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	{mso-style-noshow:yes;
	mso-style-parent:"TOC Base";
	margin-top:0in;
	margin-right:0in;
	margin-bottom:11.0pt;
	margin-left:1.0in;
	text-indent:-.25in;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	tab-stops:right dotted 6.5in;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoEnvelopeAddress, li.MsoEnvelopeAddress, div.MsoEnvelopeAddress
	{mso-style-parent:"Body Text";
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:2.0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	mso-element:frame;
	mso-element-frame-width:5.5in;
	mso-element-wrap:around;
	mso-element-anchor-horizontal:page;
	mso-element-left:center;
	mso-element-top:bottom;
	mso-height-rule:exactly;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoEnvelopeReturn, li.MsoEnvelopeReturn, div.MsoEnvelopeReturn
	{mso-style-parent:"Body Text";
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
span.MsoFootnoteReference
	{mso-style-noshow:yes;
	mso-style-parent:"";
	vertical-align:super;}
span.MsoCommentReference
	{mso-style-noshow:yes;
	mso-style-parent:"";
	mso-ansi-font-size:8.0pt;}
span.MsoLineNumber
	{mso-style-parent:"";
	mso-ansi-font-size:9.0pt;}
span.MsoPageNumber
	{mso-style-parent:"";
	mso-ansi-font-size:9.0pt;
	font-family:Arial;
	mso-ascii-font-family:Arial;
	mso-hansi-font-family:Arial;
	mso-bidi-font-family:Arial;
	font-weight:bold;
	mso-bidi-font-weight:normal;}
span.MsoEndnoteReference
	{mso-style-noshow:yes;
	mso-style-parent:"";
	font-weight:bold;
	mso-bidi-font-weight:normal;
	vertical-align:super;}
p.MsoEndnoteText, li.MsoEndnoteText, div.MsoEndnoteText
	{mso-style-noshow:yes;
	mso-style-parent:"Footnote Base";
	margin-top:0in;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:.75in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan lines-together;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:9.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";}
p.MsoToa, li.MsoToa, div.MsoToa
	{mso-style-noshow:yes;
	margin-top:0in;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:1.0in;
	margin-bottom:.0001pt;
	text-indent:-.25in;
	mso-pagination:widow-orphan;
	tab-stops:right dotted 5.25in;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";}
p.MsoMacroText, li.MsoMacroText, div.MsoMacroText
	{mso-style-noshow:yes;
	margin-top:0in;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:.75in;
	margin-bottom:.0001pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:"Courier New";
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoToaHeading, li.MsoToaHeading, div.MsoToaHeading
	{mso-style-noshow:yes;
	mso-style-next:"Table of Authorities";
	margin-top:12.0pt;
	margin-right:0in;
	margin-bottom:6.0pt;
	margin-left:.75in;
	line-height:18.0pt;
	mso-line-height-rule:exactly;
	mso-pagination:widow-orphan;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:14.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";
	mso-font-kerning:14.0pt;
	font-weight:bold;
	mso-bidi-font-weight:normal;}
p.MsoList, li.MsoList, div.MsoList
	{mso-style-parent:"Body Text";
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListBullet, li.MsoListBullet, div.MsoListBullet
	{mso-style-parent:List;
	margin-top:6.0pt;
	margin-right:.5in;
	margin-bottom:0in;
	margin-left:.5in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListNumber, li.MsoListNumber, div.MsoListNumber
	{mso-style-parent:List;
	margin-top:6.0pt;
	margin-right:.5in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoList2, li.MsoList2, div.MsoList2
	{mso-style-parent:List;
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:1.25in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoList3, li.MsoList3, div.MsoList3
	{mso-style-parent:List;
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:1.5in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoList4, li.MsoList4, div.MsoList4
	{mso-style-parent:List;
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:1.75in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoList5, li.MsoList5, div.MsoList5
	{mso-style-parent:List;
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:2.0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListBullet2, li.MsoListBullet2, div.MsoListBullet2
	{mso-style-parent:"List Bullet";
	margin-top:6.0pt;
	margin-right:.5in;
	margin-bottom:0in;
	margin-left:1.5in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListBullet3, li.MsoListBullet3, div.MsoListBullet3
