Patient's Query
Hi doctor,
I would like to schedule a regular pregnancy consultation regarding my increasing blood glucose levels. I think it is important to consult with my doctor about this issue.
Please guide.
Hi,
Welcome to icliniq.com.
I read your query and understand your concerns.
I have read your query and understand your concerns. It is completely normal to want to know about blood glucose levels during pregnancy. Based on the results you provided, your blood glucose tests are all normal.
However, please note that insulin resistance (the hormone that controls glucose metabolism) varies during pregnancy, peaking between 24 and 28 weeks. Therefore, if your tests were conducted before this period, I highly recommend repeating the tests between 24 and 28 weeks of pregnancy. Doing so will help determine if you have gestational diabetes.
It is essential to closely monitor your blood sugar levels during pregnancy, as elevated blood sugar can lead to complications for both the mother and the child. These complications can have both immediate and long-term effects.
Additionally, certain risk factors can increase the likelihood of abnormal glucose metabolism and the potential development of gestational diabetes. Here are some factors to consider:
Are you obese?
Is there any family history of diabetes mellitus (DM)?
Do you have a history of diabetes?
If this is not your first pregnancy, did you experience gestational diabetes in a previous pregnancy or deliver a macrosomic child (weighing over 4.0 kg)?
Your answers to these questions will help me assess your risk more accurately.
Also, the prenatal medications you are taking are appropriate. Please continue with them.
I hope this answers your query. Feel free to reach out anytime.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
We are currently 30 weeks into our first pregnancy. My pre-pregnancy BMI is 27, and I have a family history of type 2 Diabetes, as my father has it. I also have PCOS. During our third-month OGTT (75g glucose test), my results were normal, with a 2-hour reading of 113 mg/dl (indicating no gestational diabetes mellitus, or GDM). However, in our 28th week, the OGTT returned positive, with a 2-hour reading of 155 mg/dl.
One of our doctors mentioned that she would manage it through diet alone, with a goal of keeping postprandial sugar levels between 120 and 140 mg/dl. The doctor prescribed only postprandial sugar tests to monitor for GDM.
We consulted another senior gynecologist with over 20 years of experience specializing in GDM. She emphasized the seriousness of our situation and recommended that we regularly monitor our sugar levels, ensuring that our 2-hour post-meal glucose levels are below 120 mg/dl.
This conflicting information has left me confused. I checked the guidelines for GDM, which state that GDM should be confirmed only through the OGTT and that we need to keep our sugar levels below 120 mg/dl. If we cannot do that, we should start medication.
Unfortunately, the doctor here does not follow these guidelines. She did not provide a proper diet plan, only advising me to avoid sweets. Now, I am increasingly worried. Initially, we planned to have the delivery with this doctor, but we are uncertain about how to proceed given the discrepancies in advice.
Additionally, my postprandial test results vary from time to time; one test shows 135 mg/dl while another shows 118 mg/dl. My family, believing the first doctor's assessment that it is not GDM, does not see this as a major issue and is unsupportive of my need to follow a strict diet.
However, the senior doctor warned that without adhering to a proper diet and managing sugar levels, there is a high risk of complications. We are very concerned about our health and the well-being of our baby.
Please guide.
Hi,
Welcome back to icliniq.com.
The senior doctor is correct; the oral glucose tolerance test (OGTT) is the test used to screen for gestational diabetes mellitus (GDM). Would it be possible for you to see another doctor?
Please keep in mind that the 2-hour postprandial glucose level should be less than 120 mg/dL. If your 2-hour postprandial glucose level is greater than 120 mg/dL, you will need to start medication. In the meantime, discuss with your partner the importance of proper dietary control.
I hope this information helps with your query. Your feedback and ratings are valuable for improving patient care.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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