Dr. Krutika Shrikant Ingle
Diabetology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My wife is with a height of 5' 2" and having weight of 158 pounds. We checked her BSL in lab for fasting and BP a year back and both results were normal. Yesterday we again checked the reports and her reports are like fasting BSL 172 mg/dL, urine: no sugar detected. After two hours of lunch FBL was 173 mg/dL and urine: no sugar detected and HbA1c comes as 9.1 %. Before eight months there was no sugar detected in the reports and now it is like this. Need your advice for this. Fasting seems to be big value. How fasting is more impacted than PP? How severe is this? Can it be controlled only via diet and exercise? First pregnancy we had stillbirth. There was no sugar detected till ninth month of pregnancy. Till start of ninth month, sugar reports were fine but still we had stillbirth. She was detected with gestational diabetes which came to normal within 15 days after delivery. After one and half year we again had pregnancy and we have little girl of 3.6 years old now. During second pregnancy she does not show symbol of sugar but to avoid risk we opted for C-section at the start of ninth month itself.
Hello,
Welcome to icliniq.com.
This is very possible. Ladies who develop gestational diabetes are more prone to develop diabetes in the near future. It is like a warning sign to start healthy lifestyle measures so that you can avoid developing diabetes. Currently your wife is having diabetes and she will require medications. She will need to exercise and follow a strict diabetic diet along with the medicines. If she manages her diet and exercising well, she can get off the medications. But for now, she will need both. So when the fasting sugar is high, that means the glucose produced by the liver for our organs (especially brain) during our sleep even when we do not eat, is uncontrolled. While the post food rise in blood sugar indicates that the body is not producing enough insulin in response to the food eaten. I have tried to answer to your query in a simplified manner. Kindly meet with your local physician for start of medications or you can consult me as well.
Patient's Query
Hi doctor,
Thanks for the valuable answer. I have to ask three questions. With diet and exercise, controlling her diabetes, will she be able to live normal life? You explained very well for the reason fasting more than PP, but is it serious condition or normal condition with initial diabetes? Will it get controlled with medicines? With controlled diabetes, whether it is advisable to have pregnancy?
Hi,
Welcome back to iciniq.com.
Yes, with proper diet and exercise, she can live a normal life. She might be able to even get rid of the medications, if she is determined and compliant. It is normal and there is nothing serious about it. It is the initial stage and of controlled at this stage, she will be able to live a normal life and avoid the complications of long standing diabetes. Yes, modern medicine has made it possible to have a completely safe pregnancy and delivery in diabetics. She would just have to have a team of gynecologist and diabetologist, who would manage her together from the beginning of her pregnancy, so that she and the baby are healthy and safe.
Patient's Query
Hello doctor,
Will this be type 1 or type 2 diabetes? What kind of treatment will be required for it? I mean insulin or tablets?
Hello,
Welcome back to icliniq.com.
Type 1 is genetic and occurs when the pancreas are not producing any insulin (can be due to any reason like auto-immune, damaged cells, etc.). Type 2 is mostly lifestyle related, responds well to exercises and medications. Mostly, I think this is type 2 diabetes. She will be needed to be started on oral medications first and then according to the response, we can decide the management further.
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Diabetology
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