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What Does Impaired Glucose Tolerance During Pregnancy Indicate?
Question: Hi,
This is regarding my wife who is 29 years old. She has Hypothyroidism and a little overweight (5-7 kilos). She has polycystic ovaries with but last week we came to know that she is 3 weeks pregnant. However, there has been concerns- Her glcose tolerance test came ( after 50 gm glucose ingestion) 191 (normal range <150) Her TSH is normal and she is on the medication Thyronorm 25 mcg. Her Hb is 11.7 ( normal is 12-17). She has been prescribed Human Chorionic Gonadotropin (HCG) 5000iu (Corion) Injection for first two shots and then 2000IU for next 12 weeks. She is also on Susten , Folvite 5mg, Metformin 500mg thrice daily. I am concerned about the entire situation. I have heard that Corion is contra-indicated during pregnancy. I am not sure if the treatment is good enough or if I need to change the doctor? Please suggest as I am confused.
This is regarding my wife who is 29 years old. She has Hypothyroidism and a little overweight (5-7 kilos). She has polycystic ovaries with but last week we came to know that she is 3 weeks pregnant. However, there has been concerns- Her glcose tolerance test came ( after 50 gm glucose ingestion) 191 (normal range <150) Her TSH is normal and she is on the medication Thyronorm 25 mcg. Her Hb is 11.7 ( normal is 12-17). She has been prescribed Human Chorionic Gonadotropin (HCG) 5000iu (Corion) Injection for first two shots and then 2000IU for next 12 weeks. She is also on Susten , Folvite 5mg, Metformin 500mg thrice daily. I am concerned about the entire situation. I have heard that Corion is contra-indicated during pregnancy. I am not sure if the treatment is good enough or if I need to change the doctor? Please suggest as I am confused.
Brief Answer:
The treatment is correct.
Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
The impaired glucose tolerance test is worrisome. She needs to follow the diabetic diet as advised by her gynecologist. She can continue taking thyronorm. HCG is a hormone that is normally secreted by placenta during the pregnancy. The injections are given in early pregnancy to sustain the pregnancy. It decreases the chances of threatened abortion. There is no harmful effect of these injections on the baby . Please do not worry. Your wife is getting the right treatment. You can continue with it.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal
The treatment is correct.
Detailed Answer:
Hello,
Thanks for trusting us with your health concern.
The impaired glucose tolerance test is worrisome. She needs to follow the diabetic diet as advised by her gynecologist. She can continue taking thyronorm. HCG is a hormone that is normally secreted by placenta during the pregnancy. The injections are given in early pregnancy to sustain the pregnancy. It decreases the chances of threatened abortion. There is no harmful effect of these injections on the baby . Please do not worry. Your wife is getting the right treatment. You can continue with it.
Please feel free to discuss further. I will be glad to answer the follow up queries that you have.
Wishing you good health.
Regards.
Dr. Rakhi Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Rakhi-Tayal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi doctor,
Thank you for your help I feel relieved now. I have a few more questions that I didn't or rather could not ask my doctor.
1.As you can see that her haemoglobin level is below normal. Is it okay to give her iron tables like Orofer or Dexorange? or even multi vitamin tablets? Her doctor didn't give any apart from Folic acid 5mg. But I somehow feel that she may need a supplement. Would you suggest any prenatal multivitamin?
2. She never had diabetes but do you think that the abnormal GTT result is related to her pregnancy and may subside after child birth?
Thank you for your help I feel relieved now. I have a few more questions that I didn't or rather could not ask my doctor.
1.As you can see that her haemoglobin level is below normal. Is it okay to give her iron tables like Orofer or Dexorange? or even multi vitamin tablets? Her doctor didn't give any apart from Folic acid 5mg. But I somehow feel that she may need a supplement. Would you suggest any prenatal multivitamin?
2. She never had diabetes but do you think that the abnormal GTT result is related to her pregnancy and may subside after child birth?
Brief Answer:
Iron supplements are started after 14 weeks.
Detailed Answer:
Hello.
Thanks for writing again.
