January 13, 2004
Diagnosis and Symptoms, Gestational Diabetes
Question from Canada:
There is a history of diabetes in our family on dad and mom’s side. Dad has been living with diabetes for over 30 years. Mom was diagnosed a couple of years ago. Dad is 70 mom is 63.
Last year I was pregnant with my first child and was diagnosed with gestational diabetes. I delivered through C-section only because my son was a week late and the labour did not progress. He was born healthy and at a weight of 8 lbs 9 oz. After I had him, I lost the weight I gained with him (30 pounds) plus 15 pounds of my own in a week time. My glucose levels have stabilized (I was monitoring it with a glucose meter daily). I was supposed to go back to the endocrinologist after three months of delivery but never went.
For over a year now, I’ve had a lot of stress and just in the past three months I returned to work and have slowly gained 15 pounds. I have now begun to notice that my glucose levels are higher than usual around time of ovulation and come down to normal after my menstruation. We are talking about levels of anywhere between 8-12 mmol/L [144-216 mg/dl] after 1 hour of eating and about 6-8 mmol/L [108-144 mmol/L] after 2 hours (depending on what I eat), and after menstruation anywhere from 6-8 mmol/L 1 hour after eating (depending on what I eat). There are times when I experience the lows too, 4-5 mmol/l [72-90 mg/dl]. Mornings (fasting) is always at 5-7 mmol/L [90-126 mg/dl], never higher even in the time of ovulation. Do I have a problem? Is this a hormonal thing? Is it stress? Do I have diabetes?
I’m really worried because I’m thinking, what if this problem started years ago and never knew? I never had high blood pressure, not even when I was pregnant. I measure it daily. I don’t have high cholesterol, mainly because I try to eat healthy always. I don’t get it. I am overweight and that may be the problem. I notice that if I eat potatoes, rice or pizza, it raises higher than if I eat pasta or other carbohydrates. Can this be adjusted with diet and exercise should I see a diabetes specialist? If they put me on medications, could I have another child or will that be dangerous? I’m 32 years old and would like to have another child. What should I do?
Answer:
The clinical care recommendations for the care of gestational diabetes recommend you return at three months postpartum so that testing can be done to show you have cleared the elevated blood sugars. In the absence of that testing, you need to return to your physician to determine whether you have diabetes or not. The risk for developing type 2 diabetes is 50% in the next five years. You see, this is a huge risk and one that you need to seek care for. It is good to lose weight and exercise. However, as you have experienced, this is not protective for a lifetime. If you regain weight, that risk or presence of diabetes is there. I would strongly recommend you see your physician and have a fasting blood sugar. This will allow appropriate treatment and follow-up. To put this off may be risking your health.
JTL