	{mso-style-parent:"List Bullet";
	margin-top:6.0pt;
	margin-right:.5in;
	margin-bottom:0in;
	margin-left:1.75in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListBullet4, li.MsoListBullet4, div.MsoListBullet4
	{mso-style-parent:"List Bullet";
	margin-top:6.0pt;
	margin-right:.5in;
	margin-bottom:0in;
	margin-left:2.0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListBullet5, li.MsoListBullet5, div.MsoListBullet5
	{mso-style-parent:"List Bullet";
	margin-top:6.0pt;
	margin-right:.5in;
	margin-bottom:0in;
	margin-left:2.25in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListNumber2, li.MsoListNumber2, div.MsoListNumber2
	{mso-style-parent:"List Number";
	margin-top:6.0pt;
	margin-right:.5in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListNumber3, li.MsoListNumber3, div.MsoListNumber3
	{mso-style-parent:"List Number";
	margin-top:6.0pt;
	margin-right:.5in;
	margin-bottom:0in;
	margin-left:1.75in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListNumber4, li.MsoListNumber4, div.MsoListNumber4
	{mso-style-parent:"List Number";
	margin-top:6.0pt;
	margin-right:.5in;
	margin-bottom:0in;
	margin-left:2.0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListNumber5, li.MsoListNumber5, div.MsoListNumber5
	{mso-style-parent:"List Number";
	margin-top:6.0pt;
	margin-right:.5in;
	margin-bottom:0in;
	margin-left:2.25in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoTitle, li.MsoTitle, div.MsoTitle
	{mso-style-parent:"Heading Base";
	mso-style-next:"Heading 1";
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:.25in;
	margin-left:0in;
	line-height:22.0pt;
	mso-pagination:widow-orphan lines-together;
	page-break-after:avoid;
	background:#E5E5E5;
	mso-shading:windowtext;
	mso-pattern:gray-10 auto;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	border:none;
	mso-border-bottom-alt:solid windowtext .75pt;
	padding:0in;
	mso-padding-alt:0in 0in 4.0pt 0in;
	font-size:18.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoClosing, li.MsoClosing, div.MsoClosing
	{margin-top:0in;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:.75in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";}
p.MsoSignature, li.MsoSignature, div.MsoSignature
	{mso-style-parent:"Body Text";
	margin-top:33.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan lines-together;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoBodyText, li.MsoBodyText, div.MsoBodyText
	{margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoBodyTextIndent, li.MsoBodyTextIndent, div.MsoBodyTextIndent
	{mso-style-parent:"Body Text";
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:1.0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListContinue, li.MsoListContinue, div.MsoListContinue
	{mso-style-parent:List;
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:1.25in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListContinue2, li.MsoListContinue2, div.MsoListContinue2
	{mso-style-parent:"List Continue";
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:1.5in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListContinue3, li.MsoListContinue3, div.MsoListContinue3
	{mso-style-parent:"List Continue";
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:1.75in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListContinue4, li.MsoListContinue4, div.MsoListContinue4
	{mso-style-parent:"List Continue";
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:2.0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoListContinue5, li.MsoListContinue5, div.MsoListContinue5
	{mso-style-parent:"List Continue";
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:2.25in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoMessageHeader, li.MsoMessageHeader, div.MsoMessageHeader
	{mso-style-parent:"Body Text";
	margin-top:6.0pt;
	margin-right:1.5in;
	margin-bottom:6.0pt;
	margin-left:0in;
	text-indent:-.75in;
	line-height:14.0pt;
	mso-line-height-rule:exactly;
	mso-pagination:widow-orphan lines-together;
	tab-stops:2.5in 3.25in;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:11.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoSubtitle, li.MsoSubtitle, div.MsoSubtitle
	{mso-style-parent:Title;
	mso-style-next:"Body Text";
	margin-top:0in;
	margin-right:0in;
	margin-bottom:8.0pt;
	margin-left:0in;
	line-height:20.0pt;
	mso-pagination:widow-orphan lines-together;
	page-break-after:avoid;
	background:#E5E5E5;
	mso-shading:windowtext;
