Brief Answer:
Check your after food blood glucose

Detailed Answer:
Hi XXXXXXX

Welcome to HCM. I had gone through your question and understand your concerns.

You are having glucose intolerance in pregnancy commonly called as gestational diabetes. Your blood sugars are to be tightly controlled in pregnancy to prevent health issues in you and your baby. Two medications that can be safely taken in pregnancy are Metformin (metital) and insulin injections. Your doctor has started on Metformin with which your fasting blood glucose has come to normal.

Please check your blood glucose after food. If it is also normal you can continue with your medications, diet control and follow up every 5-6 days with fasting and post food blood glucose. If your after food sugars are high it is better to consult your treating physician and the doctor may start you on insulin.

The fasting blood glucose in pregnancy should be < 95 mg/dl in pregnancy and 1 hour and 2 hour after food should be less than 140 and 120 mg/dl respectively. What ever treatment you are on the sugar should be below this.

Good health.

Hope I have answered your question. If you have any further questions I will be happy to help.


Regards
Dr Ajish TP
Consultant Endocrinologist

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Brief Answer:
Your sugars are normal.Continue medicines

Detailed Answer:
Hi XXXXXXX

Thanks for informing the reports.

Your blood sugars are normal now. Fasting and after food sugars are normal on medications. You can continue with medications till you meet your doctor. Continue the dietary modifications. If your sugars are staying normal you can gradually decrease your medications after consulting your doctor. No need to worry now.

Regards
Dr Ajish TP
Consultant Endocrinologist

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Brief Answer:
These are not low sugars - just normal

Detailed Answer:
Hi XXXXXXX

I have gone through your SMBG (self monitoring of blood glucose) values. All are with in normal limits on metformin (metital 500). You are now on half maximum dose of metformin - which is a relatively safe medicine in pregnancy. The minimum dose I gave in pregnancy is 500mg and maximum 2500 mg/day.

Low sugars means a glucose value below 70 mg/dl. So no need to worry as the blood glucose values are never below that and Metformin do not cause significant low sugars unlike insulin.

In my practice I usually ask the patient to do SMBG every 2-7 days depending on their affordability. If all blood glucose are normal or low I start reducing the medications (to twice daily in your case).

In your case the sugar values are just normal. So I suggest you to continue the dose and monitor every 2-3 days. If all values are well below the target ( before food< 95 mg/dl,1 hour and 2 hour after food <140 and 120 mg/dl respectively) we can consider decreasing Metital to 500 mg twice daily.

Hope my answer clear your doubts.
Wishing you smooth and safe pregnancy.

If you have any further questions I will be happy to help.


Regards
Dr Ajish TP
Consultant Endocrinologist

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Brief Answer:
Monitor sugars and inform if in need

Detailed Answer:
Hi XXXXXXX
Great to know that my comments were useful.
Please continue monitoring your sugars and inform me if in any issues

Regards
Dr Ajish TP
Consultant Endocrinologist

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