
June 19, 2006
Gestational Diabetes
Question from Toronto,Ontario,Canada:
In my oral glucose tolerance test at 26 weeks, all the other results were within their individual range, except the two hour test result, which was 9.2 mmol/L [166 mg/dl]. My doctor told me this is an abnormal value, but it isn’t that high. Now, I am 34 weeks pregnant. Do I need to worry about my intake of food due to having that abnormal result? Sometimes, I have sugary foods that increase my blood sugar. Once, it was 10.4 mmol/L [187 mg/dl] two hours afterwards. Usually, how long after having foods does it to the baby’s body? Will that high sugar affect my baby? I used to have a sugar level of 6.9 mmol/L to 8.5 mmol/L [124 to 153 mg/dl] two to three times a week.
Answer:
Based on your initial glucose screening test, you do not have gestational diabetes. You need two or more elevated values to meet the diagnosis of gestational diabetes. However, gestational diabetes may occur later in a pregnancy and you do have some elevated post meal glucose values. At two hours after eating, your blood glucose should be less than 6.7 mmol/L (120 mg/dl). Therefore, some dietary adjustment is indicated. If the hyperglycemia is frequent and persistent, then medication may be necessary (glyburide or insulin). You should notify your physician of your blood sugar results to guide further management. The glucose in your circulation rapidly crosses to the baby. Thus, persistent hyperglycemia can stimulate excess insulin production in the fetus. Insulin is a growth hormone which leads to a big baby. So, good glucose control is important to prevent excess fetal growth.
OWJ