February 27, 2010

Brand New Gestational Diabetes Cutoffs Point to Safe Levels

The cutoffs for diagnosing gestational diabetes--the kind that occurs during pregnancy--have always been more stringent than those used to diagnose the general population. Now a large study that matched maternal blood sugars with the outcome of the pregnancy has documented that even more stringent blood sugar limits are necessary to avoid diabetic problems during pregnancy.

Not so surprisingly, the new blood sugar targets they urge are very similar to those that are emerging from research connecting blood sugar levels with complications with diabetes in people who are NOT pregnant. (Details HERE.)

Here, from the report in Science Daily are the findings:
Based on a study of more than 23,000 women in nine countries, Metzger and an international group of 50 experts concluded a fasting blood sugar level of 92 or higher, a one-hour level of 180 or higher on a glucose tolerance test or a two-hour level of 153 or higher on a glucose tolerance test constitute serious risks to the mother and baby.
Science Daily: Gestational Diabetes: Blood Sugar Levels Once Considered Normal Are Not Safe for Baby, Mother

Compare these findings to the results in non-pregnant people that found that the presence in young men of a fasting blood sugar over 92 mg/dl predicted the development of diabetes a decade later, and that cardiovascular risk takes a major step up once the one hour glucose tolerance test result goes over 155. (Details HERE.)

Since complications kick in at these levels you would want to keep your blood sugar a bit lower, which is why I continue to suggest that you shoot for the "Five Percent Club" blood sugar targets. Note that the fasting number in our targets is higher, largely because so many people with diabetes will find the fasting number the hardest to lower. Most research, however, points to the post-meal numbers as being those that produce the complications.

The values before are for first thing in the morning fasting blood sugar and one and two hours after eating meals.


Jolly said...

is the 1-2 hours mark timed from the start of a meal, or the end of a meal?

Radhakrishna said...

After a long time of observation of my post prandials, I find that my peaking has slowly shifted from 1 hour to 2 hours after food (lunch or supper). A typical set of readings that I obtain nowadays are: Before lunch 4.3 mmol/L (78 mg/dL); 1 hr after lunch 6.1 (110); 1 1/2 hr 7.3 (132); 2 hrs 8.2 (148); 3 hrs 5.3 (96); 4 hrs 4.5 (81).

The above readings are after a lunch of rice and curries with carb content a little over 50g.

This is not the case after breakfast - the peaking then occurs at 1 hr and by 2 hrs, the BG would normally be around 5 (90). But my breakfast is light.

What is going on? Has digestion slowed down or is it indicative of some other deterioration.


Steve Parker, M.D. said...

Thanks for shining a spotlight on this important information.

I look forward to reading the entire article in the March issue of "Diabetes Care."


Jenny said...

Jolly, I saw a study that found the average blood sugar peak to occur 75 minutes after the beginning of eating.

Rad, It is possible your second phase insulin response is weakening but it is also possible your digestion has slowed. No way to know from the information you provide.