November 2, 2006
Gestational Diabetes
Question from Trenton, New Jersey, USA:
I am currently 34 weeks pregnant with my second child. The screen in my first pregnancy was normal. With this pregnancy, I was screened for gestational diabetes at 24 weeks and had a blood glucose reading of 90 mg/dl [5.0 mmol/L] one hour after drinking 50 grams glucose. At 33 weeks, I was retested again because of a heart disorder that my daughter had when she was a newborn, which can be associated with high blood sugar levels. The results came back at 150 mg/dl [8.3 mmol/L]. Is it normal for insulin resistance to increase during pregnancy without necessarily leading to gestational diabetes? I’m going to take the GTT, but I was wondering what’s normal because most information refers to women taking the test at 24 to 28 weeks.
Answer:
Insulin resistance is progressive during pregnancy. Thus, it is possible to develop gestational diabetes later in the pregnancy. The screening is done at 24 to 28 weeks because that is when gestational diabetes is most likely to start to appear. Your first test was absolutely normal. The second test showed an elevated one hour result (I use greater than 135 mg/dl [7.5 mmol/L]). However, I bet the three hour test will be normal or close to it. At most, you may just need some dietary management, particularly since you are approaching term.
OWJ
