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Use of a more physiologic oral glucose solution during screening for gestational diabetes mellitus
J G Schwartz1, W T Phillips, M R Blumhardt
1Department of Pathology, University of Texas Health Science Center at San Antonio 78284-7750.
Objectives:
We sought to compare in pregnant women deviations in glucose values, insulin values, and the occurrence of side effects between a "standard" 50 gm oral glucose solution (50 gm of glucose in 150 ml of fluid, 1.85 mol/L) versus a modified "physiologic" 50 gm oral glucose solution (50 gm of glucose in 450 ml of fluid, 0.62 mol/L) as a screening test for gestational diabetes mellitus.
Study Design:
A total of 132 pregnant women underwent (1) a standard 50 gm, 1-hour oral glucose screening test, (2) a 50 gm, 1-hour oral glucose screening test using the modified solution, and (3) a 3-hour oral glucose tolerance test (with 100 gm of glucose in 300 ml of fluid, 1.85 mol/L).
Results:
Compared with the "standard" regimen, both glucose and insulin values were significantly higher in the "modified" regimen 30 minutes after ingestion, indicating a more rapid absorption of glucose. Nausea and vomiting were greatly decreased with the modified glucose solution. The 1-hour glucose values were not statistically different.
Conclusions:
A more dilute, more palatable oral glucose solution can be used to screen for gestational diabetes mellitus, yielding more accurate results and eliminating unpleasant side effects.