I am 30 weeks pregnant and just had the one hour glucose screening. My level was 152 mg/dl [8.4 mmol/L]. My obstetrician said the cutoff is 140 mg/dl [7.8 mmol/L] so, I need to take the three hour test. I’ve been on a special diet, no sugar and no white flour products, for three years because of yeast problems. The only sugar I have is in fruits and vegetables. I didn’t feel well taking the one hour test so, I’m considering declining the three hour test. What are the risks to me and my baby? Can I ask the doctor about monitoring my glucose levels another way?

The standard approach following an abnormal glucose screen is to do the three hour test to either rule in or rule out the diagnosis of gestational diabetes. However, not everyone can tolerate this test. Thus, the other option would be to give you a glucometer and have you check your blood sugars just before and one to two hours after meals. Your morning fasting glucose should be between 60 and 90 mg/dl [3.3 and 5.0 mmol/L] and just before a meal, should be less than 100 mg/dl [5.6 mmol/L]. At one hour after a meal, it should be less than 130 mg/dl [7.2 mmol/L] or less than 120 mg/dl [6.7 mmol/L] at two hours after a meal. If these parameters are exceeded, then additional management may be required.

OWJ