Subscribe to RSS
DOI: 10.1055/s-2004-820511
Longitudinal Changes in Plasma Glucose Values of the 75-g Glucose Tolerance Test in Triplet Pregnancies
Publication History
Publication Date:
11 March 2004 (online)
We evaluated longitudinal changing patterns of 75g glucose tolerance test (GTT) in triplet pregnancies. Eight triplet pregnancies were prospectively studied. All triplet pregnancies were fertilized with artificial reproductive techniques; patients showed no glucosuria or fasting hyperglycemia >100 mg/dL before pregnancy. The 75-g GTT was performed at first, second, and third trimester, as well as at postpartum. Longitudinal changes in glucose levels at fasting, 1 hour, and 2 hours were compared by one-way repeated-measure analysis of variance (ANOVA) and Bonferroni/Dunn test (p < 0.05). Values were expressed as mean ± standard deviation. Each of the 3-point values of 75-g GTT decreased after 28 weeks of gestation in triplet pregnancies. During the third trimester, fasting values were significantly decreased compared with postpartum values (65.5 ± 13.4 versus 74.6 ± 4.0 mg/dL), and 2-hour values were significantly decreased from those of second-trimester 75-g GTT (116.3 ± 19.5 versus 99.6 ± 17.1 mg/dL). Longitudinal glucose values of 75-g GTT improve during third trimester in triplet pregnancies, suggesting that fetoplacental fuel drain may counterbalance maternal insulin resistance.
KEYWORDS
Gestational diabetes mellitus - glucose tolerance test - triplet pregnancy
REFERENCES
- 1 Roach V J, Lau T K, Wilson D, Rogers M S. The incidence of gestational diabetes in multiple pregnancy. Aust N Z J Obstet Gynecol. 1998; 38 56-57
- 2 Shwartz D B, Daoud Y, Zazula P et al.. Gestational diabetes mellitus: metabolic and blood glucose parameters in singleton versus twin pregnancies. Am J Obstet Gynecol. 1999; 181 912-914
- 3 American College of Obstetricians and Gynecologists .Diabetes and Pregnancy. Technical Bulletin No. 200 1994
- 4 Metzger B E, Coustan D R. The organizing committee summary and recommendations of the fourth international workshop-conference on gestational diabetes mellitus. Diabetes Care. 1998; 21 B161-B167
- 5 Gillmer M DG, Beard R W, Brooke F M, Oakley N W. Carbohydrate metabolism in pregnancy. Part I, diurnal plasma glucose profile in normal and diabetic women. BMJ. 1975; 3 399-402
- 6 Lind T. Changes in carbohydrate metabolism during pregnancy. Clin Obstet Gynecol. 1975; 2 395-412
- 7 Campbell D M, Sutherland H W, Pearson D WM. Maternal glucose response to a standardized test meal throughout pregnancy and postnatally. Am J Obstet Gynecol. 1994; 171 143-146
- 8 Cousins L, Rigg L, Hollingsworth D, Brink G, Aurand J, Yen S SC. The 24-hour excursion and diurnal rhythm of glucose, insulin, and C-peptide in normal pregnancy. Am J Obstet Gynecol. 1980; 136 483-488
- 9 Rosso P. Carbohydrate metabolism. In: Rosso P Nutrition and Metabolism in Pregnancy: Mother and Fetus. New York; Oxford University Press 1990: 42-58
- 10 Angel J L, O'Brien W F, Knuppel R A, Morales W J, Sims C J. Carbohydrate intolerance in patients receiving oral tocolysis. Am J Obstet Gynecol. 1988; 159 762-766
- 11 Pritchard J A. Changes in blood volume during pregnancy. Anesthesiology. 1965; 26 393-399
Hiroshi SameshimaM.D.
Department of Obstetrics and Gynecology, Miyazaki Medical College
5200 Kihara, Kiyotake
Miyazaki, 889-1692, Japan