Importance of Postprandial Glucose Control

, Department of Medicine, University of Alabama at Birmingham School of Medicine

South Med J. 2001;94(8) 

In This Article

Postprandial Glucose Levels and Pregnancy Outcomes

In women who have gestational diabetes and require insulin, controlling postprandial plasma glucose levels has consistently been shown to result in better outcomes than controlling fasting plasma glucose. In a study that compared preprandial and postprandial monitoring of glycemic control in women with gestational diabetes, 33 women in the postprandial glucose control group had lower HbA1c levels. Their babies had lower birth weights, lower risk of neonatal hypoglycemia, and were less likely to be born by cesarean section than those of the 33 women randomly assigned to fasting glucose control.[31] The Diabetes in Early Pregnancy Study showed that high birth weight correlated closely with the mothers' third trimester nonfasting glucose levels.[32]

Similarly, Combs et al[33] reported that there was a strong correlation between macrosomia and high postprandial glucose levels occurring during the 29th to 32nd week of pregnancy. Demarini et al[34] studied two groups of pregnant women with different target levels of postprandial glucose, <120 and <140 mg/dL, respectively. Neonatal hypoglycemia occurred at a higher frequency in babies born to women in the <140 mg/dL group. Because of these studies, the American Diabetes Association now recommends monitoring both fasting and 1-hour plasma serum glucose levels during pregnancy.[35]

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