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May 1, 2000

Gestational Diabetes

Question from Lockhart, Texas, USA:

I'm pregnant with my second baby. With my first I had borderline gestational diabetes. I didn't have to take insulin shots. I just monitored my blood sugar (4 times a day) and controlled it with diet. I did a good job as I never had to be put on insulin and after my daughter was born it went away. The doctor went ahead and told me to do the diet again before I even took the glucose test. She said because I had had it before, that it was a good idea to do the diet. She told me that this did not mean I was going to get it again, but that if I did, it would come back stronger. She also told me that diet would not control it; I would have to go on insulin. Why is that? Why can't I control it with diet? Is there a more extensive diet with more choices that I can choose from? The diet I used with my daughter was very simple and plain. I only had to be on it for two months. This time it's a lot longer.

Answer:

Starting on a special diet is reasonable given your history. Your doctor is correct in that you may not get gestational diabetes again, but you are at increased risk. The diet will not prevent diabetes, but should help to control your blood sugar. If your blood sugar becomes too high, then insulin will be necessary. This is because some of the hormones from the placenta block the activity of the insulin that you make and you would need to take extra insulin to make up for this increased resistance. Talk with a dietitian to work out a palatable diet plan to give you more variety in the foods you eat.

OWJ