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Suggest Precautions To Be Taken For Uncontrolled Blood Sugar Levels During Pregnancy

Posted on Thu, 2 Jul 2015

Question: I have been diagnose with gestational diabetes at the 7 month of my pregnancy. After controlling diet my blood sugar level have not been under specified range. My physician puts me on insulin, 4 points twice a day before breakfast and before dinner. After taking insulin my blood sugar level is under control for two days, but on third day it is again at borderline. I am also taking 30-40 minutes walk daily. What could be other precaution I will take to keep my blood sugar level under control.

Answered by Dr. Dr. Abhay A Mali (1 hour later)

Brief Answer:
There may be need for increasing the dosage of insulin.

Detailed Answer:
Hi,

Thanks for your question.

After going through your question, I can understand your concern.

I would like to know your current blood sugar control.

For better blood sugar control I will advise you -

1) Discuss your diet with dietitian.
You should take 3 major meals and 3 snacks distributed not less than 2 hrs and not more than 4 hrs apart.
Starvation should be avoided in pregnancy.

2) Continue exercise as you are doing currently (30 - 40 min walk), avoid vigorous exercise or efforts to lose weight. Weight loss in pregnancy is not recommended.

3) Frequent blood sugar monitoring with using glucometer at home as follows-

- Fasting (Before breakfast)
- 2 Hours after breakfast.
- Before lunch.
- 2 hours after lunch.
- Before Dinner.
- 2 hours after dinner.

It is usually advisable to do as much as readings possible from all of above readings daily.
Otherwise at least 2 or 3 reading should be done daily.

If required additional readings should be done in case there are symptoms of low blood sugar (hypoglycemia), in that case you should also note down date and time of incidence any change in meal pattern, increased physical activity on that particular day.

According to your blood sugar level chart your physician can adjust the dosage, frequency and type of insulin, if needed.

Hope I have answered your questions.
I will be happy to answer your follow up questions if any.
Otherwise you can close the question and rate the answer.

Regards,
Dr. Abhay Mali.
Diabetologist.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Dr. Abhay A Mali (3 days later)

Dear Sir,

Thank you very much for your response.

I am attaching my sugar level chart.

Kindly advice any precaution if required.

Thanks

Answered by Dr. Dr. Abhay A Mali (9 hours later)

Brief Answer:
Need for adjustment of insulin doses.

Detailed Answer:
Hi,

Thanks for your follow up question.

I really appreciate your efforts.

Ideally for GDM, recommended target capillary glucose concentrations is as follows:
     Pre-meal ≤ 95 mg/dl
     1 hr Post-meal ≤ 140 mg/dl
     2 hr Post-meal ≤ 120 mg/dl

But depending on patient’s scenario individual Blood sugar level target is recommended.

You should discuss your blood sugar level target with your treating doctor.

For better blood sugar control:
- Follow diet and exercise as advised previously.
- There is need to change dose and frequency and may be type of your current insulin (you have not mentioned the name of insulin) after consulting your doctor.

Hope I have answered your question.
If so close the question and rate the answer.

Regards,
Dr. Abhay Mali.
Diabetologist.

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj