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How can sugar levels be controlled in gestational diabetes?

Prof Dinesh Dhanwal
Prof of Medicine and Head of Endocrinology,
Maulana Azad Medical College,
New Delhi

Q: I am 24 years old. I am suffering from gestational diabetes. I am in my 28th week of pregnancy and practicing diet control but not taking insulin. My fasting blood sugar levels are 64 mg\dl on an average and 1 hour after the meal is 135 mg\dl. My treating doctor recommends to keep it below 120. The sugar level goes up if I eat 1 cup of dal along with 2 chapattis and vegetables. I feel that it is possible to keep my sugar levels low only if I have a non vegetarian meal. Are my readings normal as per Indian standards or am I really suffering from diabetes? What level of sugar has to be maintained after 1 hour of the meal?

A:Targets for control in Gestational diabetes are fasting or pre meals < 105 mg and 1.5 to 2 hours after meal between 80-120 mg/dl. I will suggest you to do your blood glucose levels after 1.5 to 2 hours after food rather than after one hour. Also get your Glycosylated Hb done (this test tells us average blood glucose control during last three months. This should be below 6.5%).Its good enough to have vegetarian food, if you do not wish do not shift to non-vegetarian food. Outcome of pregnancy is dependent on multiple factors like nutrition, low level of stress etc. In your case it seems you are doing fine. You should take what we call three plus three meal pattern diet i.e., three major meals and three snacks in between. Its best to consult a dietician for the diet chart. Remember you need extra calories for baby's growth during pregnancy and that depends upon the gestational age. If you are not able to maintain the above targets through diet alone, then you should take insulin.