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03/11/09 03:58 PM

"I am 28 weeks pregnant with gestational diabetes, should I have to take insulin injections to control my night time sugar levels only?"
Asked By: ikpm1978  

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I was diagnosed over a month ago and have been on a strict diet and metformin to control my sugars at 500mg twice a day. My day time readings are very good but at night it will not go below 100. It was averaging 120 at night so my doctor increased my evening dose of metformin to 2 500mg pills. I am now averaging 102-106 on my fasting sugars in the morning. I will see the doctor next week and know that she wanted those numbers to be below 100. I am worried that she is going to make me see a Fetal Specialist and want me on insulin. I do not feel that these readings are high enough to justify that and am not sure how to approach this with her on my next visit. I had gestational diabetes with my first pregnancy and had to take insulin and have told her all along that I do not want to do this again if it can be avoided. My numbers are more controlled this time with diet and the metformin than they were the first time with the insulin. Any advice?

Expert Answers (1)

07/07/09 10:15 PM

Thanks for writing dLife. When dealing with gestational diabetes, every woman and every pregnancy is different- many factors affect blood sugar levels including diet, age, hormones as well as weight changes, and activity levels. As time goes on and with subsequent pregnancies, it is often the case that gestational diabetes needs to be treated just as aggressively if not more so than the previous pregnancy. The most important factor that the physicians have to decide on is the safest environment for the developing baby. Oral medications in gestational diabetes often work well, but as pregnancy progresses and insulin needs greatly increase, they may not be enough. This is an important topic to discuss with your physicians and do be sure to bring up all of your concerns. You may also benefit from another consultation with a registered dietitian/certified diabetes educator to review the other factors associated with blood glucose control including diet and activity and even stress management.
Answered By: Janice Baker
Accreditations: B.Sc., MBA, RD, CDE, CNSC
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*** All information contained on dLife.com is intended for informational and educational purposes only. Our Expert Q&A is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

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