The persistence of abnormal glucose tolerance after delivery

Article Abstract:

Gestational diabetes, a complication of pregnancy marked by sugar intolerance, can result in poor pregnancy outcome if it is not treated. Women with gestational diabetes who require insulin to correct sugar intolerance usually return to normal within 24 hours after delivery; very few women need to continue taking insulin after delivery. To see if gestational diabetes extends into the post-delivery period, 270 women diagnosed with gestational diabetes were retested seven days after delivery. Glucose tolerance test results were compared with those from 100 women with normal glucose tolerance during pregnancy. Glucose tolerance remained abnormal immediately after delivery in 28 percent of the women (223 women) with gestational diabetes who delivery vaginally and 43 percent (47) of the women who delivered by cesarean section. One of the two women who underwent cesarean delivery in the group having normal glucose control had abnormal glucose tolerance test results. At a six-week retesting, 24 percent of the women who delivered vaginally continued to have abnormal glucose tolerance tests and 30 percent of the women delivering by cesarean section had abnormal glucose tolerance. Postnatal glucose tolerance testing can be used to diagnose gestational diabetes that may have been missed during the prenatal period. Such testing could be particularly useful when a larger than normal infant is born or an unexplained fetal death occurs. In this study, if the glucose tolerance test had been administered during the postnatal period only, 70 percent of the cases would have been missed. Although a glucose tolerance test is useful during the postnatal period if the test was omitted during prenatal screening, it should not be regarded as a replacement. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Complications and side effects, Postnatal care

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Correlation between first- and early third-trimester glucose screening test results

Article Abstract:

Glucose screening of all pregnant women in the third trimester of pregnancy is generally accepted, as glucose intolerance (the inability to regulate blood glucose levels following meals) increases with advancing pregnancy. However, glucose screening in the first trimester has also been advocated, as it would allow identification of unsuspected cases of diabetes, which is strongly associated with obstetric complications. To determine if there is a correlation between one-hour glucose tolerance tests in the first and third trimesters, the test results of 124 pregnant women were evaluated. Glucose levels obtained in the first trimester correlated significantly with those from the third trimester in both white and non-white women. However, elevated glucose levels in the first trimester were more predictive of elevated levels in the third trimester for white patients. Women whose first trimester glucose levels were below 110 milligrams per deciliter (mg/dl) tended to have normal third trimester results, and none developed gestational diabetes. The results suggest that all pregnant women with glucose levels at or below 110 mg/dl in the first trimester may not need subsequent testing. Both white and non-white pregnant women with first semester glucose levels between 110 and 140 mg/dl should be screened again early in the third trimester. Women whose first trimester glucose levels were at or above 140 mg/dl should have a more informative three-hour glucose tolerance test in the third trimester, as their glucose levels are highly likely to have remained elevated. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Diagnosis, Risk factors, Demographic aspects, Medical screening, Health screening, Pregnancy, Complications of, Pregnancy complications

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