Re: Impaired Glucose Tolerance vs Gestational Diabetes - treatment?
From: Andrew Folley (agfolley@hotmail.com)
Thu Nov 10 07:18:50 2005
I believe the standard is to repeat in 4 weeks with 3hr GTT for one
abnormal. agf
>From: evsono@pipeline.com (art fougner, md)
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: Re: Impaired Glucose Tolerance vs Gestational Diabetes -
>treatment?
>Date: Thu, 10 Nov 2005 05:39:28 -0600
>
>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
|
|
