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September 19, 2002

Gestational Diabetes

Question from Livermore, California, USA:

I am 29 years old, 36 1/2 weeks pregnant with my third child, and at my latest prenatal care visit, my care provider was concerned because there was sugar in my urine (1+). This happens on and off, particularly when I have an afternoon visit and have eaten a snack before going (three or four times for the last 16 weeks or so). When I have a morning appointment, there isn't any sugar. At 27 weeks gestation, my diabetes screening was okay, and I was negative for gestational diabetes during my first and second pregnancies. I have gained 25 pounds so far. In general, I tend toward low blood sugar when I am not pregnant and am careful to balance my carbohydrate and simple sugar intake with protein and complex carbohydrates. Should I be concerned that I am insulin resistant or having other sugar problems? The other care providers who I have seen have said not to worry since the pancreas doesn't function as efficiently during pregnancy.

Answer:

Glucose in the urine is fairly common during pregnancy and is a very unreliable method of testing for diabetes or glucose control. This is not a reflection of pancreatic function, but rather how easily glucose gets filtered through the kidney during pregnancy. With the normal one hour screen and no history, I seriously doubt that you have gestational diabetes. If the concern is high however, I would recommend repeating the glucose screen as a more sensitive test.

OWJ