
January 25, 2006
Gestational Diabetes
Question from Elmhurst, Illinois, USA:
I am 31 weeks pregnant and was diagnosed with gestational diabetes about ten days ago. I went to the diabetes center to get my Accu-Chek machine and diet. I started the diet and I check my sugars four times a day. My OB clinic wants fasting number less than 90 mg/dl [5.0 mmol/L] and my two hour postprandial number less than 120 mg/dl [6.7 mmol/L]. My fasting sugars have ranged from 90 to 100 mg/dl [5.0 to 5.6 mmol/L] (99 mg/dl [5.5 mmol/L], 97 mg/dl [5.4 mmol/L], 100 mg/dl [5.6 mmol/L], 100 mg/dl [5.6 mmol/L], 99 mg/dl [5.5 mmol/L], 100 mg/dl [5.6 mmol/L], 95 mg/dl [5.3 mmol/L], 90 mg/dl [5.0 mmol/L], and 89 mg/dl [4.9 mmol/L]) and I have not had a reading two hours after meals that was above 120 mg/dl [6.7 mmol/L].
I went to the doctor yesterday and one doctor (not my doctor) wants to put me on insulin at night to get the fasting numbers lower. I am hysterical with needles. She didn’t give me any advice on how to lower this number. I started have anxiety attacks and crying. Is it normal for a doctor to put you on insulin with those numbers? Is there a pill I can take? Do I have any other options besides insulin? I’m so upset with the thought of needles that I’m making myself sick.
My diet consists of 2000 calories, 240 grams of carbohydrates, 105 grams of protein and 65 grams of fat. I’m eating six meals a day. Breakfast includes 30 grams of carbohydrates as does my morning snack. For lunch, I eat 60 grams of carbohydrates, then have 30 grams of carbohydrates for an afternoon snack. At dinner, I eat 60 grams of carbohydrates, then have a bedtime snack of 30 grams of carbohydrates.
Answer:
Although your fasting blood sugars are above the target range, they are not that bad. You may be a candidate for glyburide, which is an oral hypoglycemic agent. Insulin may be too aggressive at this point. Speak with your doctor about the option of glyburide.
OWJ