	mso-pattern:gray-10 auto;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	border:none;
	mso-border-bottom-alt:solid windowtext .75pt;
	padding:0in;
	mso-padding-alt:0in 0in 4.0pt 0in;
	font-size:17.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";
	letter-spacing:-.7pt;
	font-weight:bold;
	font-style:italic;
	mso-bidi-font-style:normal;}
p.MsoDate, li.MsoDate, div.MsoDate
	{mso-style-parent:"Body Text";
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoBodyText2, li.MsoBodyText2, div.MsoBodyText2
	{mso-style-parent:"Body Text";
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:1.0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoBodyText3, li.MsoBodyText3, div.MsoBodyText3
	{mso-style-parent:"Body Text Indent";
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:1.0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MsoBlockText, li.MsoBlockText, div.MsoBlockText
	{margin-top:0in;
	margin-right:1.0in;
	margin-bottom:6.0pt;
	margin-left:1.0in;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";}
em
	{mso-style-parent:"";
	font-family:Arial;
	mso-ascii-font-family:Arial;
	mso-hansi-font-family:Arial;
	mso-bidi-font-family:Arial;
	letter-spacing:-.2pt;
	font-weight:bold;
	mso-bidi-font-weight:normal;
	font-style:normal;}
p.HeadingBase, li.HeadingBase, div.HeadingBase
	{mso-style-name:"Heading Base";
	mso-style-next:"Body Text";
	margin-top:7.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:.75in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan lines-together;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:11.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";
	letter-spacing:-.2pt;
	mso-font-kerning:14.0pt;}
p.FootnoteBase, li.FootnoteBase, div.FootnoteBase
	{mso-style-name:"Footnote Base";
	margin-top:0in;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:.75in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan lines-together;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:9.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";}
p.BlockQuotation, li.BlockQuotation, div.BlockQuotation
	{mso-style-name:"Block Quotation";
	mso-style-parent:"Body Text";
	margin-top:6.0pt;
	margin-right:.5in;
	margin-bottom:3.0pt;
	margin-left:1.0in;
	line-height:11.0pt;
	mso-pagination:widow-orphan lines-together;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	border:none;
	mso-border-left-alt:solid gray 4.5pt;
	mso-border-bottom-alt:solid white 6.0pt;
	padding:0in;
	mso-padding-alt:0in 0in 3.0pt 3.0pt;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";
	font-style:italic;
	mso-bidi-font-style:normal;}
p.BodyTextKeep, li.BodyTextKeep, div.BodyTextKeep
	{mso-style-name:"Body Text Keep";
	mso-style-parent:"Body Text";
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.Picture, li.Picture, div.Picture
	{mso-style-name:Picture;
	mso-style-next:Caption;
	margin-top:0in;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:.75in;
	margin-bottom:.0001pt;
	mso-pagination:widow-orphan;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";}
p.DocumentLabel, li.DocumentLabel, div.DocumentLabel
	{mso-style-name:"Document Label";
	mso-style-parent:"Heading Base";
	mso-style-next:"Body Text";
	margin-top:8.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:.75in;
	margin-bottom:.0001pt;
	mso-line-height-alt:11.0pt;
	mso-pagination:widow-orphan lines-together;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:30.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";
	letter-spacing:-1.5pt;
	mso-font-kerning:14.0pt;}
p.MessageHeaderFirst, li.MessageHeaderFirst, div.MessageHeaderFirst
	{mso-style-name:"Message Header First";
	mso-style-parent:"Message Header";
	mso-style-next:"Message Header";
	margin-top:6.0pt;
	margin-right:1.5in;
	margin-bottom:6.0pt;
	margin-left:0in;
	text-indent:-.75in;
	line-height:14.0pt;
	mso-line-height-rule:exactly;
	mso-pagination:widow-orphan lines-together;
	tab-stops:2.5in 3.25in;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:11.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.HeaderBase, li.HeaderBase, div.HeaderBase
	{mso-style-name:"Header Base";
	margin:0in;
	margin-bottom:.0001pt;
	mso-pagination:widow-orphan lines-together;
	tab-stops:center 3.0in right 6.0in;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";
	letter-spacing:-.2pt;}
p.CompanyName, li.CompanyName, div.CompanyName
	{mso-style-name:"Company Name";
	mso-style-parent:"Document Label";
	margin-top:0in;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:.75in;
