Toward universal criteria for gestational diabetes: the 75-gram glucose tolerance test in pregnancy

Article Abstract:

A set of values are proposed for diagnosing gestational diabetes via a 2-hour 75-g glucose tolerance test given between 24 and 28 weeks gestation, although these values do not constitute a threshold at which adverse neonatal outcomes appear or markedly increase. A group of 3505 pregnant women were administered a 2-hour 75-g glucose tolerance test. Women with values diagnostic of frank diabetes were excluded. The values were compared with birth weight because large birth weight is associated with diabetes in pregnancty. The following factors associated with increased birth weight: maternal race, number of pregnancies, height-to-weight ratio before pregnancy, pregnancy weight gain, length of pregnancy at time of testing, fasting plasma glucose value, and 2-hour glucose value after ingesting glucose. Birth weight tended to increase with increasing glucose values, but no threshold could be identified. The values proposed are offered because due to lack of clinically meaningful thresholds, consensus is the only way to establish diagnostic criteria for gestational diabetes.

Evaluation, Diagnosis, Medical screening, Health screening, Glucose tolerance tests, Glucose tolerance test

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Should the same glucose values be targeted for type 1 as for type 2 diabetics in pregnancy?

Article Abstract:

Less rigorous control of glucose levels during pregnancy in type 1 diabetics than in women with type 2 diabetes may not increase complications, and could decrease the incidence of dangerously low glucose levels. In 46 pregnant women with type 1 diabetes, average glucose levels were higher, with target values achieved less often, compared to 113 pregnant women with type 2 diabetes. There were no statistical differences between the groups with respect to final maternal or neonatal outcome, but the incidence of severe low blood sugar was much higher in the women with type 1 diabetes.

Care and treatment, Management, Blood sugar, Blood glucose

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What proportion of birth weight is attributable to maternal glucose among infants of diabetic women?

Article Abstract:

A study was conducted to determine the proportion of birth weight attributable to glucose concentrations of diabetic mothers. The results revealed that the maternal glycemia during third-trimester and prepregnancy body mass index are independent predictors of birth weight in pregnancies complicated by insulin requiring gestational or type 2 diabetes.

Health aspects, Risk factors, Birth weight, Pregnancy, Complications of, Pregnancy complications, Birth size

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