How to control blood sugar levels in gestational diabetes?

Question

Hello doctor,

I am a 31-year-old woman pregnant with my first baby. I was diagnosed with type 2 diabetes during screening at ten weeks of pregnancy. I am on insulin, and my sugar levels have been fairly well controlled till now. I have completed 30 weeks now and taking the tablet of Novomix 30 insulin 24 units morning and night. My FBS is 112 mg/dL, post breakfast 184 (range 150 to 170) mg/dL, post lunch range 130 to 170 mg/dL, and post-dinner range 130 to 170 mg/dL in the past week. Please tell me about proper insulin dosing to control sugar and ways to decrease insulin resistance.

Answer 1

Hello,

Welcome to icliniq.com.

You need to have strict monitoring (fetal as well as maternal) sugar level charting recurrently to adjust the dose recurrently. Gestational diabetes is diagnosed during pregnancy. It can be hazardous to the fetus as well as the mother. You need to have a diabetic diet strictly, and it is better to discuss with dieticians and follow a proper diet chart. Walk daily and exercise as needed. Blood sugar levels pre-breakfast, post-breakfast, prelunch, post-lunch, and pre-dinner and post-dinner for at least three days required to adjust the insulin dose. Due to hormonal variations, blood sugar levels will carry and similarly insulin to adjust recurrently with recurrent sugar monitoring. Fetal heart sounds by Doppler can check till the second trimester, but as soon as the movement you can feel, you have to report reduced fetal movements as high sugar dangerously affect the baby. Even intrauterine death could occur at term with high sugar levels, so kindly take it seriously. Consult a gestational diabetic antenatal care unit and have regular strict advice, checkups, and fetal and sugar monitoring. Baby water size is to be measured in the third trimester, which can help to decide the mode and time of delivery. Electronic fetal monitoring is also required recurrently. So we cannot fix the insulin dose for a long time. We have to check it repeatedly for at least two to three days to readjust the dose. So it would be best if you had proper diabetic unit care. I hope this helps you.

Thank you.