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04/02/06
01:06 PM
"What is a unsafe blood glucose level when fasting that I should consult a doctor about? I test 4 x a day and my 2 hour levels are always below 105 but my fasting levels go between 90 and 105 is this a serouis problem? or am I okay?"
Asked By:
jen303
Category:
Gestational Diabetes
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Expert Answers (1)
04/02/06
01:06 PM
Physicians have different guidelines for when they will take action to change medication or initiate medication to lower blood glucose levels. In pregnancy, often decisions are made quickly when two blood sugars are out of range.
The American Diabetes Association states that fasting blood sugars for women with diabetes should be between 60 and 95. However, when to treat the fasting blood sugar is a matter of interpretation. Some physicians will make medication changes when two blood sugar levels are greater than 95, others will use a lower threshold, ie. 90. However, there are some who will wait until fasting blood sugars are greater than 105. The consensus is that no fasting blood sugar should be greater than 105. Studies have shown an increased risk of fetal death (still birth) when fasting blood sugars are greater than 105 in the third trimester. If your fasting blood sugar is always in the range of 90-105, I would think a consultation with the physician is in order. I would discuss his plan for your pregnancy and his evaluation of your progress. Some physicians will measure fetal size with ultrasound to determine the status of pregnancy. If the baby is measuring large for gestational age, and blood sugars are high, it is an indication to change or initiate medication therapy. If the blood sugars are borderline, but the fetal size is average, then the physician may decide to wait on medication. I would want to have some documentation that the baby is growing at the appropriate rate and size considering the borderline blood sugars.
Deborah Greenwood APRN,BC-ADM, MEd, CDE
Financial Disclosure
The American Diabetes Association states that fasting blood sugars for women with diabetes should be between 60 and 95. However, when to treat the fasting blood sugar is a matter of interpretation. Some physicians will make medication changes when two blood sugar levels are greater than 95, others will use a lower threshold, ie. 90. However, there are some who will wait until fasting blood sugars are greater than 105. The consensus is that no fasting blood sugar should be greater than 105. Studies have shown an increased risk of fetal death (still birth) when fasting blood sugars are greater than 105 in the third trimester. If your fasting blood sugar is always in the range of 90-105, I would think a consultation with the physician is in order. I would discuss his plan for your pregnancy and his evaluation of your progress. Some physicians will measure fetal size with ultrasound to determine the status of pregnancy. If the baby is measuring large for gestational age, and blood sugars are high, it is an indication to change or initiate medication therapy. If the blood sugars are borderline, but the fetal size is average, then the physician may decide to wait on medication. I would want to have some documentation that the baby is growing at the appropriate rate and size considering the borderline blood sugars.
Deborah Greenwood APRN,BC-ADM, MEd, CDE
Financial Disclosure
Answered By:
Deborah Greenwood
Accreditations: MEd, CNS, BC-ADM, CDE
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