	margin-bottom:.0001pt;
	mso-line-height-alt:11.0pt;
	mso-pagination:widow-orphan lines-together;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:30.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";
	letter-spacing:-1.5pt;
	mso-font-kerning:14.0pt;}
p.Enclosure, li.Enclosure, div.Enclosure
	{mso-style-name:Enclosure;
	mso-style-parent:"Body Text";
	mso-style-next:Normal;
	margin-top:11.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan lines-together;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.ReferenceInitials, li.ReferenceInitials, div.ReferenceInitials
	{mso-style-name:"Reference Initials";
	mso-style-parent:"Body Text";
	mso-style-next:Enclosure;
	margin-top:6.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan lines-together;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.ReturnAddress, li.ReturnAddress, div.ReturnAddress
	{mso-style-name:"Return Address";
	margin:0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan lines-together;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	mso-element:frame;
	mso-element-frame-width:1.5in;
	mso-element-frame-height:60.0pt;
	mso-element-wrap:no-wrap-beside;
	mso-element-anchor-vertical:page;
	mso-element-anchor-horizontal:page;
	mso-element-left:462.05pt;
	mso-element-top:33.65pt;
	mso-element-anchor-lock:locked;
	font-size:8.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";}
p.SignatureJobTitle, li.SignatureJobTitle, div.SignatureJobTitle
	{mso-style-name:"Signature Job Title";
	mso-style-parent:Signature;
	mso-style-next:"Reference Initials";
	margin:0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan lines-together;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.SignatureName, li.SignatureName, div.SignatureName
	{mso-style-name:"Signature Name";
	mso-style-parent:Signature;
	mso-style-next:"Signature Job Title";
	margin-top:.5in;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan lines-together;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.MessageHeaderLast, li.MessageHeaderLast, div.MessageHeaderLast
	{mso-style-name:"Message Header Last";
	mso-style-parent:"Message Header";
	mso-style-next:"Body Text";
	margin-top:6.0pt;
	margin-right:1.5in;
	margin-bottom:20.0pt;
	margin-left:0in;
	text-indent:-.75in;
	line-height:14.0pt;
	mso-line-height-rule:exactly;
	mso-pagination:widow-orphan lines-together;
	tab-stops:2.5in 3.25in;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	border:none;
	mso-border-bottom-alt:solid windowtext .75pt;
	padding:0in;
	mso-padding-alt:0in 0in 22.0pt 0in;
	font-size:11.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.SubtitleCover, li.SubtitleCover, div.SubtitleCover
	{mso-style-name:"Subtitle Cover";
	margin-top:0in;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:.75in;
	margin-bottom:.0001pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";}
p.TitleCover, li.TitleCover, div.TitleCover
	{mso-style-name:"Title Cover";
	mso-style-parent:"Heading Base";
	mso-style-next:"Subtitle Cover";
	margin-top:1.25in;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:.75in;
	margin-bottom:.0001pt;
	mso-line-height-alt:12.0pt;
	mso-pagination:widow-orphan lines-together;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:36.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";
	letter-spacing:-2.4pt;
	mso-font-kerning:14.0pt;
	font-weight:bold;
	mso-bidi-font-weight:normal;}
p.IndexBase, li.IndexBase, div.IndexBase
	{mso-style-name:"Index Base";
	margin-top:0in;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:.25in;
	margin-bottom:.0001pt;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";}
p.SectionHeading, li.SectionHeading, div.SectionHeading
	{mso-style-name:"Section Heading";
	mso-style-parent:"Heading 1";
	margin-top:11.0pt;
	margin-right:0in;
	margin-bottom:11.0pt;
	margin-left:0in;
	line-height:14.0pt;
	mso-pagination:widow-orphan lines-together;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	border:none;
	mso-border-bottom-alt:solid windowtext .75pt;
	padding:0in;
	mso-padding-alt:0in 0in 1.0pt 0in;
	font-size:12.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";
	position:relative;
	top:-3.0pt;
	mso-text-raise:3.0pt;
	letter-spacing:-.5pt;
	mso-font-kerning:14.0pt;
	font-weight:bold;}
p.TOCBase, li.TOCBase, div.TOCBase
	{mso-style-name:"TOC Base";
	margin-top:0in;
	margin-right:0in;
	margin-bottom:11.0pt;
	margin-left:0in;
	line-height:11.0pt;
	mso-pagination:widow-orphan;
