Pregnancy Glucose Test Information

I am 28 weeks pregnant and my blood glucose level is 147. My doctor put me on a 2,000 calorie diet, just to be safe, but I'm losing weight.

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

I'm not sure which type of glucose tolerance test was used, but the following represents the consensus guidelines of the Third International Workshop-Conference on Gestational Diabetes:

-- All pregnant women should be screened for gestational diabetes (GDM) between 24 and 28 weeks.
-- Values greater than 140 mg/dl necessitate a full three-hour glucose tolerance test (GTT)
-- Two or more venous plasma concentrations greater than the following indicate GDM: fasting, 105 mg/dl; one-hour, 190 mg/dl; two-hour, 165 mg/dl; and three-hour, 145 mg/dl.

There is a lot wrong with using a single standard for screening and diagnosis of gestational diabetes. Body weight, dietary factors, family history, ethnicity, glandular activities of the body, even stress, all play a role in glucose metabolism.

Some medical conditions are related to less-than-optimal glucose control -- such as increased blood pressure and kidney problems. One author recommended different thresholds for African Americans (130 mg/dl), Caucasians (140 mg/dl) and Asians (150mg/dl).

I would add that a screening threshold of 140 mg/dl is not sufficient to detect all women with GDM. Some are gestational diabetics in the range of 130 to 139. Some authors also believe that the 140 should be raised. It is a median, and we will miss some and misdiagnose others.

Perhaps a repeat test is in order, especially in view of the fact that you are losing weight on the 2,000 calorie diet. Make sure you are not excreting ketones in your urine. These are by-products of fat metabolism and may be harmful to the baby. You can determine this easily with test strips available at all clinics.

You might ask your physician if home monitoring is an option. That could be the most useful way for you to monitor your blood sugars throughout the day.

The American Diabetes Association may have some information for you as well. And never feel bad about getting a second opinion.

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