1. The hemoglobin level at 11.7 is just borderline low. It is best to start with iron supplements after 14 weeks. It is too early to start the supplements. It can cause more nausea, gastritis and constipation. She can take iron rich foods in her diet right now.
2. Yes. The abnormal GTT is due to pregnancy- can cause gestational diabetes during pregnancy. The levels will come back to normal soon after delivery.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Iron supplements are started after 14 weeks.
Detailed Answer:
Hello.
Thanks for writing again.
1. The hemoglobin level at 11.7 is just borderline low. It is best to start with iron supplements after 14 weeks. It is too early to start the supplements. It can cause more nausea, gastritis and constipation. She can take iron rich foods in her diet right now.
2. Yes. The abnormal GTT is due to pregnancy- can cause gestational diabetes during pregnancy. The levels will come back to normal soon after delivery.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi doctor,
Thank you very much for your help. Final question.
1. She is on a diabetic diet but are there any fruit /vegetable /food she should avoid?
2. Any helpful tips you may want to share would be appreciated.
Thank you very much for your help. Final question.
1. She is on a diabetic diet but are there any fruit /vegetable /food she should avoid?
2. Any helpful tips you may want to share would be appreciated.
Brief Answer:
Detailed below.
Detailed Answer:
Foods to be avoided: Glucose, sugars, honey, jaggery, all sweets, chocolates, ice creams and candies.
Foods to be restricted: Vegetables like Potatoes, yam, arbi, sweet potatoes; Fruits like XXXXXXX bananas, sapota, seethaphal, and avocado .Alcoholic beverages, carbonated beverages ,fried foods, Dry fruits and nuts, salad dressings like mayonnaise, cream ,etc, cakes and pastries, Tender coconut water, Refined flours like maida .Papad, Pickle, soda bicarbonate, MSG, sauces, Ketchup’s. Non-veg: Red meats, organ meats (liver, kidney), shell fish like prawns, crabs, lobster and egg yolk.
Foods to be used freely: Green leafy vegetables, tomatoes, cucumber. Radish, carrot, homemade soups. Tea, Coffee without sugar, and skimmed milk, buttermilk. Whole wheat flour, Ragi, Corn flakes, Wheat flakes. Artificial sweeteners not more than 4 numbers/pellets per day. Use Low sodium salt only.
Few useful tips for her-
1.) Let her eat fiber rich fresh fruits and green leafy vegetables and avoid foods which are not easily digestible and fatty foods
2.) Let her have six small meals instead of 3 large meals
3.) Drink plenty of fluids
4.) Go for regular Brisk walks for 30 to 40 minutes daily.
Regards.
Detailed below.
Detailed Answer:
Foods to be avoided: Glucose, sugars, honey, jaggery, all sweets, chocolates, ice creams and candies.
Foods to be restricted: Vegetables like Potatoes, yam, arbi, sweet potatoes; Fruits like XXXXXXX bananas, sapota, seethaphal, and avocado .Alcoholic beverages, carbonated beverages ,fried foods, Dry fruits and nuts, salad dressings like mayonnaise, cream ,etc, cakes and pastries, Tender coconut water, Refined flours like maida .Papad, Pickle, soda bicarbonate, MSG, sauces, Ketchup’s. Non-veg: Red meats, organ meats (liver, kidney), shell fish like prawns, crabs, lobster and egg yolk.
Foods to be used freely: Green leafy vegetables, tomatoes, cucumber. Radish, carrot, homemade soups. Tea, Coffee without sugar, and skimmed milk, buttermilk. Whole wheat flour, Ragi, Corn flakes, Wheat flakes. Artificial sweeteners not more than 4 numbers/pellets per day. Use Low sodium salt only.
Few useful tips for her-
1.) Let her eat fiber rich fresh fruits and green leafy vegetables and avoid foods which are not easily digestible and fatty foods
2.) Let her have six small meals instead of 3 large meals
3.) Drink plenty of fluids
4.) Go for regular Brisk walks for 30 to 40 minutes daily.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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