	tab-stops:right dotted 6.5in;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";}
p.SectionLabel, li.SectionLabel, div.SectionLabel
	{mso-style-name:"Section Label";
	mso-style-parent:"Heading Base";
	mso-style-next:"Body Text";
	margin-top:20.0pt;
	margin-right:0in;
	margin-bottom:22.0pt;
	margin-left:.75in;
	mso-line-height-alt:11.0pt;
	mso-pagination:widow-orphan lines-together;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:30.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";
	letter-spacing:-1.5pt;
	mso-font-kerning:14.0pt;}
p.FooterFirst, li.FooterFirst, div.FooterFirst
	{mso-style-name:"Footer First";
	mso-style-parent:Footer;
	margin-top:30.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	mso-pagination:widow-orphan lines-together;
	tab-stops:center 3.0in right 6.0in;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	border:none;
	mso-border-bottom-alt:solid windowtext .75pt;
	padding:0in;
	mso-padding-alt:0in 0in 1.0pt 0in;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";
	letter-spacing:-.2pt;
	font-weight:bold;
	mso-bidi-font-weight:normal;}
p.FooterEven, li.FooterEven, div.FooterEven
	{mso-style-name:"Footer Even";
	mso-style-parent:Footer;
	margin-top:30.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	mso-pagination:widow-orphan lines-together;
	tab-stops:center 3.0in right 6.0in;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	border:none;
	mso-border-bottom-alt:solid windowtext .75pt;
	padding:0in;
	mso-padding-alt:0in 0in 1.0pt 0in;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";
	letter-spacing:-.2pt;
	font-weight:bold;
	mso-bidi-font-weight:normal;}
p.FooterOdd, li.FooterOdd, div.FooterOdd
	{mso-style-name:"Footer Odd";
	mso-style-parent:Footer;
	margin-top:30.0pt;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:0in;
	margin-bottom:.0001pt;
	mso-pagination:widow-orphan lines-together;
	tab-stops:center 3.0in right 6.0in;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	border:none;
	mso-border-bottom-alt:solid windowtext .75pt;
	padding:0in;
	mso-padding-alt:0in 0in 1.0pt 0in;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";
	letter-spacing:-.2pt;
	font-weight:bold;
	mso-bidi-font-weight:normal;}
p.HeaderFirst, li.HeaderFirst, div.HeaderFirst
	{mso-style-name:"Header First";
	mso-style-parent:Header;
	margin:0in;
	margin-bottom:.0001pt;
	mso-pagination:widow-orphan lines-together;
	tab-stops:center 3.0in right 6.0in;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";
	letter-spacing:-.2pt;}
p.HeaderEven, li.HeaderEven, div.HeaderEven
	{mso-style-name:"Header Even";
	mso-style-parent:Header;
	margin:0in;
	margin-bottom:.0001pt;
	mso-pagination:widow-orphan lines-together;
	tab-stops:center 3.0in right 6.0in;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";
	letter-spacing:-.2pt;}
p.HeaderOdd, li.HeaderOdd, div.HeaderOdd
	{mso-style-name:"Header Odd";
	mso-style-parent:Header;
	margin:0in;
	margin-bottom:.0001pt;
	mso-pagination:widow-orphan lines-together;
	tab-stops:center 3.0in right 6.0in;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:Arial;
	mso-fareast-font-family:"Times New Roman";
	mso-bidi-font-family:"Times New Roman";
	letter-spacing:-.2pt;}
p.ChapterSubtitle, li.ChapterSubtitle, div.ChapterSubtitle
	{mso-style-name:"Chapter Subtitle";
	margin-top:0in;
	margin-right:0in;
	margin-bottom:0in;
	margin-left:.75in;
	margin-bottom:.0001pt;
	mso-pagination:widow-orphan;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";}
p.ChapterTitle, li.ChapterTitle, div.ChapterTitle
	{mso-style-name:"Chapter Title";
	mso-style-parent:"Heading Base";
	mso-style-next:"Chapter Subtitle";
	margin-top:.5in;
	margin-right:1.5in;
	margin-bottom:20.0pt;
	margin-left:.75in;
	mso-line-height-alt:27.0pt;
	mso-pagination:widow-orphan lines-together;
	page-break-after:avoid;
	mso-layout-grid-align:none;
	punctuation-wrap:simple;
	text-autospace:none;
	font-size:30.0pt;
	mso-bidi-font-size:10.0pt;
	font-family:"Times New Roman";
	mso-fareast-font-family:"Times New Roman";
	letter-spacing:-2.0pt;
	mso-font-kerning:14.0pt;}
p.ChapterLabel, li.ChapterLabel, div.ChapterLabel
	{mso-style-name:"Chapter Label";
	mso-style-parent:"Heading Base";
	mso-style-next:"Chapter Title";
	margin-top:38.5pt;
	margin-right:0in;
	margin-bottom:22.0pt;
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<p class=3DMsoTitle style=3D'background:#E5E5E5;mso-shading:windowtext;mso-=
pattern:
gray-10 auto'><o:p>&nbsp;</o:p></p>

