My daughter has gestational diabetes. Can Insulin help her?

Question

Hello doctor,

My 29-year-old daughter developed gestational diabetes during her pregnancy eight months ago and now has type 2 diabetes that will not go away, like doctors said it would.

Her blood sugars during pregnancy were controlled with diet, but now her A1C is 8.9, even on Metformin 1000 mg twice daily. She gained 55 pounds during pregnancy and has not been able to lose the weight while breastfeeding.

The endocrinologist wants to add Insulin, but she is terrified of needles and worried about low blood sugar episodes while caring for the baby alone. Her fasting glucose is usually 180 to 220, and goes even higher after meals despite following a diabetic diet.

We have tried Jardiance, but it gave her yeast infections that kept coming back. The scariest part is that her vision has gotten blurry, and the eye doctor found some early diabetic changes in the retina.

She also has numbness and tingling in her feet that started during pregnancy but has not gone away.

Can breastfeeding hormones make diabetes harder to control?
Should she stop nursing to focus on getting blood sugars down?

Please suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your daughter with diabetes now needs an active treatment so that her blood sugars come under good control, because her HbA1c (glycated hemoglobin) of 8.9 percent is quite high, and, over time, uncontrolled sugar can damage the eyes, kidneys, nerves, and heart.

The goal for most adults is to bring HbA1c below about seven percent, and she is already noticing blurred vision, and even the retina shows changes, which means control cannot be delayed any longer.

Insulin can be started safely while she is breastfeeding; you do not need to stop nursing to treat your diabetes properly.

The important thing is to learn how to monitor your blood sugar regularly and to recognize and treat low sugar episodes, especially around breastfeeding times, so that both you and the baby stay safe and healthy.

The numbness and tingling in your daughter's feet are also likely due to diabetes, so please do not postpone treatment, and diet alone will not be enough at this stage.

To make Insulin safer and more comfortable, you can use a continuous glucose monitor, which helps you and your doctors detect and manage any low or high sugar readings earlier.

I hope this helps you.

Feel free to reach out to me anytime. I am here to help you.

Thank you.