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August 29, 2001

Gestational Diabetes

Question from Muscatine, Iowa, USA:

I'm currently 31 weeks pregnant, and I recently had the a three-hour glucose tolerance test done, and my results were: Fasting --- 93 mg/dl [ 5.2 mmol/L] One-hour --- 200 mg/dl [11.1 mmol/L] Two hours --- 122 mg/dl [6.8 mmol/L] Three hours --- 75 mg/dl [ 4.2 mmol/L] Based on the criteria I've seen for diagnosing gestational diabetes, I failed just one of the four. My doctor is not saying I have gestational diabetes, but she wants to keep an eye on me. She has asked me to record my fasting and one hour after meal blood glucose levels, and told me that the fasting should be less than 105 mg/dl [5.8 mmol/L], and a one hour should be below 120 mg/dl [6.7 mmol/L]. I have been keeping track, and my fasting is usually 95-102 mg/dl [5.3-5.7 mmol/L], and my one-hour can go up to 170 mg/dl [9.4 mmol/L] (depending on what I eat), but it is back down to around 120 mg/dl [6.7 mmol/L] at two hours. Do you think I have gestational diabetes? Is my doctor just being overly cautious?

Answer:

You do not meet the criteria for gestational diabetes. However, you have some degree of impaired glucose tolerance as demonstrated by your elevated postprandial blood sugar. This may get worse which is why your doctor is watching your blood sugars. You may want to talk to her about starting a special diet that should help to control these elevations in glucose.

OWJ