title: Meal related glucose monitoring is a method of diagnosing glucose intolerance in pregnancies with high probability of gestational diabetes but normal glucose tolerance by oral glucose tolerance test.
abstract: Gestational diabetes mellitus diagnosed by classical oral glucose tolerance test can result in fetal complications like macrosomia and polyhydramnios. Guidelines exist on management of patients diagnose by abnormal oral glucose tolerance test with diet modification followed by insulin. Even patients with abnormal oral glucose tolerance test maintaining apparently normal blood sugars with diet are advised insulin if there is accelerated fetal growth. But patients with normal oral glucose tolerance test can present with macrosomia and polyhydramnios. These patients are labelled as not having gestational diabetes mellitus and are followed up with repeat oral glucose tolerance test. We hypothesise that these patients may have an altered placental threshold to glucose or abnormal sensitivity of fetal tissues to glucose. Meal related glucose monitoring in these patients can identify minor abnormalities in glucose disturbance and should be treated to targets similar to physiological levels of glucose in non pregnant adults.
authors.affiliation: Providence Endocrine and Diabetes Specialty Centre, TC 1/2138, Near GG Hospital, Murinjapalam, Trivandrum 695011, India. drmathewjohn@yahoo.com
authors.forename: Mathew
authors.initials: M
authors.lastname: John
authors.forename: Deepa
authors.initials: D
authors.lastname: Gopinath
mesh_terms: D000328:Adult; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D016640:Diabetes, Gestational / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis / Q000188:drug therapy; D018149:Glucose Intolerance / Q000175:diagnosis*; D005951:Glucose Tolerance Test / Q000379:methods*; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008954:Models, Biological; D010920:Placenta / Q000378:metabolism; D006831:Polyhydramnios / Q000175:diagnosis / Q000188:drug therapy; D019518:Postprandial Period; D011247:Pregnancy
chemical_list: D007328:Insulin