Chicago GD mom
08-05-2009, 01:35 AM
Hi fellow diabetic and GD moms,
I've had gestational diabetes through two pregancies and just had to be put on insulin for the second in spite of the fact that blood sugar levels are mostly within range and the baby's size appears to be normal. I wanted to share my story to alert fellow moms to a concern about managing your ketone levels. As most of you probably know already, your body spills ketones when it does not get enough carbs, or if your body is not producing enough insulin to help your body process the carbs correctly and carry them to the baby. Most doctors (even mine - and I go to a maternal endocrinology branch that specializes in pregnancy-related diabetes research) will only tell you to check ketones first thing in the morning. Because of the overnight fast, that is supposed to be the time when you are most likely to spill ketones. Otherwise, they tend to assume everything is okay.
In my case, even though I did not spill ketones in the mornings, I started testing a bit more frequently and found that I was regularly spilling ketones (sometimes trace or small, sometimes moderate or large) every afternoon - a time when I wasn't alerted to the need to test. Apparently my body wasn't producing enough insulin during a normal day's activities to process my lunch carbs correctly. I never would have known the baby was getting ketones every day (sometimes at pretty high levels) if I had not started testing more frequently than recommended. While the research available on the impact of spilling ketones is still limited and the recommendations about ketone testing vary, my hospital participated in a long-term study of children who were born to diabetic moms that found a correlation between moms who regularly spilled ketones and lowered IQs of 10-15 points. Even if the jury is still out on best practices to manage ketones, I feel reassured by being proactive and taking precautions just in case. Testing for ketones is simple and relatively low cost. Adding in an occasional afternoon or evening test just to see if you have any similar issues (even if your doctor doesn't tell you to do it) may alert you to potential problems that you should discuss with your physician, as it did me.
I've had gestational diabetes through two pregancies and just had to be put on insulin for the second in spite of the fact that blood sugar levels are mostly within range and the baby's size appears to be normal. I wanted to share my story to alert fellow moms to a concern about managing your ketone levels. As most of you probably know already, your body spills ketones when it does not get enough carbs, or if your body is not producing enough insulin to help your body process the carbs correctly and carry them to the baby. Most doctors (even mine - and I go to a maternal endocrinology branch that specializes in pregnancy-related diabetes research) will only tell you to check ketones first thing in the morning. Because of the overnight fast, that is supposed to be the time when you are most likely to spill ketones. Otherwise, they tend to assume everything is okay.
In my case, even though I did not spill ketones in the mornings, I started testing a bit more frequently and found that I was regularly spilling ketones (sometimes trace or small, sometimes moderate or large) every afternoon - a time when I wasn't alerted to the need to test. Apparently my body wasn't producing enough insulin during a normal day's activities to process my lunch carbs correctly. I never would have known the baby was getting ketones every day (sometimes at pretty high levels) if I had not started testing more frequently than recommended. While the research available on the impact of spilling ketones is still limited and the recommendations about ketone testing vary, my hospital participated in a long-term study of children who were born to diabetic moms that found a correlation between moms who regularly spilled ketones and lowered IQs of 10-15 points. Even if the jury is still out on best practices to manage ketones, I feel reassured by being proactive and taking precautions just in case. Testing for ketones is simple and relatively low cost. Adding in an occasional afternoon or evening test just to see if you have any similar issues (even if your doctor doesn't tell you to do it) may alert you to potential problems that you should discuss with your physician, as it did me.