The most recent edition of the journal "Diabetes Care", published by the American Diabetes Association has an article by Lois Jovanovic, M.D., the worlds most foremost authority on the subject of gestational diabetes. The article references a recent glucose study done by Dr. Paretti titled :
" Third Trimester Maternal Glucose Levels
From Diurnal Profiles in Nondiabetic Pregnancies:Correlation With
Sonographic Parameters of Fetal Growth"
The study and the article include important information concerning the level of normoglycemia-normal glucose. Most labs in the country list the normal range as 70-140. ACOG recently acknowledged that women in the range of 130-140 should still be treated as diabetic. Dr. Jovanovic now states that normal glucose levels for pregnant women are lower than normal levels for non pregnant women. This is consistant with the recent ACOG view but goes further. Dr. Jovanovic, noting the study of Dr. Paretti, suggests the high range of normal should be 120. This is very significant as it lowers the ACOG high normal by 10 and the present accepted lab value by 20.
Many women who have 120-140 on the glucose screen are told they are normal, when in fact they are gestational diabetic. They are not given the 3 hour GTT In many cases we can only confirm the gestational diabetes if the baby shows signs of hypoglycemia at birth. If the baby is not checked for hypoglycemia, and many are not, it makes the proof the the gestational diabetes difficult.
Those of you that have cases pending where diabetes is an issue, if you had a glucose screen of 120-140, you should bring this information and the recent ACOG study to the attention of your lawyers. For those of you that are pregnant and had a screen of 120-140, you should not accept being told that you are normal and should demand the three hour GTT.
If you have any questions, or want a copy of the article and/or study, please do not hesitate to contact me.
Ken Levine
BRL77@world.std.com
617-566-2700