Question:
She tells me that her doctors say gestational diabetes is not similar
to the ordinary Type II that I have. What are the differences? She
tests 7 times a day (before & after meals and before bed) and says her
BGs are all over the map from over 200 to below 80. Somehow I have the
feeling this is plenty serious, but hesitate to say because - well you
know. Would like some heads up feed back - by email if feasible.
Thanks.
Answer:
If she can't get her BG under control almost immediately, she'll likely be
put on insulin. There are no oral meds that are considered acceptable for
pregnant women. Gestational diabetes is in fact very similar to type 2, and
in fact she has a greater chance of getting type 2 in the near future after
she has the baby. One difference is that the GD may go away after she has
the baby, but she'd be wise to continue eating as a diabetic for the rest of
her life. I did not, and was diagnosed with type 2 about a year after the
birth.
GD can be a lot harder to control than type 2 because of the hormones given
off by the placenta and because of the baby itself. In my case, I seemed to
be able to eat more food than ever, and in fact needed to eat more
frequently during the pregnancy. I had only 1 incidence of high BG, and
that was a fasting of 110. Pregnant women are also held to much stricter
standards than non-pregnant diabetics. I was told if I ever had so much as
one more high reading, I'd be put on insulin. I should also add that my
diabetes was handled in a rather lax fashion, and I did not test my BG
throughout the day. It was tested only when I went to the Drs. office or to
the blood lab. The reason for this was that the 5 Drs. I had couldn't seem
to agree whether or not I in fact had GD. Three said I did not, 2 said I
"might". I was not given the second GTT like I should have been, and was
told that it would merely been assumed that I had it. Looking back, I see
that this was the wrong way to go. I now have Neuropathy caused by
diabetes. Perhaps had I been held to stricter control, or even been given
an official diagnosis, this might not have happened.
The main concern of a GD pregnancy is that the baby will grow too large,
especially the head. If this happens, the birth can be very difficult.
Also, high BG can adversely affect the baby, especially in the first
trimester. GD is usually not diagnosed until the last trimester. By this
time, damage may have already occurred. She will likely be given frequent
non-stress tests and Ultrasounds to make sure that the baby is doing well.
She may also be given one or more specialized Ultrasounds if they think
there is a problem. I had two of these. They show much better detail than
the standard Ultrasound, although I've read that Ultrasounds in general are
much more progressed than they were 6 years ago when I had my baby. And
lastly, the baby may be born with low BG. If this happens, they will likely
put the baby in ICU until this stabilizes.
There is also a likelihood of her having an induced labor or C-section
(planned or otherwise). Because of the tendency for the baby to be large,
women with GD are usually not allowed to go beyond their due date, and often
will be pushed to induce from the second it appears that the baby is big
enough and stable enough to be born.
