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Pregnant. Stopped taking progesterone. Suggested to drink glucose. Worried for gestational diabetes

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Practicing since : 1999
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Hi Dr. Raichle,

Thanks for all your help so far. I stopped the progesterone suppositories on Saturday and it's been 3 days now and I feel ok so I am happy about that.
I have another question. I just saw my regular obgyn today and he told me I have to drink the glucose drink and do the blood test at 25 weeks i.e. in the next few days. I asked him why not 28 weeks (which I have read is standard) but he said it's better to detect things early. So I was wondering, what if I develop gestational diabetes let's say between 26-28 weeks i.e. after the test? How would it be detected? I am asking since my dad, my grandma, my grandfather and great grandma all have diabetes so I am at a bit higher risk.
My endocrinologist constantly checks my sugar though through a regular glucose test (i.e. without drinking the glucose drink). So let's say if he was to give me a normal blood test around 30 weeks, and I happen to have the gestational diabetes then, would it be detected through a normal blood test i.e. is it possible for the test to show completely normal but for me to have the diabetes? Or would the glucose show elevated?
Also, I have the strips that test protein and sugar in the urine, so would these detect gestational diabetes or if they show normal, it means, I cannot have it?
Posted Sat, 9 Mar 2013 in Pregnancy
Answered by Dr. Timothy Raichle 1 hour later
Hello and thank you very much for the direct inquiry. It is my pleasure to try and help you today.

Yes, the standard timing for the diabetes screen is around 26-28 weeks, you are correct. That being said, there are patients in whom we sometimes do the screen earlier. These might include patients with:
1. A personal history of being overweight
2. A personal history of a condition called PCOS
3. A strong family history

In your case, from what little I know about you, based on your family history alone, it is reasonable to perform the test slightly earlier. With regard to your concern about it developing later, here are the ways that we detect gestational DM that seems to be "flying under the radar":

1. Every visit we test your urine for glucose (if present persistently it might indicated a problem)
2. We measure your fundal height (not a great test, but if the baby were big or there were extra fluid, which is associated with gestational DM, this might be abnormal and trigger further evaluation)

If you were concerned you could consider:

1. Having a random fasting glucose checked sometime in the third trimester
2. Checking your blood sugar using a finger-stick machine fasting and 1-2 hours after meals, randomly (talk with your doctor about blood sugar goals)

So, I think you are getting good care in terms of the timing of screening, and it would be reasonable to ask for some kind of simple followup plan, whether it is a third trimester ultrasound or check of blood sugars, to put your mind at ease and know that everything remains normal.

If you have any followup questions, please ask!
Above answer was peer-reviewed by
Follow-up: Pregnant. Stopped taking progesterone. Suggested to drink glucose. Worried for gestational diabetes 11 minutes later
Thank you very much dr. Raichle, so just to clarify, when you mention to have a random fasting glucose in the third trimester, do you mean a blood test when you drink the glucose drink or a blood test without drinking the drink (just fasting and having the blood drawn)?

Answered by Dr. Timothy Raichle 17 minutes later
You could do either:

1. A repeat 1 hour glucose tolerance test OR

2. A random fasting blood glucose

I just thought that #2 was a bit easier. In thinking about it further, assuming the current screen is normal, I think that some random fasting and after meal blood sugars might be the best way to go. Please ask if you would like further clarification.
Above answer was peer-reviewed by
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