement has begun to decrease. I count baby movements several times a day, and he moves a lot. Also, I have two non-stress tests every week and the results are very good. I have a few questions.
Is this normal?
Is this a sign of placental failure?
Do the non-stress tests guarantee that the placenta is working properly, and the baby is happy?
Answer:
I have seen the same phenomenon of decreasing insulin requirements towards the end of pregnancy. The question is does this mean that the hormones that lead to insulin resistance are being produced in lesser amounts and does this reflect placental function? There is not a good answer to this. However, as long is the fetal testing is reassuring (this is a better marker of placental function) then the pregnancy can continue. I would recommend that you be delivered no later than your due date even with good fetal testing.
OWJ
