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Question:

From Gainesville, Florida, USA:

Is diet-management needed if I passed the three hour glucose tolerance test (GTT)? I am 30 weeks pregnant, and recently took both the 50 gram glucose challenge test (GCT) and subsequently the three hour (100 gram) GTT. I failed the screening GCT (which was after an overnight fast), with a 96 mg/dl [5.3 mmol/L] fasting and a 178 mg/dl [9.9 mmol/L] one hour. My certified nurse midwife/obstetrician (CNM/OB) wanted me to get diabetes counseling immediately, change my diet and monitor blood sugars. I asked to take the diagnostic test first, and went for the three hour test. After an overnight fast, my pre-loading level was 90 mg/dl [162 mmol/L]. At the half-hour draw, the level was 151 mg/dl [8.4 mmol/L]; at one hour, it was 149 mg/dl [8.3 mmol/L]; at two hours, it was 136 mg/dl [7.6 mmol/L]; and at three hours, it was 77 mg/dl [4.3 mmol/L].

Based on everything I've read and researched, these fall within the normal levels regardless of the scale used. However, the OB said my two hour level was "concerning" and wants me to still go for the diabetes counseling and start monitoring my blood sugars.

My other history is that I'm overweight and had a previous gestational diabetes negative pregnancy with a 9 pound, 4 ounce child at 40 weeks, five days via Cesarean. Am I wrong to think that I do not have gestational diabetes this time? Is there any reason why I would be considered "borderline"? I am worried about being incorrectly diagnosed (and thus, treated) as I am planning on a vaginal delivery.

Answer:

The results of the three hour test are normal. You do not meet criteria for gestational diabetes. Your doctor may be concerned because of your previous delivery of a large baby. Thus, he is encouraging you to watch your diet and follow your blood sugar values in the event that you may develop some degree of glucose intolerance later in the pregnancy. Another idea would be to follow the baby's growth with ultrasound as well.

OWJ

DTQ-20041119170725
Original posting 26 Nov 2004
Posted to Gestational Diabetes

  
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Last Updated: Tuesday April 06, 2010 15:10:00
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