From Kentucky, USA:
I am 28 years old and diagnosed with gestational diabetes. I am very frightened and have several questions. First of all, what is an acceptable blood glucose level for me to maintain? My ob/gyn insists that anything over 120 is extremely harmful for my baby, but in order to maintain that level I have to be in the 60's before a meal. I am very scared about having low blood sugars and the damage that they do. Right now my 2 hour numbers are in the 140-150 range. Is that too high? I am currently taking 2 insulin shots per day, 10 NPH/3-5 R in the A.M. and 15 NPH/3 R at bedtime. I have only gained 8 pounds in this pregnancy. I was overweight before the pregnancy by about 25 pounds. One last question: does being insulin dependent with gestational diabetes increase my risk of continuing as a diabetic after the birth of my child? My doctor has assured me that my numbers indicate that this is only gestational diabetes, but I am scared.
I would be glad to receive e-mail from others with the same issues.
"Harmful" is probably too harsh a word to use for the effects of hyperglycemia on the fetus. In gestational diabetes the increase in blood sugar occurs well after the fetus has completely formed so there is minimal risk of any abnormalities such as spina bifida or heart defects (findings associated with pre-existing diabetes). Persistent elevation in blood sugar usually results in a large baby. Therefore, by keeping your blood sugars (particularly the after meal values) under good control, you will minimize, but not eliminate, the risk of a large baby. The values of 140-150 are high but not terrible. Ideal would be less than 120. However, if you are having problems with hypoglycemia, then I would be willing to live with the slightly higher blood sugar values. A blood sugar of 60 should not be harmful to the fetus.
Immediately after the pregnancy your diabetic condition will resolve. However, you are at increased risk of developing non-insulin dependent diabetes later in life. Therefore, it will be important to have a followup blood sugar test.
[Editor's comment: I would hazard a guess that with three or four shots a day, and 8-12 blood sugar levels a day, you could get lower postprandial (after meal) blood sugar levels without substantially increasing the risk of hypoglycemia. If you are not seeing a doctor who's comfortable with these more complicated programs, ask for a referral to an endocrinologist who is! WWQ]
Original posting 24 Jun 1998
Posted to Gestational Diabetes
Last Updated: Tuesday April 06, 2010 15:08:58
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