
January 22, 2001
Gestational Diabetes
Question from :
From: Bedford, The United Kingdom:
I have been told I have gestational diabetes, but think they might be overcautious. They did a 75 gram load test at 30 weeks< and the results were: one-hour -- 10.5 mmol/L [189 mg/dl] and two-hours -- 8.1 mmol/L [146 mg/dl] (I think, it might have been 8.5 mmol/L [155 mg/dl] ).Since then, home monitoring results have been: fasting -- 4 to 5 mmol/L [72 to 90 mg/dl], and two hours after meals less than 7 mmol/L [126 mg/dl], usually around 6 mmol/L [108 mg/dl]. I did my own 75 gram test and this came out much lower. Did I have a problem? If so, could it have off? I wanted a natural birth if possible, but now I am classified as high risk and my options have been narrowed significantly. Also I had a scan at 36 weeks and the baby is 5-7 days small for dates.
Answer:
Here in the USA. I use a 50 gram glucose test to screen for gestational diabetes so I am not as familiar with the cutoff values for the 75 gram glucose test, other than the criteria for diagnosing diabetes in a non-pregnant condition (glucose greater than 11.1 mmol/L [200 mg/dl] at 2 hours). However, your current fasting and postprandial values are very good. Tests results may vary depending on what kind of diet you were on prior to the glucose tolerance test. The idea of the glucose challenge is to see how you respond to an intense glucose load, more than someone would usually take in all at once. Thus, with a proper diet, the expectation is that you will have more normal blood sugar values. If not, then insulin may be required. Even with gestational diabetes, you are a good candidate for a vaginal delivery. It does not appear that your baby is becoming too large.
OWJ