My 29 year old wife is 26 weeks pregnant, and she has gained 8 kilograms (17.6 pounds). We performed the test at home, and it’s as follows: her fasting blood sugar was 91 mg/dl [5.1 mmol/L], one- hour postprandial was 175 mg/dl [9.7 mmol/L], two-hour postprandial was 164 mg/dl [9.1 mmol/L], and three hour postprandial levels were 115-142 mg/dl [6.4-7.9 mmol/L]. Please advise me as to whether or not she needs to start insulin.

The parameters that I use are a fasting: 70-90 mg/dl [3.9-5 mmol/L]; one-hour post meal less than 130 mg/dl [7.2 mmol/L] or a two-hour post meal less than 120 mg/dl [6.7 mmol/L]. mg/dl. The fasting of 91 mg/dl [5.1 mmol/L] is acceptable, but some of the post meal values you list are elevated and require management.

You need to consult with your own obstetrician for specific details for management, but I would recommend the following. A diet plan needs to be established low in fats and simple carbohydrates (sugar) and increased in protein and complex carbohydrates (rice, pasta, etc.). If that does not improve the blood sugar values, then either insulin or an oral hypoglycemic agent should be started.

OWJ

[Editor’s comment: Since these values were obtained on a home meter, I’d suggest you have a formal three-hour glucose tolerance test done in a laboratory before a diagnosis of gestational diabetes can be established. See What is Gestational Diabetes?.

SS]