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January 29, 2001

Gestational Diabetes

Question from New York, New York, USA:

I'm 29 weeks pregnant and found out I have borderline gestational diabetes about two weeks ago. I started with a low carb diet and testing ketones in the morning. My numbers were pretty low, so the dietitian then allowed me to eat normally with the exception of sugary items like candies and juice. I have several questions: When I first started the low carb diet, I had moderate to large amount of ketones in my urine for one day,and I drank a lot of water to flush them out. Even now that I am eating normally, I still detect a trace of ketones in my urine, sometimes in the morning or sometimes in mid-day between meals. Will my baby be harmed by the presence of these ketones? I now understand that ketones can be produced when you haven't eaten for a while or have long time between meals. When I was in my first trimester, there were times when I waited too long between meals, and there were times when I was hungry, but didn't have time to eat immediately. Does that mean I was producing large ketones at that time and how did that affect my baby in the first trimester? I understand that if you are diabetes before you get pregnant, you can do harm to the baby by not controlling your blood sugar. How do I know I didn't have diabetes all along and just didn't notice it until I had the GTT [glucose tolerance test]. Is that possible?

Answer:

Pregnant women frequently spill ketones in their urine. This is not a problem. The fact that your glucose test was borderline only suggests that you do not have preexisting diabetes.

OWJ