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GLUCOSURIA IN PREGNANCYGlucosuria is defined as the presence of glucose in the urine with a dipstick reading + to ++++ .
If one dipstick reading of + to ++++ , with no symptoms or family history occurs, the midwife should evaluate diet and repeat urine dipstick.
Nutritional therapy is very important with a diet very high in protein and complex carbohydrates, with ample calories and limited sugars is usually recommended. Chromium picolinate supplements may be helpful. Regular, aerobic exercise is encouraged.
Blood glucose testing can be done using a hand-held glucose monitoring system used by diabetics. There are many on the market and these can be purchased over-the-counter at a local drug store along with the blood-glucose testing strips. They are very similar to the urine dipsticks and can be read with an electronic device, which is more accurate, or by sight and comparing the color of the strip with the colors shown on the strip bottle. Instructions should be carefully read and followed for accurate results. Fasting (no food for at least 12 hours) levels should be under 90 mg/dl for normal whole blood. The glucose levels will depend upon the foods she has eaten, the time lapse since her last meal, whether she has exercised after her last meal and whether or not she is smoking cigarettes.
GLUCOSE SCREEN: The most common test for gestational diabetes is called a glucose screen. With this test the mother ingests 50 mg of liquid glucose and her blood is drawn an hour later. This test gives a great deal of false positives. However, if the blood glucose level is above 140 mg/dl she is usually given further testing with an OGTT.OGTT - ORAL GLUCOSE TOLERANCE TEST: The mother must fast without food for at least 12 hours before testing. The blood is drawn to establish a baseline glucose level. She is then given 100 mg glucose syrup orally. In the commonly used OGTT, she has her blood drawn at one, two and three hours. During the this time she is not allowed to eat or smoke. The test should use whole blood, not plasma for this test. If two of the following levels are met or exceeded, a diagnosis is made as gestational diabetes.
1. fasting, above 90 mg/dl
2. one hour, above 165 mg/dl
3. two hour, above 145 mg/dl
4. three hour, above 125 mg/dl
Caution should be taken when using liquid oral glucose for testing. This substance often causes nausea, vomiting, headaches, profuse sweating or bloating. An alternative to liquid glucose would be to use the "Jelly Bean Test", with 18 jelly beans substituted for the 50 mg of glucola.
2-HOUR POST PRANDIAL TEST: This is possibly the most reliable test at this time. A fasting blood sample is desired for a baseline level after a 12 hour fast. The mother is then given a full meal high in calories and complex carbohydrates. She has her blood drawn two hours later. Readings will be more accurate if she has done some exercising lightly after eating. Normal levels are 120 to 140 mg/dl.
MoonDragon's Obgyn Information & Discussion - Gestational Diabetes (GD)
MoonDragon's Obgyn Information & Discussion - Gestational Diabetes Intro
American Diabetes Association - Clinical Practice Recommendations
NIH Index - Government Publications About Gestational Diabetes
Plus Size Pregnancy Website by Kmom
Kmom has some excellent information & resources about Gestational
Diabetes and the larger woman.
MoonDragon's Nutritional Guidelines & Information
MoonDragon's Birthing Guidelines Index
MoonDragon's Birthing Guidelines - Pregnancy Variations
MoonDragon's ObGyn Information & Discussion Index by Subject Order
MoonDragon's ObGyn Information & Discussion Index by Alphabetical Order