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Self Management Gestational Diabetes Didn't Go After Delivery

Discussion in 'Gestational Diabetes' started by asingh, Jul 23, 2017.

  1. asingh

    asingh Active Member

    Messages:
    60
    Gender:
    Female
    Location:
    Boston
    Diabetic Since (dd-mm-yyyy):
    2015
    Hi everyone, I have a case study. 30 year old female s/p gestational diabetes, delivery 2015. There is no history of diabetes in her family. One year after delivery her HbA1C was 5.7. She managed to get it down to 5.4 with exercise and diet. After sometime she lost the track and started eating without much thought, her HbA1C went to 5.8. Started getting back on the track of eating low carb and exercise. One day after eating chickpeas and paranthas (of course not low carb options) her one hour pp was 140 and 2 hour 100. That got her cautious, now on a low carb diet and trying to walk after every meal to get numbers under control. Her BMI was always around 20 but now is 18- not so great. What are your recommendations? Take metformin and control numbers or continue with the same exercise and diet lifestyle and not worry about the weight.
     
  2. Anup Singh

    Anup Singh Admin

    Messages:
    12,057
    Gender:
    Male
    Location:
    Indore, India
    Diabetic Since (dd-mm-yyyy):
    14-02-2011
    Diabetes Type:
    Type 2
    Test fasting and PPBS insulin levels
    Test LIPIDS/KFT/LFT/Thyroid
     
    Recyan and shashikantiyengar like this.
  3. asingh

    asingh Active Member

    Messages:
    60
    Gender:
    Female
    Location:
    Boston
    Diabetic Since (dd-mm-yyyy):
    2015
    Thank you so much for the reply. PP and Fasting numbers are under control since on a low carb diet. But getting insulin levels checked is a great idea. Will recommend LIPIDS, KFT, LFT. I am learning so much through all of you. Thanks !
     
    Recyan and shashikantiyengar like this.
  4. shashikantiyengar

    shashikantiyengar Moderator

    Messages:
    10,510
    Gender:
    Male
    Location:
    Mumbai
    Diabetic Since (dd-mm-yyyy):
    29/09/2015
    Diabetes Type:
    Type 2
    At this levels no need of metformin
    Can be controlled by low carb high fats
    Exercise... should continue
     
    Recyan, Anup Singh and asingh like this.
  5. Vinay Raj

    Vinay Raj Veteran Member

    Messages:
    1,631
    Gender:
    Male
    Location:
    Chennai
    Diabetes Type:
    Type 2
    Based on insulin and BS, there will be a rough idea of where she is in Kraft's assays and one could go from there. In my opinion a great predictor of state of Type 2. I would use that all the time instead of the silly term "pre diabetes".
     
    Recyan, asingh and Anup Singh like this.
  6. Anup Singh

    Anup Singh Admin

    Messages:
    12,057
    Gender:
    Male
    Location:
    Indore, India
    Diabetic Since (dd-mm-yyyy):
    14-02-2011
    Diabetes Type:
    Type 2
    (y)(y)(y)
    Pre Diabetes is a fashionable term to fool.

    Going by @Pragya's case, I am a bit concerned at BMI 18. She hit DKA even with normal insulin levels.
    So, we will need to look at Fasting and Post meal insulin also.
     
  7. asingh

    asingh Active Member

    Messages:
    60
    Gender:
    Female
    Location:
    Boston
    Diabetic Since (dd-mm-yyyy):
    2015
    I don't think DKA can be the reason since her diabetes in still under control but can't say for sure.
    The other concern would be getting the insulin levels checked. I am kind of sure that no insurance in US is going to cover that. Has anyone have them done in US and how was the insurance coverage. Will look for private labs also.
    I am not familiar with @Pragya's case. Tried to find it but could not.
    Weight seems like a concern but that been said she mentioned that her BMI has always remained between 19-20. So not sure how much to blame LCHF diet for this new number of 18.
     
    Recyan likes this.
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