July 21, 2003
Gestational Diabetes
Question from Georgia, USA:
I’m 38, about 40 pounds overweight, I am 29 weeks pregnant with my sixth child, and I’ve never had any problems before even though I was overweight with each pregnancy. My one-hour glucose tolerance test was 156 mg/dl [8.7 mmol/L]. I am not sleeping well. have been on asthma medications (Pulmicort, Singulair and Albuterol) for three months, and the doses were increased.
My midwife allowed my to bypass the three-hour glucose tolerance test and begin monitoring blood glucose four times per day because I had been monitoring the past month with okay numbers. For the first week, the fasting levels were in the 113-116 mg/dl [6.3- 6.4 mmol/L] (just started the new dose of asthma medications), and during the second week, the fasting levels have fallen to 104-106 mg/dl [5.8-5.9 mmol/L] with two-hour after meal levels all under 120 mg/dl [6.7 mmol/L].
I am already following a generic diet for gestational diabetes that I obtained from my nurse. The medications are also allowing me to start working out again, and I use the treadmill for a short period of time after breakfast and supper along with resistance training after lunch. Is there anything else I can do about the fasting numbers? When are pregnant women placed on insulin?
Answer:
The fasting blood sugar values are high enough to warrant further management. I would first recommend that you consult with a trained dietitian to review your diet and make sure that it is appropriate for your needs. Since your values are only mildly elevated you may do well on glyburide if the diet does not work.
OWJ
[Editor’s comment: Use of glyburide in gestational diabetes is not part of the approved label for this product. See the discussion about the use of oral hypoglycemic drugs for gestational diabetes at the Diabetes Monitor.
WWQ]
