Hi all,
Speaking as a former gestational diabetic, now a Type II diabetic, & office-mate to our diabetes educator, I'd like to assure this mom that breastfeeding has nothing to do with her fasting blood sugars being elevated.
Diabetics (of any type) are more sensitive to changes in levels of the "wake-up" hormone, cortisol. When her body responds to the cortisol, the liver mobilizes glucagon to make some "start-up" sugar, so to speak, and her slightly sluggish pancreas doesn't wake up in time to cover it quickly with insulin. If her blood sugar is normal IMMEDIATELY upon wakening, it will, most likely, go up over the next few hours, whether or not she has eaten--OR breastfed.
I remember during my last pregnancy (16 years ago), my OB & diabetes educator suggested I get up a little earlier & walk 1-2 miles before taking my blood sugar, to see if we could get my fasting ones down (they were getting into the 120's). Don't know if was just the cortisol effect, or the STRESS (which also raises cortisol & blood sugars) of getting up & exercising at 5 a.m. that caused the problem, but my fasting sugars actually went UP! ;-)
I strongly suggest this mom get in touch with a certified diabetes educator, especially if there's one who works primarily with pregnant diabetics. It really isn't too early to begin diligent monitoring, and to start making dietary changes to keep her blood sugars on an even keel.
She also should start dipping her urine for ketones in the morning. She may be spilling ketones at night (a sign she didn't have enough calories on board at bedtime, & her body broke down fat to make blood sugar as well), & if she's spilling ketones, adding a bedtime snack that's a mix of protein & complex carbs (like, peanut butter or ham sandwich on whole grain bread, or a bowl of whole grain cereal with lowfat milk) may help--and may help the fasting sugar in the morning, as well.
Increasingly, studies are showing that early and TIGHT control of blood sugars during pregnancy make for better outcomes for both mom & baby. She also shouldn't feel she's "failed" if she needs to start on insulin. I wish I had---fought it as a matter of pride ("I'm gonna beat this thing") as well as being a needle-phobe (like sticking my finger 7-12 times/day didn't hurt?!). I ended up delivering an 8lb 11oz baby at just under 37 weeks, who developed sepsis & spent 2 weeks in NICU. He's fine now, & driving me nuts as only an adolescent can do, but I still burst into tears when I see the polaroid photo of him in the NICU that first day.....
Off to get that son from summer school....and give him an extra hug for all he's taught me!
Smiles,
Carol
Carol Schlef, RNC, MSW, IBCLC, LCCE
www.humorhealthhugs.com
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