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Pregnant. Suffer from high blood sugar levels. Taking insulin. Suggestions?

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General & Family Physician
Practicing since : 2005
Answered : 2572 Questions
Hi ,
My wife is 28 weeks pregnant. She is suffering from high blood sugar levels.

History of the Patient:

Her age is 32, We got married in Aug 2008. She could not concieve because she was Suffering from PCOD. We have used injections and other tablets to increase the egg size. Finally in Mar 2013 she concieved. Doctor scanned in 2nd month and she asked my wife to take bed rest.

we went for scanning and RBS in her 5th month. And we observed her sugar levels are too high. Then doctor asked us to go for test next day to make sure the results are correct.

1st suagr test done on 24/07/2013.
Result is : Random Blood Suagr 249.0

2nd suagr test done on 25/07/2013.
FBS: 106.0
PPBS: 197.0

We went to doctor and shown reports to doctor. She suggested us to XXXXXXX a diabetic doctor.
Then diabetic doctor asked us to go for test again.


Fasting: 88
ppbs: 134
HBA1c: 6.6%

After seeing this report, She asked to go for test again.
we went for test again on 16/08/2013.

Results are:
Post Lunch: 190 which is higher. Then she suggested us to go for INsulin, My wife is taking injection everyday now.

Here are my questions:

1. Does she really need to take insulin?
2. How does is effect baby?
3. How to keep sugar levels low by eating protien food?
4. What food she should eat and what not?
Posted Mon, 16 Sep 2013 in Pregnancy
Answered by Dr. Prasad 1 hour later
Brief Answer:
I wouldn't start insulin yet...

Detailed Answer:

Thanks for sharing your concerns here. I went through the details and reports attached with diligence. It would have been better to know whether or not she had diabetes in the past. I presume your answer to be no - she did not have diabetes in the past.

Based on this presumption, I deduce that she has glucose intolerant state due to pregnancy. Pregnancy increases resistance to insulin thereby giving to this condition.

Now, since she has glucose intolerance and not diabetes, I wouldn't start insulin yet. If she was to be my patient, I would recommend strict diabetic diet and lifestyle while I monitor her blood sugars monthly or every fortnight. This would be my plan of action.
That being said, there is no harm in starting insulin; it gives us better control on blood sugar while increasing spectrum of food intake.

I shall now answer your individual questions:
1. Does she really need to take insulin? - According to me, she doesn't need insulin. If you also do not like the idea of taking insulin for the aforementioned reasons, you can discuss with her treating doctor / second diabetologist and stop them.

2. How does it affect baby? - If you meant, how diabetes effect baby, then increase blood sugar are associated with large babies - your child can grow faster and larger giving rise to difficulties during delivery; head can grow unproportionate to the body; the liquour (amniotic fluid) can increase in quantity (polyhydramnios) and so on. Thus increased blood sugar is detrimental both on baby growth as well chances of normal delivery.

3. How to keep sugar levels low; what to eat and what not?
- Following a strict diabetic diet and life style is going to be the key with or without insulin. I see your doctor has listed some changes in the diet. More than knowing what to eat and what not, you need to learn "how much to eat".

Every food has a glycemic index. Food that have high glycemic index can irrationally increase sugar. She needs to restrict taking such products. Foods with high glycemic index include chocolates, sweet, ice cream, potato, food / salad dressing such as mayonnaise, papad, fruits like sethaphal, refined bread and cereals, fruit juice, coffee, watermelon, ripe banana, dates and so on. Those high glycemic index food needs to be restricted or avoided completely.
Low glycemic index food are relative safe and taken in moderate amounts. Low glycemic foods are green vegetables, whole grains/cereal, millet, lentils, chickpeas, XXXXXXX apricot, banana preferably unripe, milk, and so on.

With this data, you can balance her diet accordingly. You may also take help of dietician to balance her diet.

Hope that helps. Let me know if you need clarifications.

Above answer was peer-reviewed by
Follow-up: Pregnant. Suffer from high blood sugar levels. Taking insulin. Suggestions? 2 hours later
Thank you so much for your kind reply. I have got Contour TS glucometer, Where we are testing her blood sugar levels regurlarly. As of now she has started taking 4 units. After that we could see that there are changes in her sugar levels.
I have attached reading what we have noted after every test.

I went to her with readings, Then she suggested to decrease from 4 units to 2 units as few of them are going low.

Here is her diet now.

Morning 8AM : Bensi Ravva Upma/ Wheat Dosa and one glass OATS

11:30 Am: Half XXXXXXX

Afternoon 1:00 PM: Small amount of Rice

4:00 PM: Small amount of rice/Half apple/Gauvva

Evening 8pm: 3 Chapathis

11pm: 1 Glass Milk with Nestle Baby and me Protien food

Butter 2 or 3 times a day.

Here is my concern, As i belive she is not taking much protien , I am not sure how many protiens baby is taking and baby health.

Could you please suggest diet changes.
And explain why these many changes in a week in her blood sugar levels.

Thank you so much for your patience to answer my questions.

Answered by Dr. Prasad 1 hour later
Brief Answer:
Diet seems to be Ok....

Detailed Answer:

As far as I see, except from days when she had insulin, I see her sugars are fairly constant.
a) A practical comment cannot be done over random blood sugar since the test is done at a random time.
b) Fasting sugars are almost under normal limits.
c) Post prandial blood sugars are much higher.

This is a clinical picture of glucose intolerance - a prediabetic state and that is why I usually do not prescribe insulin in such cases.

The changes in blood sugar especially the ones where the sugars are much lower are due to the effects of insulin. Her doctor's have rightly cut down the insulin doses. I would not encourage many changes to diet if the primary diet is balanced and sufficient when sugar levels are fluctuation. She can include low glycemic vegetables into her diet. Whole grain / cereal wheat chapathi/roti can be added instead of refined maida product perhaps for lunch meal too. You can include millets (ragi/bajra) - it is a XXXXXXX source of iron; additionally has low glycemic index. For better tuning of diet, you can talk to a nutritionist; off course when sugar levels stop to fall low.

As far as protein intake, it seems to be ok. That being said, there is no means for us to record the precise protein intake of growing fetus. Regular ultrasound scan during antenatal period will monitor the baby’s growth; and that would be a direct indicator of fetal nourishment.

Hope this helps. Let me know if you need clarifications.

Above answer was peer-reviewed by
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