January 22, 2000
Gestational Diabetes
Question from San Jose, California, USA:
My wife was diagnosed with gestational diabetes (at 28th week) and had been on diet and exercise only for 1 week, but levels over 100 (on 4 occasions over a week) for fasting made her dietitian ask for insulin shots at bedtime (although her post meal readings — 1 hour after breakfast, lunch, dinner — were typically 110-120). She has been on insulin now for 10 days — progressively going from 8 units to 12 to 16 (in those 10 days). But still her fasting readings are above 100 (between 100-110) and now her after breakfast readings are over 130! What’s going on? We asked the dietitian who says she is puzzled too (and murmured that these meters are +/-12% accurate). Any wisdom to share?
Answer:
It is possible that the single injection of insulin before bedtime is not adequate for glucose control. Typically mothers require two, sometimes three or more injections a day, depending on the type of insulin that is used. Also, as the pregnancy progresses, the degree of insulin resistance increases. So, your observations may be due to a combination of these factors.
OWJ
