--
Richard Chudacoff, MD
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Steve &
Eryl Raymond
Sent: Wednesday, October 06, 2004 10:47 PM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Metformin, early pregnancy and glucose screening
If the patient is on Metormin then her glucose tolerance will be at or
close to normal and there will be nothing to be gained by doing a
glucose screen. Simply keep an eye on her blood sugars after she stops
the Metformin as it is blood sugar elevation that causes the problems
seen in diabetic pregnancies. Remember that a screening test of any
sort is intended to find abnormal individuals in a general population
before they become symptomatic. This patient is hardly in that category
so doing a routine screening test in her makes no sense.
Steve Raymond
Garry E. Siegel, M.D. wrote:
>50 grams glucose randomly followed by a serum glucose in an hour, just
>like 24 to 28 weeks.
>
>I have no literature other than what I thought was the propensity to be
>more likely to be diabetic during pregnancy if a mature gravida. Thus,
>we are screening early and late on those 35 or more.
>
>Garry
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry
>E. Siegel, M.D.
>Sent: Tuesday, October 05, 2004 9:35 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: OB: Metformin, early pregnancy and glucose screening
>
>37 YO P1001 at 9 weeks, on metformin for insulin resistance. She is not
>overtly diabetic, and has a viable pregnancy. The referring REI has
>suggested that she stay on Metformin until 12 weeks.
>
>Normally, we screen for gestational diabetes at the initial visit for 35
>or mores, or if insulin resistant.
>
>Does anyone have any thoughts/information/reference as to whether she
>should delay her glucose screen until AFTER she stops Metformin, or not?
>
>The MFM and I both are using obstetric horse sense to say wait until
>after 12 weeks.
>
>Garry
>
