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Diabetes ScreeningFrom: CNMPAT@aol.comTue Aug 27 16:16:07 1996
I wasn't sure whether you were directing your comments to me, so will clarify, since my name is mentioned. "Risk factors" for me does not equal a known diabetic. Risk factors would include: obesity (> 200 #, HX LGA, HX Gestatinal Diabetes with a previous pregnancy, age > 35, etc). These are women we consider screening early in pregnancy on the off chance they might be a gestational diabetic. We always screen everyone at 26-28 weeks as per guidelines. I am interested in something simpler for screening during pregnancy. Some women do not like the glucola, and the 3 hour GTT is not fun, but we do it when indicated. I would never suggest doing a glucola screen on a known Diabetic. As a matter of fact, CNMs in our practice don't care for IDD's. My second comment (below) was in reference to the concluding coment below about one individual's use of HGA1C. Again, thank you all for your comments about the pros and cons of this type of screening. <<I think you missed the boat. I would only do this on a known Diabetic and I would never do a 50 Gm glucola screen on a known diabetic (This is a good way to screw up whatever kind of control they might already have.) Kind of like throwing in 2 Hershy bars without any extra insulin. The 50 gram glucola is only intended to screen a low risk population to determine who in that population needs a 3 hour Glucose Tolerance Test. It is a screening test just like a pap smear is to determine which low risk patients need a colposcopy It does not diagnose cancer and the 50 gm. glucola test doesnot diagnose diabetes AND it should never be done on a diabetic.>> <<This is why we have to be very specific in what we are talking about and why the (Reader) listener must pay attention to all the details and not apply something in a manner in which it has not been tested or intended.
>>> <CNMPAT@aol.com> 08/25/96 11:38am >>> This certainty makes sense to me Pat Sonnenstuhl, CNM,ARNP,RH South Sound Women's Center: 2 CNMs and 3 OB/GYNs Olympia, WA cnmpat@aol.com HTTP://home.aol.com/CNMPAT August 25, 1996 9:30 am
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