Diabetes and Pregnancy - Medications and Gestational Diabetes
Medications and Gestational Diabetes
By Nina Nazor
When diet is not enough, insulin
therapy is the most commonly used treatment to maintain blood glucose levels at the desired ranges. Traditionally the use
of pills to reduce blood glucose levels has not been recommended during pregnancy because they cross the placenta and affect
the baby. However, recent news report that glyburide (a pill used to reduce high blood levels) may be effective to control
gestational diabetes that is unresponsive to diet.
No matter what you use
to control your glucose levels, you should try to reach the following goals: fasting blood glucose between 60-90 mg/dl, and
after-meals blood glucose less than 120 mg/dl.
If blood glucose levels are
not controlled properly, this can increase the rate of problems for you and your such as macrosomia (babies weighing more
than 8 pounds), cesarean section, hypoglycemia shoulder problems, neonatal intensive care unit days, and respiratory complications.
The optimal insulin regimen and the type and dose of insulin must be tailored
by your doctor to meet your own requirements. Human insulin is currently recommended by the American Diabetes Association.
However, insulin lyspro (fast acting) seems to be as effective as regular insulin in controlling glucose levels with fewer
episodes of hypoglycemia.
The use of insulin lyspro is in category B by
the FDA and insulin aspart, as well as other types of pills, are considered to be in Pregnancy Category C by the FDA. The
use of insulin glargine is currently being considered to be in Pregnancy Category C by the FDA.
All this means that the first choice is human insulin, but your doctor must calculate the amount of insulin you require
and teach you how to adjust the insulin dose according to your glucose readings in order to correct any high blood glucose
levels you detect.
I believe that human insulin is the best medication for
controlling diabetes in pregnancy, because it is designed to be just the same as your own insulin or mine, and will not cross
the placenta. After all, mommy is who has glucose problems, so the baby does not need any of those substances because he or
she is producing enough insulin to grow and develop properly in your womb.