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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pregnant. High Sugar Levels. Taking Insulin. Suggestion?

Hi doctor, I am 30 weeks pregnant.The last time i checked my sugar levels was sept 2012 and found to be within the range. Since last two weeks i am checking the levels regularly and found to be too high i.e. 180-260. Currently i am on insulin 4-6-4, and on strict diet and having a walk after every meal then also there is no reduction in the sugar levels. Kindly suggest what should i do to reduce the levels? Rgds, Sarika.
Mon, 11 Feb 2013
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General & Family Physician 's  Response
Hello,
After 20 weeks of gestation, peripheral insulin resistance increases insulin requirements so that it is not unusual for a pregnant woman to require 2-3 times as much insulin as she did prior to pregnancy. This requirement of insulin increases further if woman falls ill during pregnancy.
Diabetic ketoacidosis carries the highest risk of fetal mortality in the third trimester thought in part due to the extreme insulin resistance in these patients and insulin requirments to treat DKA that are nearly twice as high as in the second trimester.

Frequent monitoring allows appropriate insulin dosage adjustments. 

It is very important to have a tight blood sugar control for the  prevention of complications such as fetal malformations in the first trimester, macrosomia in the second and third trimesters, and neonatal metabolic abnormalities.
Consult your doctor and get the dose of insulin increased accordingly.
Thanks
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Pregnant. High Sugar Levels. Taking Insulin. Suggestion?

Hello, After 20 weeks of gestation, peripheral insulin resistance increases insulin requirements so that it is not unusual for a pregnant woman to require 2-3 times as much insulin as she did prior to pregnancy. This requirement of insulin increases further if woman falls ill during pregnancy. Diabetic ketoacidosis carries the highest risk of fetal mortality in the third trimester thought in part due to the extreme insulin resistance in these patients and insulin requirments to treat DKA that are nearly twice as high as in the second trimester. Frequent monitoring allows appropriate insulin dosage adjustments.  It is very important to have a tight blood sugar control for the  prevention of complications such as fetal malformations in the first trimester, macrosomia in the second and third trimesters, and neonatal metabolic abnormalities. Consult your doctor and get the dose of insulin increased accordingly. Thanks