You are 32 weeks pregnant and your doctor has just told you that you have gestational diabetes and put you on insulin. So lets review for all the newbies to gestational diabetes.
Pregnant women who have never had diabetes before but who have high blood sugar (glucose) levels during pregnancy are said to have gestational diabetes. Gestational diabetes affects about 4% of all pregnant women - about 135,000 cases of gestational diabetes in the United States each year.
We don't know what causes gestational diabetes, but we have some clues. The placenta supports the baby as it grows. Hormones from the placenta help the baby develop. But these hormones also block the action of the mother's insulin in her body. This problem is called insulin resistance. Insulin resistance makes it hard for the mother's body to use insulin (sound familiar to you type 2's?) and she may need up to three times as much insulin.
Gestational diabetes starts when your body is not able to make and use all the insulin it needs for pregnancy. Without enough insulin, glucose cannot leave the blood and be changed to energy. Glucose builds up in the blood to high levels. This is called hyperglycemia.
Gestational diabetes affects the mother in late pregnancy, after the baby's body has been formed, but while the baby is busy growing. Because of this, gestational diabetes does not cause the kinds of birth defects sometimes seen in babies whose mothers had diabetes before pregnancy.
However, untreated or poorly controlled gestational diabetes can hurt your baby. When you have gestational diabetes, your pancreas works overtime to produce insulin, but the insulin does not lower your blood glucose levels. Although insulin does not cross the placenta, glucose and other nutrients do. So extra blood glucose goes through the placenta, giving the baby high blood glucose levels. This causes the baby's pancreas to make extra insulin to get rid of the blood glucose. Since the baby is getting more energy than it needs to grow and develop, the extra energy is stored as fat.
This can lead to macrosomia, or a "fat" baby. Babies with macrosomia face health problems of their own, including damage to their shoulders during birth. Because of the extra insulin made by the baby's pancreas, newborns may have very low blood glucose levels at birth and are also at higher risk for breathing problems. Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.
Treatment for gestational diabetes aims to keep blood glucose levels equal to those of pregnant women who don't have gestational diabetes. Treatment for gestational diabetes always includes special meal plans and scheduled physical activity. It may also include daily blood glucose testing and insulin injections (in your case Humulin N). For you as the mother-to-be, treatment for gestational diabetes helps lower the risk of a cesarean section birth that very large babies may require.
Gestational diabetes usually goes away after pregnancy. But once you've had gestational diabetes, your chances are 2 in 3 that it will return in future pregnancies. You are one of the lucky "2" it appears. In a few women, however, pregnancy uncovers type 1 or type 2 diabetes. It is hard to tell whether these women have gestational diabetes or have just started showing their diabetes during pregnancy. These women will need to continue diabetes treatment after pregnancy.
Many women who have gestational diabetes go on to develop type 2 diabetes years later. There seems to be a link between the tendency to have gestational diabetes and type 2 diabetes. Gestational diabetes and type 2 diabetes both involve insulin resistance. Certain basic lifestyle changes may help prevent diabetes after gestational diabetes. Im not going to go into all the lifestyle changes that can prevent diabetes but there is plenty written about it in this forum.
So lets talk about your Insulin and what it is or is not doing for you. There are many different types of insulin and they are absorbed at different rates and work for varying periods of time. Humulin N is an intermediate-acting insulin. It takes one to three hours to begin working after injection, reaches its maximum effect between five and eight hours, and stops working after about 18 hours. Since you're fasting test is taken while your insulin is peaking, AND your readings are still too high, there are one of two things happening. 1) Your dose is not high enough as your readings will only go up from here. 2) You need a drug like Metformin (glucophage) to stimulate your sensitivity to the insulin you are taking and the insulin you are producing naturally. This could drop your numbers dramatically. In any event, you absolutely have to discuss this situation with your doctor - sooner than later.
Hope this helps
What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease. - George Dennison Prentice
- It's not that some people have willpower and some don't. It's that some people are ready to change and others are not. - James Gordon, M.D.
I can only please one person per day, today is not your day...tomorrow doesn't look good either.
Post Edited (Warren) : 4/20/2006 2:59:50 PM (GMT-6)