USE OF A MORE PHYSIOLOGICAL ORAL GLUCOSE SOLUTION DURING SCREENING FOR GESTATIONAL DIABETES-MELLITUS

OBJECTIVES: We sought to compare in pregnant women deviations in gluco se 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 gl ucose 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 tota l of 132 pregnant women underwent (1) a standard 50 gm, 1-hour oral gl ucose screening test, (2) a 50 gm, 1-hour oral glucose screening test using the modified solution, and (3) a 9-hour oral glucose tolerance t est (with 100 gm of glucose in 300 ml of fluid, 1.85 mol/L). RESULTS: Compared with the ''standard'' regimen, both glucose and insulin value s were significantly higher in the ''modified'' regimen 30 minutes aft er ingestion, indicating a more rapid absorption of glucose. Nausea an d vomiting were greatly decreased with the modified glucose solution. The 1-hour glucose values were not statistically different. CONCLUSION S: A more dilute, more palatable oral glucose solution can be used to screen for gestational diabetes mellitus, yielding more accurate resul ts and eliminating unpleasant side effects.