-----Original Message-----
From: Johan en Maureen Barnard [mailto:[log in to unmask]]
Sent: Monday, January 22, 2001 07:05
To: [log in to unmask]
Subject: Diabetes, oral hypoglycaemias and nursing mothers
I am new on Lactnet but would like to enter into the discussion regarding
the request from Jeanette Panchula <[log in to unmask]>, massage dated
Wed, 17 Jan 2001.
<< She has been successfully breastfeeding, but since the baby was 6 months
old he MD has been pressuring her to stop breastfeeding and stop
breastfeeding so she can take the medications that will stabilize her blood
sugar. She has gained 12K since delivery despite the help of a dietician,
and has difficult time maintaining stable blood sugar levels, including
emergency room visits due to hypoglycaemia. >>
Jeanette you haven't mentioned if she is using insulin or not. Having
hypoglycaemia attacks and having the weight gain it could be that she is
overinsulinised. What is her HbA1c like?
<<She is taking "Tiroxina" >>
Hypothyroidism could also be a reason for her weight gain. Is this
"Tiroxina" perhaps a Thyroxin drug?
<< Her MD wants her to start "Xenical" for controlling of "fats" and
"Mepformina" to control the "low Insulin levels">>
"Xenical", Orlistat, is contra-indicated for nursing mothers and organic
causes of obesity, such as hypothyroidism, should be excluded before
prescribing Xenical. You could visit their web at www.Xenical.com.
"Mepformina" might be a biguanide which is used to partially reverse insulin
resistance and decrease the hepatic glucose production. All oral
antidiabetic agents are contra-indicated for nursing mothers according to
Funnell et al (1998: pg 602.) To help her increase her insulin sensitivity,
exercise is the answer!! If she is not on insulin then that is the way to
go. Lactation is actually to her benefit because it is lowering her blood
glucose.
Reference: Funnell M.M., C. Hunt, K. Kulkarni, R.R. Rubin, P.C. Yarborough.
A CORE CURRICULUM FOR DIABETES EDUCATION. 1998. American Association of
Diabetes Educators, Chicago, Illinois.
Maureen Barnard. RN. Diabetes Educator.
George, South Africa.
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