Pregnancy-Related Insulin Toxicity
Gestational Diabetes Is a Misnomer. Pregnancy-related Insulin Toxicity Is the Appropriate Term. I Explain.
Majid Ali, M.D.
Three Reasons For Preferring Pregnancy-Related Insulin Toxicity
- The term gestational pregnancy clearly implies that diabetes is related to the fetus and can be expected to clear out by itself when the pregnancy ends. This is a regrettable misunderstanding. Various publications on the subject have reported that diabetes Type 2 developes in 30-50% of women in 3-10 years.
- There is no agreement on the criteria for the diagnosis of gestational diabetes. By contrast, there can be no disagreement on the concentration of blood insulin concentrations. Good laboratories can perform insulin tests with a high degree of precision and accuracy.
- Insulin profiles determined following a standard 75-gram glucose challenge provide precise numerical values for the fasting, 30-minutes, 0ne-hour, two-hour and three-hours blood samples.
- I have used the fasting and peak insulin concentrations in a 3-hour profile to be extremely valuable, both for the patients and the clinician.
Dr. Ali’s Insulin Course
I offer a free Insulin Course at this web site.
For the professional readers, below are selected and important citations for further studies.
- de Veciana M, Major CA, Morgan MA, Asrat T, Toohey JS, Lien JM, Evans AT: Postprandial versus preprandial blood glucose monitoring in women with gestational diabetes mellitus requiring insulin therapy. N Engl J Med 333:1237-41, 1995.
- Peters RK, Kjos SL, Xiang A, Buchanan TA: Long-term diabetogenic effect of single pregnancy in women with previous gestational diabetes mellitus. Lancet 347:227-30, 1996.
- Sermer M, Naylor D, Gare DJ, Kenshole AB, Ritchie JWK, Farine D, Cohen HR, McArthur K, Holzapfel S, Biringer A, Chen E, for the Toronto Tri-Hopital Gestational Diabetes Investigators: Impact of increasing carbohydrate intolerance on maternal-fetal outcomes in 3,637 women without gestational diabetes. Am J Obstet Gynecol 173:146-56, 1995.
- Coustan DR, Carpenter MW, O’Sullivan PS, Carr SR: Gestational diabetes mellitus: predictors of subsequent disordered glucose metabolism. Am J Obstet Gynecol 168:1139-45, 1993.