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Q. I have developed gestational diabetes with FBS 130 mg/dL. Do I need to start Insulin?

Answered by
Dr. Shaikh Sadaf
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 19, 2020

Hello doctor,

I am 2.5 months pregnant now. And I have developed gestational diabetes and consulted with a gynecologist in the nearby polyclinic and made HbA1c (blood sugar monitoring test) and the result is 6.4 % reference range normal up to 6%. Before pregnancy diabetes range used to be always in normal range. Nowadays blood sugar while fasting is 130. Do I need to start insulin? I need your advice.

I am 24 years old. My height is 5.2 feet and weighs around 105 kg.

Dr. Shaikh Sadaf

Diabetology Endocrinology


Welcome to

I just read your query and from what you have mentioned it appears that your blood sugar is not very high as to start insulin treatment as of now but you need to be closely monitored as regards to blood sugar, ultrasound fetal monitoring by an obstetrician and a dietitian for low carbohydrate diet consumption.

Try to eat more vegetables like green leafy vegetables and not potatoes which contain high carbohydrates. You need to check 50 gm oral glucose tolerance test fasting and after 1 hour and 2 hours. If still high we need to assess the results and do further tests for the same and then decide whether to start insulin or not.

Maintain blood sugar chart by checking it fasting, 2-hour post-meal, and before bedtime. Be in touch with a physician. Avoid rice, sweets, and sugary drinks. Take Folic acid 5 mg once daily.

I hope this helps.

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Thank you doctor,

Due to COVID-19 it is a curfew in our town and nearby polyclinic do not have OGTT test facility. I am afraid this will lead to high sugar in baby, and also the doctor I consulted with said to continue with Folic acid 1 mg, do you advise to change into 5 mg? Is there any problem as I cannot do the OGTT test now?

Dr. Shaikh Sadaf

Diabetology Endocrinology


Welcome back to

Gestational diabetes needs a higher dose of Folic acid, still, if you have only 1 mg then not a problem. You can access medical facilities in case of curfew by taking appropriate permission from the government. If not possible then better do a strict low carbohydrate diet with more green leafy vegetables and green or raw fruits like green apple or pears or unripe half banana, etc.

You can use brown bread and avoid full-fat milk. Drink plenty of water and maintain sleep hygiene like try to sleep at night and avoid daytime sleep except a short nap in the afternoon. Poor sleep hygiene can also cause sugar spikes.

You definitely need close monitoring and follow up with the doctor nearby to you as and when possible. Yes, it is very important to do OGTT (oral glucose tolerance test) in the coming few days or weeks to decide insulin treatment.

Until then do strict diet control. Eat small meals.

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