Supposed "gestational diabetes" diagnosed at 6 weeks and wondering about my current treatment

Diabetes and Pregnancy
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Hi everyone. I've lurked on here for several months, but this is my first post. I'm currently 32 weeks pregnant with my second child. I was diagnosed with what they're currently calling "gestational diabetes" when I was 6 weeks pregnant (and from what I've read, a GDM diagnosis before 20 weeks indicates the person probably had diabetes before pregnancy). Anyway, I'm 31 and was underweight and had hypothyroidism before this pregnancy, so I imagine I might have early LADA or MODY or something? I had two of the antibody tests and the c-peptide done in early pregnancy and they were normal, though.

I guess I just want to vent and see if others with more experience think my sugars are being managed ok. My perinatologist has me only on 12 units of NPH once daily in the morning. At my last visit, he said he didn't want to give me any rapid-acting insulin to cover meals because my sugars "aren't bad enough." I feel like I can't eat anything! I eat about 15 carbs for breakfast and 30 each for lunch and dinner, plus 3 snacks of 15 carbs each. I'm still over goals (95 fasting and 120 at 2 hrs) half the time or more (the sugar goals in GDM are clearly lower than in regular DM). My fasting sugar is typically 100-105 and my 2 hr postprandials are 90-150. My baby has not been measuring large, so my doctor says he's not really too concerned about my elevated sugars (but I kind of am, since I do so much reading about the risks to babies of diabetic moms with poor sugar control). Should I push for a rapid-acting insulin? Should I just calm down?

Thanks for any and all advice and just for listening. Sorry this is so long!

Erin

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  1. go over to our Oh Baby group here on TuD. We will help support you through the pregnancy!

  2. at 32 weeks, you are doing great to have such tight control. The basal insulin is probably enough, but it’s certainly up to you if you’d like to explore a fast acting insulin at meal times. I agree that it doesn’t sound like GD (diagnosed after 20 weeks when the placental lactogen starts to wreak havoc) but rather pre-existing type 2 (since your antibodies are normal). It is possible that your insulin resistance will continue to increase for another month or so before dropping off. It doesn’t hurt to ask about how to keep your blood sugar under control while also eating the food you feel you need. You needn’t suffer hunger just to keep your numbers in check.