HomeAnswersEndocrinologygestational diabetesWhat to do for fluctuating sugar levels in pregnancy even after insulin injection?

I am 7 months pregnant and my sugar level is fluctuating too much. What to do?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Shaikh Sadaf

Medically reviewed by

iCliniq medical review team

Published At November 13, 2019
Reviewed AtSeptember 6, 2023

Patient's Query

Hello doctor,

I am 7 months pregnant. My sugar is not constant and is fluctuating too much. I am taking Insulin two times a day.

I have attached my file.

Answered by Dr. Shaikh Sadaf

Hello,

Welcome to icliniq.com.

I read your query and gone through your reports. (attachment removed to protect patient identity).

It appears that you have gestational diabetes and cord around the neck of the baby. Now, this is a complicated pregnancy and you must follow a senior gynecologist with an MD degree and significant experience in dealing with such complicated pregnancies because of the cord around the neck of the fetus.

Secondly, now I will come to the diabetes part. I saw that you are taking Novomix. However, during pregnancy, the Insulin should be Insulin Apidra 3-3-3 units during breakfast, lunch, and dinner and Insulin Levemir 4 units before bedtime. You have to measure your blood sugar with a home checking glucometer and write your daily fasting, two hours post-meal, just before meals and before bedtime blood sugar chart and Insulin taken. You must report that chart weekly to your diabetologist and get your insulin adjusted accordingly. If your blood sugar falls below 100 mg/dL then, you must eat something and report to your diabetologist immediately.

So I hope that you understand that you must seriously follow a senior MD gynecologist with experience in the pregnancy with a cord around the neck of the fetus which is a serious issue and change your type of insulin and follow up with the chart of blood sugar measurements weekly with the diabetes doctor. Please maintain a low carbohydrate diet and avoid sugar consumption in any form at all times.

I hope this helps.

The Probable causes

Diabetes.

Investigations to be done

Blood sugar monitoring.

Differential diagnosis

Gestational diabetes.

Probable diagnosis

Gestational diabetes and cord around the neck of the fetus.

Treatment plan

Insulin Apidra and Levemir.

Preventive measures

Low carbohydrate diet.

Regarding follow up

Weekly with a diabetologist and to change to MD gynecologist doctor as well.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Shaikh Sadaf
Dr. Shaikh Sadaf

Endocrinology

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