<p class=3DMsoTitle>Glucose Tolerance Test, 3 Hour Gestational Collection
Instructions<span style=3D'mso-tab-count:1'> </span></p>

</div>

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indowtext 1.0pt;
mso-border-bottom-alt:solid windowtext .75pt;padding:0in 0in 1.0pt 0in'>

<h1>Principle</h1>

</div>

<p class=3DMsoNormal style=3D'margin-left:0in'><span style=3D'font-family:A=
rial'>Gestational
diabetes mellitus (GDM) is an operational classification identifying women =
who
develop diabetes mellitus during gestation. Women who develop type 1 diabet=
es
mellitus during pregnancy and women with undiagnosed asymptomatic type 2
diabetes mellitus that is discovered during pregnancy are classified with
gestational diabetes mellitus. However, most women classified with gestatio=
nal
diabetes mellitus have normal glucose homeostasis during the first half of =
the
pregnancy and develop a relative insulin deficiency during the last half of=
 the
pregnancy, leading to hyperglycemia. GDM complicates <!--[if gte vml 1]><v:=
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src=3D"GTTGestationalCollectionInstructions_files/image001.gif" alt=3D"~" v=
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of all pregnancies in the <st1:place w:st=3D"on"><st1:country-region w:st=
=3D"on">U.S.</st1:country-region></st1:place>,<sup>
</sup>resulting in <!--[if gte vml 1]><v:shape id=3D"_x0000_i1026" type=3D"=
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src=3D"GTTGestationalCollectionInstructions_files/image001.gif" alt=3D"~" v=
:shapes=3D"_x0000_i1026"><![endif]>135,000
cases annually. The prevalence may range<sup> </sup>from 1 to 14% of
pregnancies, depending on the population studied.<sup> </sup>The hyperglyce=
mia
resolves in most women after delivery but places them at increased risk of
developing type 2 diabetes mellitus later in life.<o:p></o:p></span></p>

