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31 weeks pregnant. Have cold and cough. Fasting test done. What does the reading says?

Aug 2012
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Practicing since : 1999
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hi i wanted to know,im 31 weeks pregnant and i got my fasting tested today i.e. 17/09/2012 and it was high i.e. the reading was 127 mg/dl.The psecifications are I HAD MY LAST MEAL AT 8.30 PM.WALKED FOR 30 MINS AT 10.30 PM.GAVE BLOOD FOR TESTING AT 10.15 AM.TO ADD TO THAT I HAVE COLD AND COUGH FOR THE LAST 3 DAYS.
Posted Sat, 6 Oct 2012 in Pregnancy
Answered by Dr. Madhuri Patil 1 hour later

A good question!

Before answering it, I would request to know if you are already diagnosed to have gestational diabetes (GDM). Alternatively, this test was performed to rule out GDM.

In case you have already been diagnosed to have GDM some 2/3 weeks back (as generally we check for GDM between 24 to 28 week, if your first trimester test- carried out before 12th week- was negative for sugars), then this high sugar needs attention immediately before you want to know whether your cold cough was the reason for it to go up.

You need to consult a diabetologist for such a fasting sugar, as it is high for any pregnant woman (for GDM it has to be less than 105).

Cold and cough or any such physical stress does increase the sugars but if a person has normal secretion of insulin or compatible insulin sensitivity during pregnancy, then sugars are kept in best possible control. Therefore, that means you could not pass the 'stress test' or 'challenge test' of sugars.

In addition, if you are already diagnosed to have GDM then in any such situation you need to increase the insulin dose to avoid further highs in your fasting, other pre-meals and post prandial readings.

In case of second option, that you are getting to know that the sugar is high for the first time, then also you need to see a diabetologist right away to get to know what food to eat, how frequently to eat, what to avoid and what medication to be taken in the interest of best baby outcomes and comfortable delivery, as this is GDM. This is again irrespective of the cause of high sugar.

Most importantly, I want to make a note on your eating pattern and the gap between your last meal of the day and the morning meal. What you have mentioned here is you had taken dinner at 8.30 pm. Then you did not have any snacks before going to that because you wanted to go for the test next morning or because this is what your pattern is? If this is your pattern, then please understand that a pregnant woman is supposed to keep minimum gaps in these meals, as there is a tendency of ketone formation in your blood, which is not good. If it was because you were supposed to give your blood sample the next day morning, then that means your fasting (tested at about 7 AM) would have been much more higher than 127 mg/dl (which you tested at 10.30 AM) as the duration of starvation is really too big.

In short, you have fasting sugar in the GDM range now. Please do not delay and see a Diabetologist for knowing your post glucose challenge and HbA1c test reports and the best results from your pregnancy. He/she will also see your general health like cough, cold and will advice best.

Again, this is mostly a temporary phenomenon as many pregnant women get this kind of sugar imbalance, which disappears after delivering the baby. So take it positively for the best interest of you and the baby and do not waste time further.

All the best. Get back to me for any further clarification or further guidance.

- Dr Madhuri
Above answer was peer-reviewed by
Follow-up: 31 weeks pregnant. Have cold and cough. Fasting test done. What does the reading says? 3 hours later
Thanks XXXXXXX for your advice.I would like to give you more details on my case,in the first and second trimester my fasting and PP were in control.They XXXXXXX in the last trimester itself.The GCT was i.e. 206mg/dl.So my gynaec got my fasting/PP checked.Both were 127/122 respectively.Later on I was adviced strict diet control, and my PP came within range and my fasting came down to 115 mg/dl.Now again fasting is high i.e. 127 mg/dl but the PP is normal.Seeing this pattern can you please advice what steps can be taken to reduce my fasting sugar levels as my PP and my random sugar levels have always been normal and are still normal?
Answered by Dr. Madhuri Patil 1 hour later

even a fasting reading of 115 is not acceptable when you are pregnant as it has to be within 105 as many studies have found direct correlation between higher sugars and heavy babies and other consequences.
But do not get scared here. When you have this kind of impaired fasting glucose (and unknown HbA1c- average sugar ove a period, which seems to be not done in your case by your doc) you are supposed to undergo OB scans as often as once in 4 weeks to see what is the abdominal girth of the baby. If it is more than normal, then we recommend very strict glucose control. To be XXXXXXX insulin therapy- in your case at least one injection shot of insulin NPH at 10 pm every night as long as your postprandial sugars are within 125 to 130 all the time. If they also go beyond that then short acting insulin shots before each major meal is the treatment. This lasts till you deliver the baby.
You need to see an Endocrinologist in Delhi for this. They know how to handle this kind of sugar. As I had mentioned, your fasting is likely to be higher as you had checked it late that day. After delivery your doctor will check if you have something called 'MODY' as predominently higher fasting sugars detected during pregnancy have this diabetes, which YOU DO NOT NEED TO WORRY ABOUT RIGHT NOW.
In short the steps to be taken:
- Get fresh OB scan done from a good radiologist asking specifically to look for 'PERCENTILE OF BABY'S ABDOMINAL CIRCUMFERENCE' and HbA1c test
- Go to a very good Diabetologist with your OB scan and HbA1c report and he/she will check if the high sugar is affecting your baby.
- He/she will recommend night dose of Human NPH insulin to be taken at 10 pm- a very small dose, as your dietary restrictions and exercise in the evening are unlikely to help you reduce the fasting sugar further.
- He/she will ask you to keep monitroing all your day time sugars also to watch the increase till your delivery.
So take it seriously and let me know how far you are what did the doctor do for this case.
All the best.
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