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How should I manage diabetes during pregnancy?

Q: I am 34 years old diabetic woman and 8 months pregnant. I take 40 units of insulin in the morning and 22 units at night. The doctor prescribed Susten 200 mg since the 4th month of pregnancy and also gave injection Hucog 5000 for the growth of the child. Even after taking insulin my sugar levels keep increasing after the completion of 6th month i.e. 165-220 mg/dl (fasting) and 180-203 mg/dl (random). Is this due to Susten 200 or Hucog 5000? What should I do to control my blood sugar levels? Please advise.

A:Insulin requirement normally go up in pregnancy in a diabetic patient due to the hormonal changes. So your insulin doses will constantly need to be adjusted as the pregnancy advances. Your high blood glucose is not related to Susten and Hucog. A tight blood sugar control is advised during pregnancy as uncontrolled diabetes can cause a large sized baby, birth defects and other complications in the baby and increase the chances of preterm labour and high BP in the mother. We usually advise frequent blood glucose monitoring at home, mostly fasting (in the morning before breakfast) and 2 hours after eating breakfast, lunch and dinner. Insulin is adjusted aggressively by the treating physician to achieve following blood glucose goals without causing frequent low blood glucose:

  • Fasting blood glucose = 95 mg/dL HbA1C = 6 percent
Based on the information that you have provided me, your insulin doses will need to be increased. In addition, you will need to watch your carbohydrate and calorie intake closely. A close follow up with your diabetes specialist is recommended.


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