Effect of fetal hyperinsulinism on oral glucose tolerance test results in patients with gestational diabetes mellitus

Article Abstract:

Pregnant women with diabetes may have a normal glucose tolerance test because the baby is metabolizing more blood sugar than normal. This happens because the baby responds to the higher blood sugar levels in the mother by producing more insulin.

Research

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Serum fructosamine and amniotic fluid insulin levels in patients with gestational diabetes and healthy control subjects

Article Abstract:

Gestational diabetes is a complication of pregnancy marked by abnormal sugar tolerance due to a decreased availability of insulin. Pregnancies complicated by gestational diabetes are at risk for larger infants, obesity and chemical abnormalities. Although gestational diabetes is diagnosed by an abnormal glucose tolerance test (GTT), these results are often not reliable or reproducible. In addition, the transfer of glucose and insulin from the mother, through the placenta, to the fetus is not well understood. The amount of insulin in the amniotic fluid surrounding the fetus can be used to determine the insulin state of the fetus. However, this determination requires amniocentesis, an invasive procedure involving the removal of small samples of amniotic fluid. Management of gestational diabetes depends on the degree of glucose intolerance and the fetal insulin state. Amniotic insulin levels that are considered to be low risk can be managed with diet, while higher amniotic insulin levels require insulin therapy. The value of measuring fructosamine in the mother's blood, which reflects the maternal blood glucose levels, was tested for 87 women with gestational diabetes. The fructosamine levels and amniotic fluid insulin levels were compared with those from 678 healthy pregnant women, 113 of whose amniotic fluid levels were available. Maternal fructosamine levels differed among women with fetuses who had normal amniotic insulin and those with high amniotic insulin. Amniocentesis could have been avoided in 70 percent of the patients who had abnormal glucose tolerance testing in combination with normal maternal blood fructosamine. Only one diagnosis was missed when these two testing measures were used. Although fructosamine level alone is not useful in diagnosing gestational diabetes, glucose tolerance testing combined with fructosamine testing can help in the management of pregnant women with glucose intolerance. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Pregnancy, Complications of, Pregnancy complications, Amniotic fluid, Insulin, Fructose metabolism

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Toward universal criteria for gestational diabetes: relationships between seventy-five and one hundred gram glucose loads and between capillary and venous glucose concentrations

Article Abstract:

Screening pregnant women for gestational diabetes with a one-step procedure using a 75 gram glucose solution may be as effective as the two-step procedure using 100 grams of glucose. Researchers gave 30 healthy pregnant women and 30 pregnant women with gestational diabetes the 75-gram glucose tolerance test followed by a second test using either 75 grams or 100 grams within 3 days. In the healthy women, blood glucose levels were different depending on whether they received 75 grams or 100 grams, but this was not true in the women with gestational diabetes.

Blood sugar, Blood glucose, Glucose tolerance tests, Glucose tolerance test

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