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Pregnant. Underwent GTT. Slight Improvement In The Result. Should Take Insulin Or Control By Diet And Exercise?

Posted on Tue, 9 Jul 2013

Question: My wife is currently 26 week pregnant. On 24th week (1 XXXXXXX 2013) she underwent GTT for which attaching the report for your reference. Past two weeks she was under controlled diet and exercise (only brisk walk for 30 min) as advised by doctor. Now again she went for GTT (17 XXXXXXX 2013) to see the progress and attaching the report for your reference. We saw the slight improvement in the result, but need your advice for significant improvement? Is she also need to take insulin or can it be reduced by controlled diet and/or exercise? Please advise.

Answered by Dr. Dr. Soumen Patra (35 hours later)

Hello,

Thanks for writing to us.

I have reviewed attached 2 reports and it reveals Impaired Glucose Tolerance (IGT). In this stage, controlling & monitoring of blood glucose is mandatory to prevent future development of Gestational Diabetes Mellitus (GDM) which can cause major risk for growing baby and pregnancy related complication.

IGT or GDM is significantly corrected after delivery of the baby and in the due time, periodic monitoring of blood glucose through OGTT, HbA1c, RBS (Random Blood Sugar) etc and supportive therapy can improve the condition with great extent.

As per Indian National Diabetes Data group, her 2nd test report of OGTT is near borderline of cut-off value than previous one. Here, diet control and mild to moderate exercise (at least 1 hr walking daily) are the key element. In addition, oral hypoglycemic agent (safe one) may be used to control blood sugar. Please consult with your obstetrician regarding this.

In my opinion, insulin is not required in this stage as per last test report. It is decided on the basis of periodic test result (abnormally high).

Hope, it helps for your information. If you have any other query, you can freely ask me.

Wish her good health and successful motherhood.

Regards,
Dr Soumen

Above answer was peer-reviewed by : Dr. Vasanth

Follow up: Dr. Dr. Soumen Patra (3 hours later)

Thank you doctor for your response.

Lats time when we consulted our doctor after 24 weeks GTT test, he told that only way to reduce blood sugar at the time of pregnancy is using Insulin and there is no oral medication is possible because she is pregnant. We're yet to consult our doctor after 26 weeks GTT report.

You've suggested Oral Hypoglycemic Agent instead of Insulin for reducing blood sugar. I want to know is the oral medicine you suggested because my wife 26 weeks GTT report reflects her blood sugar is near borderline of cut-off value. Please confirm.

Thank again for providing your valuable feedback.

Regards,
XXXXX

Answered by Dr. Dr. Soumen Patra (42 minutes later)

Hello,

Thanks for follow up query.

Subcutaneous insulin therapy is the mainstay of treatment for gestational diabetes mellitus (GDM), that is not controlled by modification of diet and exercise.

Some studies have shown that oral hypoglycemic agents like Metformin and Glyburide are effectively safe and alternative to insulin therapy for short term course. These are quite useful to treat IGT (Impaired Glucose Tolerance). Though, diet control and regular exercise are to be continued as described earlier. Please consult with your obstetrician regarding this for proper guidance.

Hope, I have answered your query. If you do not have any other query, you can close the discussion and rate the answer.

Good luck. Best wishes.

Regards,
Dr Soumen

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Above answer was peer-reviewed by : Dr. Vaishalee Punj