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January 30, 2002

Gestational Diabetes

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Question from Dallas, Texas, USA:

I have PCOS, I am 14 weeks into my first pregnancy, I’m having twins, and since my glucose screen was high, my doctor ordered a three-hour GTT. The results are as follows: Fasting — 78 mg/dl [4.8 mmol/L], one-hour 240 mg/dl [13.3 mmol/L], two-hours — 255 mg/dl [14.2 mmol/L], and three-hours — 165 mg/dl [mmol/L].

What do you think about these readings? How come my one- and- two-hour readings were that high when my fasting was only 78 mg/dl [4.8 mmol/L]? Does my PCOS increase my chances of getting gestational diabetes? Is there a high chance of getting gestational diabetes with a twin pregnancy? I am going to see a dietitian tomorrow.

Answer:

From: DTeam Staff

You have gestational diabetes. Your main risk is probably some degree of glucose intolerance due to the Polycystic Ovary Syndrome, and the twins may contribute slightly to the risk of gestational diabetes.

You make enough insulin to produce a normal fasting blood sugar. However, when you eat there is insulin resistance to the insulin that is released, so it takes longer to get a response. This results in the prolonged elevation in the blood sugar. The three-hour test is artificial. In a well regulated diet, you would not take in as much glucose all at once as you do during a glucose tolerance test.

OWJ