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183933 tn?1290216962

gestational diabetes

Hi, my gestational carrier (surrogate) is pregnant with twins. She usually does get gestational diabetes when she is nearing the end of her second trimester. She is now 7 1/2 weeks pregnant and is already getting diabetes. It started around 5 1/2 weeks. Around that time she tested her blood sugar levels at home and her numbers were around 280. I know for about a week they were pretty high, centering around that number. Now she is 7 1/2 weeks along and her numbers are around 125. That is all controlled from her diet. She has not been put on anything yet to help control it. She has an appointment at the dieabet center but has not gone yet. I'm really concerned that those really high numbers around 5 1/2-61/2 weeks may have really harmed the babies. I know that is when the brain and major organs are developing. What are your thoughts. I'm hoping I'm just over worrying here. I'm just so concerned about their health. Also, is 280 really as high as I think it is? I just don't know what to think. Thanks, Carisa
9 Responses
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291531 tn?1193610693
MEDICAL PROFESSIONAL
Hi Carisa,
Congratulations on your wonderful news about having twins in the future.

Yes, 280 is indeed too high.  It is very good that your surrogate's numbers are now around 125mg/dl but I urge you to ensure she is seen and VERY closely followed by both a high risk obstetrician and an endocrinologist. There are risks associated with hyperglycemia and I cannot say whether or not the prior exposure during the earlier weeks has done any harm. Often there will be ultrasound examinations to determine if all is okay early in the pregnancy. Most likely everything will be okay especially now that the glucoses are better controlled, but she should really be under very close care with specialists because glucose levels tend to increase later in the pregnancy.

Take care and congratulations again.

Helpful - 1
183933 tn?1290216962
Hi Anita Ramsetty,

Thanks for anwering all of my questions. I'm having a hard time not stressing myself out and worrying too much. Even though her A1C levels were good, which I'm so grateful for, I'm still worried about her current numbers. She has had a hard time getting them completely under control. She told me today after lunch that her numbers were 150. That seems awfully high, but then I'm certainly no doctor. Often times her numbers are lower though, around 117-130.

My question is how high is too high when it comes to talking about possible birth defects. She is now about 9 weeks pregnant with my twins. Thanks.

Carisa
Helpful - 0
183933 tn?1290216962
OH, by the way, she does have a high risk OB which is a great thing!
Helpful - 0
291531 tn?1193610693
MEDICAL PROFESSIONAL
Hi Carissa,
That is indeed good news that her A1C was not very high. This means that her period of very high sugars likely was short-lived and prior to that time her blood sugars were good as well.  Right now she needs to focus on her diet and trying to gain the appropriate amount of weight during the pregnancy(especially for two babies!) all the while keeping her sugars in check. It is a challenge but with dedication and the right support system(including the specialists) she will do just fine.

Take care.
Helpful - 0
183933 tn?1290216962
Thanks for the quick response! I spoke with my gestational carrier tonight on the phone. She had an appointment at the diabetic center today and also met with a dietician. She said that they took an average of her levels over the last two or three months. I can't remember quite how long it was. Her levels were hardly over at all. I think she said if normal was 5.5, hers was 5.8 or something like that. So they did not put her on medication yet, but will probably have to go on something later on in the pregnancy. Is that a good sign that her average over the last few months was only slightly over?
Helpful - 0
291531 tn?1193610693
MEDICAL PROFESSIONAL
Hello Carissa,
I certainly understand your worry given the precious little people on the way.
The general guidelines for pregnant women are for 1-hour post-meal sugars not to exceed 140mg/dL. One outlying number now and then is probably not a big deal, but if this is a pattern then something needs to change--likely both the eating pattern as well as need for some medication in future. Keep a close eye on those numbers while ensuring your surrogate is getting adequate nutrition for herself and the babies. Please do keep up with all appointments with the nutritionist and al involved specialists.
Take care and all the best.
Helpful - 0
183933 tn?1290216962
Hi there,
I was curious what your thoughts are on taking glyburide in the first trimester. Everyone I ask seems to think it's just fine. But everything I read online says it's unknown and there may be a risk associated with the use of it in the first trimester. My gestational carrier is on it now. She is on a very low dose and started in the 9th week.
Helpful - 0
291531 tn?1193610693
MEDICAL PROFESSIONAL
Hello,

This is a difference in common practice. Glyburide is sometimes prescribed by OBs in pregnant women for treatment of diabetes. It is not, to my knowledge, officially FDA approved for this condition but the word-on-the-street from observational conditions is that is has been safe. Endocrinologists as a group do not use it during pregnancy but instead use insulin which has FDA approval for use in pregnancy.
Hope all is going well, take care.

Helpful - 0
Avatar universal
Hi!  I just wanted to ease your mind a little... I had "gestational" starting before 7 weeks pg.  They discovered it at 7 weeks, but my A1c was REALLY bad, so I obviously had high blood sugar since before I became pg.  They did not put me on glyburide, but put me directly on fast acting insulin, 3X a day.  While I had all kinds of crazy issues including strict bed rest with my hips elevated for 3 months, the baby never had a problem.  She is 6 years old now, smart as a whip and cute as a button (of course that may be a little biased :-)).  There was never a problem with her, and the dr just wanted to be sure she did not go to term (since they can get too big), but since you are having twins, that shouldn't be a problem.  Relax... babies are more resilient than expectant moms give them credit for.  Congratulations on twins!  My only advice now is to get some sleep while you can :-).
Helpful - 0

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