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August 30, 2006

Gestational Diabetes

Question from Washington, D.C., USA:

At my 18 week appointment, a urine test found my glucose levels to be about 250 mg/dl [13.9 mmol/L]. The midwife said not to worry about it, but I really think something isn't right. I went online to do my own research on dietary changes I could make and began restricting my carbohydrate intake to less than 180 grams per day and felt much better (less frequent urination, constant parched feeling gone). Last night, at dinner, I had a small amount of potatoes and about four bites of dessert and it sent me right back to dire thirst and frequent urination. I want a GTT (glucose tolerance test) test now, but my midwife says wait. Should I try to convince her otherwise? My mother was diagnosed pre-diabetic at 64, while my aunt was diagnosed diabetic at 62.

Answer:

Pregnant women often spill glucose in their urine. This is not always indicative of diabetes. Your other symptoms are not specific for diabetes either. Usually, testing for gestational diabetes is done between 24 and 28 weeks gestation. However, you can do the test earlier. If it is normal, then you should still be tested at the usual time. Another idea would be to have your midwife check a fasting and one hour postmeal glucose value. The fasting should be less than 90 mg/dl [5.0 mmol/L] and the postmeal should be less than 130 mg/dl [7.2 mmol/L]. This is not a formal evaluation for diabetes, but may give you information about your glucose status. If the values are elevated then further testing would be indicated.

OWJ