By Greg Arnold, DC, CSCS, March 31, 2010, abstracted from “International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy” in the March 2010 issue of Diabetes Care
Defined as "any degree of glucose intolerance during pregnancy" (1), gestational diabetes affects approximately 7% of all pregnancies and results in more than 200,000 cases each year. (2) Gestational diabetes affects the mother late in pregnancy and can hurt the baby, as the high blood sugar also gives the baby high blood glucose levels. This extra sugar in the baby's blood will get stored as fat and lead to what's called "macrosomia", or a "fat" baby (3). A new 2010 study has now placed the total cost of diabetes at $210 billion per year, with gestational diabetes costs now at $636 million per year (4).
Current medical approaches to maintaining blood sugar health during pregnancy include prescription drugs (5) while alternative approaches include exercise (6), and L-Carnitine (7). Now a new study (8) has found that blood sugar levels that qualify the diagnosis of gestational diabetes are actually lower than previously thought.
In the study, 25.000 pregnant women in the third trimester of pregnancy participating in the HAPO Study (9) were given a Glucose Tolerance Test (10) to assess for gestational diabetes. The researchers looked at birth weight, if there was a cesarean section delivery, blood sugar levels in the newborns, and levels of a protein called C-peptide in the umbilical cord, which indicates how much insulin the body is using and is a marker for diabetes (11).
At the completion of the pregnancies and looking at the data on the aforementioned outcomes, the researchers concluded that a fasting blood sugar level of 92 mg/dL or higher, a 1-hour level of 180 mg/dL or higher, or a 2-hour level of 153 mg/dL or higher on a glucose tolerance test should now qualify as a diagnosis of gestational diabetes.
What these new results now show is that the actual rate of gestational diabetes is more than double (16% of all pregnancies) than was previously thought (7% of all pregnancies). The current recommendations for fasting plasma glucose is 126 mg/dL or above and two-hour glucose is 200 mg/dL or above (12) to qualify for diabetes.
Greg Arnold is a Chiropractic Physician practicing in Danville, CA. You can contact Dr. Arnold directly by emailing him at mailto:PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com
1. Metzger BE, Coustan DR (Eds.): Proceedings of the Fourth International Work-shop-Conference on Gestational Diabetes Mellitus. Diabetes Care 21 (Suppl. 2):B1–B167, 1998
2. Gestational Diabetes Mellitus. Diabetes Care 2003; 26: 103S-105S
3. “Gestational Diabetes” posted on the American Diabetes Association Website http://www.diabetes.org/gestational-diabetes.jsp
4. Dall TM. The Economic Burden Of Diabetes. Health Affairs, Supplement 2010; 29(2): 297-303.
5. “Diabetes Mellitus During Pregnancy” posted on emedicine.com January 27, 2005 www.emedicine.com/med/topic3249.htm#section~medication
6. Zhang C. A Prospective Study of Pregravid Physical Activity and Sedentary Behaviors in Relation to the Risk for Gestational Diabetes Mellitus. Arch Intern Med. 2006;166:543-548.
7. Chemical Monthly 2005; 136: 1523-1533
8. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010; 33(3): 676-673
9. “Glucose Tolerance Test” - www.nlm.nih.gov/medlineplus/ency/article/003466.htm
10. HAPO Study Cooperative Research Group. The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. Intl J Gynaecol Obstet 2002;78:69-77
11. “C-peptide” - www.medterms.com/script/main/art.asp?articlekey=12467
12. “Diagnosing Diabetes” - http://diabetes.niddk.nih.gov/dm/pubs/diagnosis/