Re: Impaired Glucose Tolerance vs Gestational Diabetes - treatment?
From: R. Daniel Braun (rd.braun@gmail.com)
Thu Nov 10 04:48:12 2005
Search for the work done by Oded Langer when he was in San Antonio. It makes
a good case for putting them on a diet, if I remember correctly.
Dan
On 11/10/05, art fougner, md <evsono@pipeline.com> wrote:
>
> OK ... so there is some evidence that one abnormal value is correlated
> with some abnormal outcomes. Would anyone therefore place these
> patients on a diabetic diet or are we simply repeating the GTT at a
> later time?
>
> art
>
> At Wed, 09 Nov 2005, Robert J. Carpenter, Jr. MD wrote:
> >
> >The 75 gm WHO std is not the std for dx in the US. Additionally the
> present of 1
> >elevated value in a large study from Italy years ago (the 2hr value)
> showed that
> >increasing value correlated with increased size and increased c/s rate
> (Tallerigho -
> >sp?). If GDM is dx, then retesting at 8-10wks PP with the 75gm WHO std is
> >appropriate for determination of class of glu tolerance
> >
> >On 8 Nov 2005 at 15:12, ainsron wrote:
> >
> >> 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
> >>
> >--
> >Robert J. Carpenter, Jr. MD
> >6624 Fannin, #2720
> >St. Luke's Medical Tower
> >Houston,TX 77030-2339
> >713-795-4600
> >
>
> --
> art fougner, md
>
> "I knew I was going to take the wrong train, so I left early."
> Lawrence Peter Berra
>
--
R. Daniel Braun
Kinky for Governor
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