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Question:

From Rochester, New York, USA:

I was diagnosed with gestational diabetes at 22 weeks with level of 184 on 1 hour test. I went straight to a diet. So far so good. I'm managing with fasting blood sugars of 78-89 and post prandials of less than 140 after 1 hour. I have begun testing for ketones in last several days. Morning ketones have been negative, however every day after either lunch or dinner (about 2 hours after), I have had trace to small (even one moderate) ketone levels recorded. Why would I be getting small ketone readings after I eat, but not in morning, or other times of day? My endocrinologist said that doesn't make sense. I'm looking for some information. I'm very nervous about ketones getting to my baby.

Answer:

During pregnancy there is a phenomenon that has been labeled "accelerated starvation". There appears to be increased breakdown of fats after even a brief period of fasting which results in increased amounts of ketones. In some women this can occur even during the short period between meals. There is probably also increased renal clearance of ketones as well which means that ketones appear in the urine in association with a lower amount of ketones in the blood. However, these episodes are transient and do not represent risk to the fetus. It may be worth increasing your insulin dosing slightly to shoot for 130 mg/dl blood sugar after meals.

OWJ

Original posting 14 Mar 1999
Posted to Gestational Diabetes

  
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Last Updated: Tuesday April 06, 2010 15:09:02
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