Gestational Diabetes info

[HariB]

Hey Birth Pros--

Posting for a friend here...who is possibly dealing with pregnancy blood sugar issues.  What are your most-respected places to find info about the normal range of blood sugar for pregnancy?  One CNM says, for instance, that fasting bs should be 95 or below...Anne Frye's book on pregnancy testing says it should be below 120, I believe...?  Anyway.  Are there books or websites that give good info on this question?

thanks!

[msmiranda]

I've seen a lot of sources, and I think there is general agreement about postprandials -- less than 140 after 1 hour, less than 120 after 2 hours.  Fasting is a bit more controversial, but in general sources say either below 95 or below 90 is the goal.  Here is a page from the Cleveland Clinic's website that shows these numbers:

http://my.clevelandclinic.org/disorders/diabetes_gestational/hic_gestational_diabetes.aspx

A more "conservative" practitioner will probably want fasting below 90.  A very conservative one might want 120 or below at 1 hour postprandial, and such providers would be more likely to jump quickly to insulin (as well as close monitoring for macrosomia and recommending other interventions like induction at 38-39 weeks and scheduled c-section for suspected macrosomia). 

ETA: On rereading your post, I realized that the numbers I cited above are for women who have already been diagnosed with GD.  Here is an article about how they are lowering the numbers for diagnosis based on recent research. http://www.sciencedaily.com/releases/2010/02/100226084005.htm.  Of course the numbers cited here are in response to the glucose tolerance test.

As for what's normal in pregnancy, many in the NCB community will say that some elevation of blood sugar levels is normal.  Henci Goer is most often cited -- here are two links.

http://www.ivillage.com/gestational-diabetes-3/6-a-129187?p=1

http://www.ivillage.com/gestational-diabetes-common-sense-approach/6-a-129188?p=1

As best I can tell, what is considered normal during pregnancy by the medical community is the same as what is considered normal in a non-pregnant, nondiabetic person. 

http://diabetes.webmd.com/blood-glucose?page=3

But the issue is that they have brought the GTT values down so that more women will be diagnosed as GD.  Maybe they did this because many of these women, were they monitoring at home, would exceed the above levels (depending on what they ate of course).  I could go on and on about this all day but really the solution for blood sugar elevation is control of the diet, and more exercise.  This will usually work.  Some women will need insulin to stay in normal range, but most can control with diet if they are strict enough with what they eat.

[HariB]

Thanks!  Just what I was looking for.