Raspberry Leaf and Hypoglycemia in Gestational Diabetes Mellitus.

BACKGROUND: Raspberry leaf is commonly consumed by pregnant women. Hypoglycemic effects have been documented with other species within the plant family. Whether raspberry leaf affects glycemic control in gestational diabetes mellitus (GDM) is unknown. CASE: A 38-year-old nulliparous woman with GDM developed hypoglycemia requiring lowered insulin dose after consuming raspberry leaf tea at 32 weeks of gestation. The temporal relationship was confirmed by the patient's self-withdrawal and reintroduction of the herb. Fetal surveillance and growth were reassuring. A cesarean delivery was performed at 39 weeks of gestation. The neonate did not experience hypoglycemia or other complications. Placental biopsy revealed normal findings. CONCLUSION: Consumption of raspberry leaf may lead to reduced insulin requirements in GDM. Women with GDM should be cautioned about its use and their glucose levels more closely monitored.

Glucose intolerance in polycystic ovary syndrome--a position statement of the Androgen Excess Society.

OBJECTIVES: Women with polycystic ovarian syndrome (PCOS) are at increased risk for developing glucose intolerance and type 2 diabetes mellitus (DM). Recommendations for the timing and method of screening have varied. The purpose of this statement is to determine the optimal screening method, timing of screening, and treatment modalities for impaired glucose tolerance (IGT) among women with PCOS. PARTICIPANTS: The expert panel was appointed by the Androgen Excess Society (AES) to review the literature and make recommendations based on the available evidence. Meetings were open, and there was no funding for the panel. EVIDENCE: A systematic review was conducted of the published, peer-reviewed medical literature using MEDLINE to identify studies that addressed the prevalence, risk factors, testing, and treatment for IGT in both adults and adolescents with PCOS. Unpublished data were not considered. CONSENSUS PROCESS: The panel held meetings to review the literature and draft the statement as a committee. The AES board members reviewed and critiqued the manuscript, and changes were made based on their comments. CONCLUSIONS: The panel recommends that all patients with PCOS be screened for IGT with a 2-h oral glucose tolerance test. A few members of the AES board recommend alternatively screening women with PCOS for IGT and type 2 DM using an oral glucose tolerance test only in patients with a body mass index of 30 kg/m2 or greater or in lean patients with additional risk factors. Patients with normal glucose tolerance should be rescreened at least once every 2 yr, or more frequently if additional risk factors are identified. Those with IGT should be screened annually for development of type 2 DM. PCOS patients with IGT should be treated with intensive lifestyle modification and weight loss and considered for treatment with insulin-sensitizing agents.