Insulin therapy in Gestational Diabetes, the ouch is more expectation than reality

Insulin therapy in Gestational Diabetes, the ouch is more expectation than reality

People with Type 1 diabetes have to take insulin and although no one likes insulin injections or shots in fact they are not the major irritation in the handling of diabetes.  Certainly when I was caring for people who had islet transplants and  these people had come off insulin, it was the freedom from the regimen of diabetes, the attention to meals, the timing of meals, the monitoring rather than just escaping the insulin injection that was the bigger deal.

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Just how low can a normal blood sugar go in pregnancy?

Just how low can a normal blood sugar go in pregnancy?

Recently in the clinic I was asked “Is 3.8 mmol/l (68 mgs/dl) two hours after my lunch too low? The blood sugar normally varies though out the day:  lower before breakfast, peaking just over an hour after a meal and coming back down by two hours.  Firstly, sugars at this level do not harm the baby but let us look at what normal sugars in people without GDM are and then we can look at the situation in gestational diabetes and for those with pre-existing diabetes, either Type 1 or Type 2 diabetes.

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Morning sugar rise

Morning sugar rise

 

My sugar rises in the early morning even if I don’t eat!

A puzzling and frustrating issue for many with diabetes and pregnancy is that the blood sugar may rise coming into breakfast time even though no food was taken.  The usual scenario is the woman checks  her sugar when going to the bathroom at five or six in the morning,  takes nothing, goes back to bed and then at eight AM the sugar is higher by 1 mmol/lI (18 mgs/dl). Just what is going on?

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