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Re: Impaired Glucose Tolerance vs Gestational Diabetes - treatment?From: ainsron (ainsron@sbcglobal.net)Tue Nov 8 14:10:31 2005
Here's the position paper from the American Diabetes Association: http://care.diabetesjournals.org/cgi/content/full/26/suppl_1/s103 If they IFG (impaired fasting glucose) or IGT (Impaired glucose tolerance) the recommendations only suggest retesting postpartum and annually. Retesting later in pregnancy, ~34 wks is also reasonable. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Natalie Melanson, RM Sent: Monday, November 07, 2005 6:28 PM To: Multiple recipients of list OB-GYN-L Subject: Impaired Glucose Tolerance vs Gestational Diabetes - treatment? First a brief intro: I am a registered midwife working in a group practice in Northern Ontario, Canada. Notwithstanding the controversy surrounding even screening for GDM - at our practice we do screening based on risk factors - I am wondering what everyone's treatment protocol is regarding confirmed Gestational Diabetes vs "just" Impaired Glucose Tolerance of pregnancy, ie. only one elevated value on 75g GTT that is NOT diagnostic of GDM. Do you do the same diet counseling, glucose monitoring, fetal monitoring in the last trimester, etc? My feeling is that diet counseling should be enough for IGT and then perhaps repeat the test after a month or so of dietary changes. thanks, Natalie Melanson, RM Sudbury Community Midwifery Practice Sudbury, Ontario
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