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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 46954
Experience:  Board Certified Physician
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I have a question about the impact on gestational diabetes

Customer Question

Hi I have a question about the impact on gestational diabetes and treatment on my son. I have 2 children. My older son was born in 2010 and although my glucose readings were at the top of normal I did not get gestational diabetes. He was born at just under 8lbs, has always had a good appetite and been around 50th percentile. I was pregnant again in 2014 and had gestational diabetes. I was advised to take metformin as I still had three high blood sugar readings in one week even when trying to manage by diet. I was reluctant to take medication as I felt the high readings were partly due to me being unwell with a virus but I was advised that my baby was at risk of being very big due to my diabetes so I took the medication, however he was born at under 7lbs and even at 4 months old he is only 9th percentile. I don't really understand this. My partner is keen for me to introduce formula to encourage him to put on weight but he is an otherwise happy baby so I am continuing to breastfeed exclusively. He is putting on weight steadily but is just very small.
I suppose my questions are as follows 1) whether it was really necessary to take medication during my pregnancy and if not are there any implications for my son 2) whether the medication only affects birth weight or could still be affecting my sons growth/weight now 3)whether he has a raised risk of diabetes himself given my diagnosis.
I have been re-tested postnatally and am no longer diabetic.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. David replied 2 years ago.
Dr. David :

This is Dr. David

Dr. David :

1. in most cases with gestational diabetes, you need it controlled during pregnancy to help the baby.

Dr. David :

but in your case, it seems like your second baby was delivered fine.

Dr. David :

most likely medications would not help helped with birth weight.

Dr. David :

your choice of not taking medication most likely is not affecting your sons growth and weight now.

Dr. David :

he does not have increased risks for diabetes necessarily

JACUSTOMER-2jqz1v0p- :

Hi Dr David, I'm sorry if it wasn't clear - I was not keen to take medication but I did take it for the last six weeks of my pregnancy. I have subsequently wondered if it was really necessary as I find it strange that I was told I was likely to have a bigger baby due to the diabetes but he is so small compared to my older son and have wondered whether this was due to the medication.

Dr. David :

no, the size of the baby was not due to you taking the metformin.

Dr. David :

fetal development size is complicated and depends on many factors .

JACUSTOMER-2jqz1v0p- :

Hi Dr David sorry if I wasn't clear. I was not sure that I needed the medication but I did agree to take it as I was told it was necessary for the baby, I would have a bigger baby. What I find strange is that he is not bigger - he is so much smaller than his brother. This has made me wonder whether the medication was really necessary and if not whether taking the metformin during pregnancy is the reason he is so small now or whether he would have been this weight anyway.

Dr. David :

http://www.ncbi.nlm.nih.gov/pubmed/24633859

Dr. David :

is a good article.

Dr. David :

no, the size of the baby was not influenced by you taking metformin.

Dr. David :

"The degree of fetal metformin exposure does not influence fetal outcome in gestational diabetes mellitus."

Dr. David :

do you have any other questions?

JACUSTOMER-2jqz1v0p- :

Oh ok, that's interesting. What is the reason for taking metformin then when pregnant? I was told it was to prevent him from being too big?

Dr. David :

the metformin is to help you gain less weight

Dr. David :

so you don't gain so much weight

Dr. David :

and to control your blood sugar levels.

JACUSTOMER-2jqz1v0p- :

Oh right. That is different from what I was told. I was told it is for the baby. Ok well thanks.

Dr. David :

thanks

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