PREGNANCY-BIRTH Messages for July, 2000: Re: Hyperemisis/Gestational Diabetes/Prednisone

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Re: Hyperemisis/Gestational Diabetes/Prednisone

From: Lynn D. Montgomery, MD (anonymous@obgyn.net)
Wed, 26 Jul 2000 17:37:07 -0500 (CDT)

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In reply to: Amy: "Hyperemisis/Gestational Diabetes/Prednisone"

At Wed, 26 Jul 2000, Amy wrote: >
>I have posted many times about my problems with hyperemisis, kidney
>infections and stones, preterm contractions and Lupus during pregnancy.
>I thank you for all the input I've received so far. Because of my
>hyperemisis I could not tolerate the GTT so the doctors assumed
>everything was fine. I went in for a routine ultrasound to check growth
>yesterday and at 30 weeks gestation the baby weighed in at 2091 grams
>and was in the 95 percentile in growth, so my mfm doc took noticed, paid
>attention to the random glucose tests my rhuematologist had ordered
>which were always elevated and has decided that I have carbohydrate
>intolerance (aka gestational diabetes?). How can this be so when I
>still throw up 20 times a day, manage to keep down far fewer than 2000
>calories/day and have only gained 10 pounds (no net gain in 10 weeks)? I
>take 20 mg of prednisone to control my Lupus. Could the prednisone be
>affecting my blood sugar? If I cut down or went off of it would that
>solve my problems? I'd rather live with pain and fatigue than
>gestational diabetes. What happens now? Will my baby just keep getting
>bigger--until I have a 10 or 11 pound baby? How do they treat people
>with "carbohydrate intolerance" late in pregnancy? My doc has me
>scheduled to talk to a nutritionist in a week, but I don't know how she
>can help me. It's just to a point where I can eat ANYTHING and keep it
>down. Radically modifying that tends to make my hyperemisis much worse.
>What can I expect in terms tests/monitoring for the rest of my
>pregnancy? If my baby is huge will they induce? I'm sorry for all the
>questions. I just can't believe all the crazy things that keep
>happening to me.

Amy, It is very likely that your prednisone therapy is responsible for all or part of your diabetes. Prednisone therapy also makes treatment of gestational diabetes very difficult. On the other hand, if it has been determined that the prednisone is required for your lupus, then it must stay. This means that you start on an ADA diet, chart your glucoses daily and if required, insulin therapy... Lynn

--
Lynn D. Montgomery, MD
Director, Maternal-Fetal Medicine
Rocky Mountain Perinatal Center
Missoula, Montana

**Note:  Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship.  This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.

**Private e-mails cannot be entertained due to time constraints, consequently no private e-mails will receive a response.

**Thank you for your understanding ;-)

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