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
