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Mody 2 and pregant!

C

ClareRW

Newbie
Hi, I am 38 years old and I have had, apparently, insulin dependent gestational diabetes for two and 3/4 pregnancies ( I am 33 weeks now) and have constantly complained to my Dr that on the insulin that I am prescribed that I can not tolerate sugars below about 4.8 (anything below this I am shivery shaky and feeling awful). I have been a good patient and have followed my diet and insulin despite this. My fasting sugars no matter what insulin I am on seem to be in or around 5.5 - 6.5 and they want them to be below 5. My two children where 9lbs 2 and 8lbs 13 on being induced at 38 weeks.

I have not had any diabetic systems ever, so I am very confused. I am normally fit and active and have always had the ability to outwork, play, etc all my friends and family (ie seem to need less sleep and can keep going for longer!) On insulin I can not exercise without feeling sick, I am constantly tired and unenergetic, get very bad tempered and irritable very easily (I am normally very even tempered and it takes a lot of upset and unnerve me) and. I don't really know what to do, as without any treatment I feel great and with it I feel like I can not function very well.

If I allow my sugars to stay between 6.5 and 8.5 I feel normal (these seem to be constant and natural levels before food and between 1 and 2 hours after) Does anyone have any ideas... is this normal? - My sugars do not vary from this even when not pregnant.

Anyway I have now been diagnosed with Mody 2. What does this mean? can anyone else explain it to me.

many thanks

Clare
 
Hi Clare,

Congratulations on your pregnancy - hope the rest of it goes well!

That site is really good if you can check it out - but just thought I'd give some information too.

MODY 2 is a defect of one of the gene's involved in blood sugar control, glucokinase. You will have one normal copy and one "faulty" one (as a result your children have a 50% chance of inheriting the condition too).

Glucokinase acts a bit like a thermostat, and controls the baseline level of your blood sugar. People with glucokinase mutation/MODY 2 typically run blood sugars, even fasting levels of 7-8mmol/L, as the "thermostat" is set faulty as it were. However they do still produce insulin and so should not get excessively high or long lasting readings after eating. It typically presents with gestational diabetes as you yourself are experiencing, since normally blood sugar levels are not consistently high enough to cause the osmotic symptoms of high sugars.

As a result the good news is that MODY 2 is one of the "better" genetic diabetes to have (if there is ever a better, but I hope you know what I mean ...) in that most cases it can be managed with diet and exercise alone (I'm not sure about during pregnancy, I imagine people err on the side of caution more and treat). Monitoring of HbA1c is the best way to determine if long-term treatment is needed - do you know what your HbA1c is? The other good news is that complications associated with diabetes are rare in MODY 2 people.

With regards to your struggling to get by on insulin, it is possibly due to the fact your body is usually used to these consistenly higher (but outside of pregnancy not dangerous) sugar levels, and so anything lower feels hypo. If you are able to keep a normal HbA1c (best less than 6.5, but with MODY 2 most likely less than 7) then hopefully outside of pregnancy with care taken about what you eat and exercise (I'm sure 3 children will help there!) and feel normal then maybe you can stay off the medication. Are they referring you to an endocrinologist?

All the best,
Rachel
 
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