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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pregnant. Developed Diabetes And High Blood Pressure. Got Fasting Glucose Report.Suggest Diet Chart

I have developed diabetes in my 8th months of pregnancy. My Fasting Glucose level is 110 and PP is 169.4. What precautions I should take. I do not eat sweets, sugar, rice, potato, fat and spices. I walk 4 KM daily from last 4-5 days after diagnosed with diabetics. I am very worried, if it will affect my baby. I also have developed high blood pressure these days. Can you suggest me with a proper diet chart. Thanks - Tanu Shri
Mon, 22 Apr 2013
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General & Family Physician 's  Response
Hello,
Criteria for diagnosis of gestational diabetes according to Indian National Diabetes Data group
Fasting 105mg/dl
1 hour 190mg/dl
2 hours 165mg/dl
3 hour 145mg/dl
Since your fasting levels are 110 and PP levels after 2 hours  are 169,they are marginally above normal.
 Targets  during pregnancy are a little lower than normal diabetes. You should be aiming for 130 or less ONE hour after eating, 120 or less TWO hours after eating.
Fasting blood sugar should be 90 or less in the morning. 

you are definitely right that women with uncontrolled gestational diabetes are at increased risk of problems like large babies,still birth,seizures etc.But most patients are able to manage their sugar levels with proper healthy diet and moderate exercises.
Some may require injection insulin for the control of sugar levels.
You are doing very well with your dietary restrictions and regular exercises and there seems to be no need to do anything more.
Keep salt restriction in place and keep your BP normal.
Keep checking your sugar levels every week and if you find that they are going out of control,then don't hesitate to be put on injection insulin.
Don't worry too much as everything shall be all right.
Thanks
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Internal Medicine Specialist Dr. Akhilesh Dubey's  Response
Hi,
Welcome to HCM,
You have blood sugar level which in Pregnancy falls in Diabetic range, It is good that you have started walking which improves peripheral utilisation of glucose and keep it in normal range, diet needs to provide sufficient calories for pregnancy, typically 2,000 to 2200 K cal depending on your weight, please exclude simple sugars from diet as they increase the blood sugar level.Please note slow release carbohydrates can be used to provide calories.
You can self monitor your sugar level with the help of Glucometer keeping a chart fasting, pre lunch and 2 hour after lunch.
It is equally important to avoid low blood sugar level that is Hypoglycemia.
If your sugar level is not controlled with these measures in pregnancy insulin is treatment of choice, but Glyburide may be used for which you need to take prescription from physician.
There is risk of macrosomia in baby but it can be avoided by taking care of blood glucose.
Your BP is also high which could be due to Gestational Hypertension so reduce salt intake and if required drugs like alfa methyl dopa may be given by your Gynecologist.
You will be required to take a Glucose tolerance test after 6 weeks to decide if you need diabetic treatment even after delivery.

Please take care
Good Luck.
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General & Family Physician Dr. Bruce Kinney, DO's  Response
Hello, and thank you for using Healthcare Magic!

Diabetes during pregnancy (known as gestational diabetes) can be dangerous for the baby. Problems such as growing too large and needing a c-section are common. You should discuss this with your doctor, and ask if you need a sonogram to determine the size of the baby again and see if there is enough amniotic fluid surrounding the baby.

Here is a link to some excellent information on gestational diabetes, including recommended dietary changes: http://www.diabetes.org/food-and-fitness/food/

Typically gestational diabetes goes away after the baby is born. The disease can cause problems for the baby immediately after it is born, but it will not necessarily develop diabetes itself. Gestational diabetes places you as the mother at a much higher risk of developing diabetes later in life, so it is something that you should be tested for on a regular basis by your doctor.



I hope I have provided you with some useful information, and wish you the best of health.

Sincerely,

Dr. Kinney
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Pregnant. Developed Diabetes And High Blood Pressure. Got Fasting Glucose Report.Suggest Diet Chart

Hello, Criteria for diagnosis of gestational diabetes according to Indian National Diabetes Data group Fasting 105mg/dl 1 hour 190mg/dl 2 hours 165mg/dl 3 hour 145mg/dl Since your fasting levels are 110 and PP levels after 2 hours  are 169,they are marginally above normal.  Targets  during pregnancy are a little lower than normal diabetes. You should be aiming for 130 or less ONE hour after eating, 120 or less TWO hours after eating. Fasting blood sugar should be 90 or less in the morning.  you are definitely right that women with uncontrolled gestational diabetes are at increased risk of problems like large babies,still birth,seizures etc.But most patients are able to manage their sugar levels with proper healthy diet and moderate exercises. Some may require injection insulin for the control of sugar levels. You are doing very well with your dietary restrictions and regular exercises and there seems to be no need to do anything more. Keep salt restriction in place and keep your BP normal. Keep checking your sugar levels every week and if you find that they are going out of control,then don t hesitate to be put on injection insulin. Don t worry too much as everything shall be all right. Thanks