<s>[INST] Hi doctor, My wife is with height 159 cm and having weight 72 kg. We checked her BSL in lab for fasting and BP a year back and both results were normal. Yesterday we again checked the reports and her reports are like fasting BSL 172 , urine: no sugar detected. After two hours of lunch FBL was 173 and urine: no sugar detected and HbA1c comes as 9.1 %. Before eight months there was no sugar detected in the reports and now it is like this. Need your advice for this. Fasting seems to be big value. How fasting is more impacted than PP? How severe is this? Can it be controlled only via diet and exercise?First pregnancy we had stillbirth. There was no sugar detected till ninth month of pregnancy. Till start of ninth month, sugar reports were fine but still we had stillbirth. She was detected with gestational diabetes which came to normal within 15 days after delivery. After one and half year we again had pregnancy and we have little girl of 3.6 years old now. During second pregnancy she does not show symbol of sugar but to avoid risk we opted for C-section at the start of ninth month itself. [/INST] Hello. This is very possible. Ladies who develop gestational diabetes are more prone to develop diabetes in the near future. It is like a warning sign to start healthy lifestyle measures so that you can avoid developing diabetes. Currently your wife is having diabetes and she will require medications. She will need to exercise and follow a strict diabetic diet along with the medicines. If she manages her diet and exercising well, she can get off the medications. But for now, she will need both.  So when the fasting sugar is high, that means the glucose produced by the liver for our organs (especially brain) during our sleep even when we do not eat, is uncontrolled. While the post food rise in blood sugar indicates that the body is not producing enough insulin in response to the food eaten. I have tried to answer to your query in a simplified manner. Kindly meet with your local physician for start of medications or you can consult me as well. For more information consult a diabetologist online --> </s>