<p class=3DMsoBodyText>Previous recommendations included screening for GDM
performed<sup> </sup>in all pregnancies. However, there are certain factors
that<sup> </sup>place women at lower risk for the development of glucose
intolerance<sup> </sup>during pregnancy, and it is likely not cost-effectiv=
e to
screen<sup> </sup>such patients. <b style=3D'mso-bidi-font-weight:normal'>P=
regnant
women who fulfill <i>all</i> of these criteria<sup> </sup>need <u>not</u> be
screened for GDM.<sup> </sup><o:p></o:p></b></p>

<p class=3DMsoBodyText>This low-risk group comprises women who: </p>

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style=3D'mso-list:Ignore'>&middot;<span style=3D'font:7.0pt "Times New Roma=
n"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span></span><![endif]>are &lt;25 years of<sup> </sup>age<sup> </su=
p></p>

<p class=3DMsoBodyText style=3D'margin-left:.5in;text-indent:-.25in;mso-lis=
t:l1 level1 lfo1;
tab-stops:list .5in'><![if !supportLists]><span style=3D'font-family:Symbol;
mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol'><span
style=3D'mso-list:Ignore'>&middot;<span style=3D'font:7.0pt "Times New Roma=
n"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span></span><![endif]>are a normal body weight<sup> </sup></p>

<p class=3DMsoBodyText style=3D'margin-left:.5in;text-indent:-.25in;mso-lis=
t:l1 level1 lfo1;
tab-stops:list .5in'><![if !supportLists]><span style=3D'font-family:Symbol;
mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol'><span
style=3D'mso-list:Ignore'>&middot;<span style=3D'font:7.0pt "Times New Roma=
n"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span></span><![endif]>have no family history (i.e.,<sup> </sup>fir=
st-degree
relative) of diabetes<sup> </sup></p>

<p class=3DMsoBodyText style=3D'margin-left:.5in;text-indent:-.25in;mso-lis=
t:l1 level1 lfo1;
tab-stops:list .5in'><![if !supportLists]><span style=3D'font-family:Symbol;
mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol'><span
style=3D'mso-list:Ignore'>&middot;<span style=3D'font:7.0pt "Times New Roma=
n"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span></span><![endif]>have no history of abnormal<sup> </sup>gluco=
se
metabolism<sup> </sup></p>

<p class=3DMsoBodyText style=3D'margin-left:.5in;text-indent:-.25in;mso-lis=
t:l1 level1 lfo1;
tab-stops:list .5in'><![if !supportLists]><span style=3D'font-family:Symbol;
mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol'><span
style=3D'mso-list:Ignore'>&middot;<span style=3D'font:7.0pt "Times New Roma=
n"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span></span><![endif]>have no history of poor obstetric outcome<su=
p> </sup></p>

<p class=3DMsoBodyText style=3D'margin-left:.5in;text-indent:-.25in;mso-lis=
t:l1 level1 lfo1;
tab-stops:list .5in'><![if !supportLists]><span style=3D'font-family:Symbol;
mso-fareast-font-family:Symbol;mso-bidi-font-family:Symbol'><span
style=3D'mso-list:Ignore'>&middot;<span style=3D'font:7.0pt "Times New Roma=
n"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
</span></span></span><![endif]>are not members of an ethnic/racial group wi=
th a
high prevalence<sup> </sup>of diabetes (e.g., Hispanic American, Native
American, Asian<sup> </sup>American, African American, Pacific Islander)<su=
p> </sup></p>

<div style=3D'mso-element:para-border-div;border:none;border-bottom:solid w=
indowtext 1.0pt;
mso-border-bottom-alt:solid windowtext .75pt;padding:0in 0in 1.0pt 0in'>

<h1><sup><span style=3D'position:relative;top:0pt;mso-text-raise:0pt'><o:p>=
&nbsp;</o:p></span></sup></h1>

