Investigators, analysing gestational diabetes data, have suggested that the optimal first step cut off for additional screening would be a blood sugar level of 135mg/dl for women carrying twins.
The findings, published in the American Journal of Obstetrics and Gynecology, suggest that screening cut off points for women carrying twins should not be based on singleton pregnancy data.
Nathan S. Fox, MD, Associate Clinical Professor, Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, said: “With the increasing prevalence of twin pregnancies, understanding how to better screen for GDM is important in this population because of the unique circumstances that may put this group at increased risk for development of insulin resistance, as well as their altered physiology, which would limit the ability to extrapolate from data derived from singleton pregnancies.”
Twin births make up around 16.1 of every 1000 births in the United Kingdom, increasing on average four per cent per year.
Gestational diabetes affects approximately six to seven per cent of pregnant women. It is believed to be caused by raised levels of human placental lactoge, cortisol, prolacti, estroge, and progesterone.
This study is an important step towards recognising and acting upon the significant differences between gestational diabetes in twin and single pregnancies. However, to more thoroughly develop guidelines for mothers carrying twins, more research is necessary. “There is much more to learn regarding GDM in twin pregnancies that could be addressed with future prospective studies,” said Dr. Fox. “More research is needed in twin pregnancies to confirm this finding in other populations, as well as to establish the optimal GDM screening and treatment paradigm in twin pregnancies.”

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