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May 14, 2005

Gestational Diabetes

Question from Burlington, North Carolina, USA:

I am 15 weeks pregnant and just received results of my three hour glucose test. I had gestational diabetes with my three previous children so my provider skipped the one hour test and performed the three hour test early. My mother also had gestational diabetes during both of her pregnancies. I just received my results over the phone from the nurse, who said that I do not have gestational diabetes. My results were: fasting = 88 mg/dl [4.9 mmol/L]; one hour = 184 mg/dl [10.2 mmol/L]; two hours = 150 [8.3 mmol/L]; and three hours = 52 [2.9 mmol/L] Do these results mean that I am borderline or that I do not have gestational diabetes? Do you recommend that I be tested again later? I would like to avoid another three hour test if possible. I have the monitor from my last pregnancy. Should I test and monitor my blood sugar levels throughout the pregnancy as a precaution? I am interested in your opinion, if possible, prior to my next midwife appointment.

Answer:

The glucose value at one hour is slightly elevated (normal is less than 180 mg/dl [10.0 mmol/L]). One abnormal value does not make the diagnosis of gestational diabetes. Plus, you were tested earlier than is recommended. However, it may be worth the effort to get back on the diet you used during the previous pregnancies. It is not necessary, but, if you want the information, then go ahead and do some glucose testing at home before and after meals. Your morning fasting blood sugar should be between 60 and 90 mg/dl [3.3 and 5.0 mmol/L]; just before a meal, 90 to 100 mg/dl [5.0 and 5.6 mmol/l]; and one hour after a meal, less than 130 mg/dl [7.2 mmol/L]. You should be re-tested at 24-28 weeks, which is the standard protocol.

OWJ