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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pregnant On A Low Carbohydrate Diet Due To Diabetes. High Sugar Levels. Concerned

Hi. My wife is 22 weeks pregnant and was diagnosed with pre diabetes 4 years ago. There is a high rate of diabetes in her familly.
She has been on a carb restricted diet since her diagnosis. She used to test her blood sugar with a monitor on a regular basis but, thinking that she had it under control with diet, stopped doing so quite a while ago.
However, last week, she tetsted her BS 2 hours post prandial and got an alarmingly high reading of 10.2mmol/l.
She arranged for a glucose challenge test and failed with a 10.9. (8.3 being the cut off at this hospital)
She then did the 3 hour test and got the following results : 5.6, 8.9, 7.9, 6.8 and was told that she had not blood sugar problems.
Knowing that that she quite obviously HAS high BS, this was a rediculous result, so I did a little research and found that, for this test to be accurate, the person being tested must have been eating a normal diet for at least three days before the test. Her carb restricted diet must therefore been the reason for her passing the test.
You may well be wondering why the maternity unit taking care of her during her pregnancy was not taking care of her high risk condition as a pre diabetic, but we have just found out that her midwife mistakenly never put it on her chart during their first meeting.
Even though we told the hospital that she was in fact on a carb restricted diet before the OGTT, they still insist that she does not have diabetic issues because "that test is the gold standard" and if she passed that she is fine.....unbelievable..no?!
To make matters worse and more infuriating, we went to our local GP for a second opinion. She said that we shouldn't worry because it is normal for people to get blood sugar spikes over 10 even without diabetes.....???!!! She even advised my wife not to check blood sugar with the monitor at all because it would only cause worry and be dangerous for her pregnancy.
We are at our wits end......please advise.
Thank you in advance.




Tue, 7 May 2013
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General & Family Physician 's  Response
Hello, thanks for the query to H.C.M. Forum
Frankly I would like to say one thing that your's wife is a diabetic prone so whatever some one say please make sure regular check up of diabetes for your wife and glucose monitoring is necessary and it will booster her morale.
If any thing abnormal you can take treatment well in time so don't forget this thing.
Secondly your wife is pregnant so diet restriction is also very important and after consultation with a gynaecologist , diabetologist move in right direction.
Mind it one thing ,if she have high sugar level than why worry take treatment.
If not high than than why worry, don't take treatment.
Light regular exercises only for pregnant patients are advised so consult a physiotherapist and have good life.
Good luck Dr. HET
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Internal Medicine Specialist Dr. Akhilesh Dubey's  Response
Hi,
Welcome to HCM,
Your wife has positive family history of Diabetes and she is pregnant, as such also there is more risk of Gestational Diabetes ( Diabetes in pregnancy).
It is true that before Oral Glucose tolerance test carbohydrates should not be restricted and 75 gram Glucose should be used for test.
In her case fasting is >5.6 which is little on upper side in her case best would be to repeat the test after normal diet Oral glucose tolerance test and take a fresh view.
OGTT Fasting 5.3, 1 hour 10.0, 2 hour 8.5, and 3 hour 7.8.
In the meantime continue to take usual precautions related to pregnancy and it would be better if you consult a Endocrinologist or Internal medicine specialist.
Please take care
Good Luck
Dr.Akhilesh Dubey M.D.
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Pregnant On A Low Carbohydrate Diet Due To Diabetes. High Sugar Levels. Concerned

Hello, thanks for the query to H.C.M. Forum Frankly I would like to say one thing that your s wife is a diabetic prone so whatever some one say please make sure regular check up of diabetes for your wife and glucose monitoring is necessary and it will booster her morale. If any thing abnormal you can take treatment well in time so don t forget this thing. Secondly your wife is pregnant so diet restriction is also very important and after consultation with a gynaecologist , diabetologist move in right direction. Mind it one thing ,if she have high sugar level than why worry take treatment. If not high than than why worry, don t take treatment. Light regular exercises only for pregnant patients are advised so consult a physiotherapist and have good life. Good luck Dr. HET