Glyburide

I saw the dietitian and the nurse this morning after having trouble controlling my blood sugar last week. The last 3 mornings my fasting levels have been 95 or under and my post-meal levels have mostly been OK the last two days. But looking back over the week, my averages were too high. And they pointed out that even when my fasting levels weren't high (prior to the triage incident and in the last 3 days) they are still hovering right around 95.

I had really hoped to control my blood sugar through diet and exercise, in part because my OB thought I would be able to, but mostly because I feel that is best for me and the baby. So I was disappointed when they decided to start me on medication. I had hoped that since I was doing better since I started exercising again that we could modify my diet a little first. But the dietitian didn't see that I was eating a lot of carbs and she feels that the high levels are most likely due to pregnancy hormones. Plus the fasting level which seemed to be their highest concern, along with my post-breakfast levels, which could be high due to a higher fasting level, seems to be harder to control with exercise and diet. And she said she didn't want me to starve myself by cutting back my carbs even more. And some mornings, I was so hungry, I felt like I was starving myself.

The medication is Glyburide. The nurse explained that it makes the pancreas pump out a little more insulin and that it doesn't cross the placenta. I can't take it when I'm breast feeding, though, so I won't take it past the delivery. They are starting me on 2.5 mg, to be taken with my night time snack.

They started to talk about my high post-lunch readings, but when I pointed out that it seemed to be higher the times I had fruit, we decided I would avoid fruit at lunch time for now and see how it goes. The dietitian even suggested adding fruit to my dinner (as extra carbs) since my post-dinner readings are so good (usually 110 or less, often under 100 when I go for a walk). I do have fruit with cottage cheese every day for my afternoon snack, so I might just stick with that for now.

They warned me about hypoglycemia - low blood sugar - and that if I woke up at night with any of the symptoms, I should test my blood sugar. If it is below 60, I should have a fast-acting carbohydrate, like 1/2 cup of juice, then retest my blood after 20 minutes (I think that is right, but I have to double-check the time). If that happens 2 nights in a row or if my fasting blood sugar is under 60 2 mornings in a row, I should call and they could cut my dose back to 1.25 mg, but she didn't think I'd have a problem. 2.5 mg is a pretty low dose, apparently.

I'm not thrilled about it, but I want to do whatever is best for the baby. And maybe it will mean I have an easier time controlling my blood sugar after breakfast and after lunch. I'm just worried that I'll end up putting a little sugar in my coffee or skipping my morning walk if the glyburide is doing all the work.