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Question about levels ... when will the doctor resort to meds/insulin?


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  #1  
March 28th, 2010, 03:32 PM
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Hey there! My name is Sarah. I'm 26ish weeks pregnant with my third kiddo. I was just diagnosed with GD last week and have been trying to get the hang of eating better, exercising more and monitoring my blood sugar regularly. It hasn't been too tough so far, so I think I'm pretty borderline. So far, in three days of monitoring, my post-meal glucose level has only been above 120 once and even then it was only 129. My fasting level has been great every day (always below 95.) So, I'm feeling pretty good about being able to control my GD with diet and exercise, but since this is all so new to me, I have a ton of questions. I'll start with just one, though!

My doctor wants me to monitor my levels for three weeks and then go back to see him and show him my logs so he can see how I'm doing. He said if I can't control the GD with diet, he'll put me on meds and/or insulin. Maybe this is a dumb question, but what exactly is controlling GD? Does that mean I can never go above 120? Or I can only go over a few times? Or will he only resort to meds/insulin if most of my numbers are really high?

I know every doctor is different and nobody can tell me exactly what MY doctor wants or expects (except for him!) I'm just curious for those of you who tried to control it and couldn't ... at what point did your doctor resort to meds and/or insulin? Are there certain levels that are just too high and can't be dealt with any other way?

Thanks in advance for any info! I'm sure I'll be posting more questions soon ... I'll try to not sound tooooo terribly clueless when I do
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  #2  
March 28th, 2010, 07:31 PM
rebeccabaltimore and more's Avatar (rebeccabaltimore)
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It's honestly a little hard for me to say exactly what levels your doctor would see that would make him want to prescribe meds. I was diagnosed with diabetes during my first pregnancy, but it was Type 1, so I went on insulin pretty much immediately. I have to say that if you continue at the rate you are going, I would be pretty shocked if he put you on anything. And a few highs are normal, you basically have to be consistently out of range (particular your fasting levels) before they usually get medication involved. Right now your GD is being entirely controlled by your diet - you are giving your body enough carbs to have energy and provide energy for the baby, but not more than your body can handle. GD is caused by the hormones released by the placenta, they cause your body to be insulin resistant, that is to say your pancreas is producing insulin but your body isn't recognizing it. As the placenta gets bigger, more hormones are released, causing more insulin resistance and thus crazier blood sugars. So some women end up on medications towards the end of their pregnancies.

There are some blood glucose levels that are consistently too high and need medicine to help. Being type 1, I'm a good example of that. But my body barely makes insulin anymore - yours still does, so if you need any help it would be in the form of medications that treat insulin resistance, Metformin and Glyburide being the two most common in pregnancy.

A lot of people are scared of medicine, but the GD medications are actually quite helpful. While you are working hard at eating the right carbs at the right time, the medications are working hard at getting your body to recognize the insulin your pancreas is making. It's a tag team effort really.

I have known a few GD moms who have needed insulin, but not many. I LOVE insulin because I have a lot more freedom in what I eat, as well as the ability to correct high blood sugars when they accidentally happen, but honestly most GD moms never get that far.

Based on your numbers so far, you are doing great. If you just keep doing what you are doing, my guess is you won't need medications. And if you have any questions, please feel free to PM, I like turning my diabetes into something that can help people
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  #3  
March 29th, 2010, 11:42 AM
BluvnU4evr's Avatar Erica
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Ask if he'll send you to the lab to check your A1C. My OB used that as a base. If it was 6.0 or higher he would have instantly put me on insulin. It came back 5.9, so he suggested I control it with diet, but after about two weeks of monitoring my regular BG levels weren't improving all that well and he put me on Glyburide (2.5mg twice a day) and that seemed to do the trick with getting my BG in check. I've had to adjust the times I take my meds, but everything looks good with just taking the meds and regular A1C checkups about every 4weeks.
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  #4  
March 29th, 2010, 02:11 PM
rebeccabaltimore and more's Avatar (rebeccabaltimore)
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I'm not actually sure how useful an A1C would be, because it measures your glucose control for a three month period and your GD developed recently. I'd still ask to have it done of course, but he might not find it useful.
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  #5  
March 31st, 2010, 04:50 PM
austlanabmv's Avatar Mega Super Mommy
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i agree with the a1c not helping in the decision for meds or insulin.......

if you fastings are 95 and 1 hour after is 120 you seem to be doing great so far... my fastings are 110 and 1 hour after is 140's on insulin..... ugh!
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  #6  
April 1st, 2010, 04:02 PM
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Thanks ladies!
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  #7  
April 2nd, 2010, 02:12 AM
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Quote:
Originally Posted by austlanabmv View Post
i agree with the a1c not helping in the decision for meds or insulin.......

if you fastings are 95 and 1 hour after is 120 you seem to be doing great so far... my fastings are 110 and 1 hour after is 140's on insulin..... ugh!
Thank goodness I'm not the only one!!!! See my new thread....
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