<h1>Specimen</h1>

</div>

<p class=3DMsoBodyText>Heparinzed plasma (preferred) or serum.</p>

<p class=3DMsoBodyText><o:p>&nbsp;</o:p></p>

<div style=3D'mso-element:para-border-div;border:none;border-bottom:solid w=
indowtext 1.0pt;
mso-border-bottom-alt:solid windowtext .75pt;padding:0in 0in 1.0pt 0in'>

<h1><!--[if supportFields]><span style=3D'mso-element:field-begin'></span><=
span
style=3D'mso-spacerun:yes'>&nbsp;</span>INCLUDETEXT
&quot;L:\\LABGEN\\PROC\\PROCSAFE.DOC&quot;<span style=3D'mso-spacerun:yes'>=
&nbsp;
</span>\* MERGEFORMAT <span style=3D'mso-element:field-separator'></span><!=
[endif]-->Safety<sup><o:p></o:p></sup></h1>

</div>

<p class=3DMsoBodyText>To minimize the risk of accidental exposure, Univers=
al
Precautions and all safety policies should be followed when handling biolog=
ical
specimens. This includes the use of personal protective equipment such as
gloves, lab coats, and face protection when necessary. </p>

<div style=3D'mso-element:para-border-div;border:none;border-bottom:solid w=
indowtext 1.0pt;
mso-border-bottom-alt:solid windowtext .75pt;padding:0in 0in 1.0pt 0in'>

<h1><!--[if supportFields]><sup><span style=3D'mso-element:field-end'></spa=
n></sup><![endif]-->Patient
Preparation </h1>

</div>

<p class=3DMsoBodyText>The GTT should be administered in the morning after =
the
patient has had at least 3 days of an unrestricted diet (&gt;150 g
carbohydrates daily) and usual physical activity.</p>

<p class=3DMsoBodyText>The patient should be fasting for at least 8 hours p=
rior
to the test, during which the patient may drink water only. The patient sho=
uld
not exercise during this fast. </p>

<p class=3DMsoBodyText>The patient should be seated comfortably during the =
test.
The patient should remain inactive and take nothing by mouth (including
tobacco) during the test period. Only small sips of water and ice are permi=
ssible
during testing. </p>

<p class=3DMsoBodyText>Glucose Tolerance Beverage (Dexicola), 100g glucose/=
10
ounces</p>

<p class=3DMsoBodyText>Pregnant adult dosage: 10 ounces (100g of glucose)</=
p>

<p class=3DMsoBodyText><o:p>&nbsp;</o:p></p>

<div style=3D'mso-element:para-border-div;border:none;border-bottom:solid w=
indowtext 1.0pt;
mso-border-bottom-alt:solid windowtext .75pt;padding:0in 0in 1.0pt 0in'>

<h1>Specimen Collection Procedure</h1>

</div>

<p class=3DMsoBodyText style=3D'margin-left:.25in;text-indent:-.25in;mso-li=
st:l0 level1 lfo2;
tab-stops:list .25in'><![if !supportLists]><span style=3D'mso-fareast-font-=
family:
Arial;mso-bidi-font-family:Arial'><span style=3D'mso-list:Ignore'>1.<span
style=3D'font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
 </span></span></span><![endif]>Order
a GTT, GEST in PathNet, This will generate labels for fasting, 1, 2 and 3 h=
our
glucoses.<span style=3D'mso-spacerun:yes'>&nbsp; </span></p>

<p class=3DMsoBodyText style=3D'margin-left:.25in;text-indent:-.25in;mso-li=
st:l0 level1 lfo2;
tab-stops:list .25in'><![if !supportLists]><span style=3D'mso-fareast-font-=
family:
Arial;mso-bidi-font-family:Arial'><span style=3D'mso-list:Ignore'>2.<span
style=3D'font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
 </span></span></span><![endif]>Print
a copy of the Glucose Test Result Interpretation (in Lab Help Interpretative
Information) for the patient to read.</p>

<p class=3DMsoBodyText style=3D'margin-left:.25in;text-indent:-.25in'>3.<sp=
an
style=3D'mso-tab-count:1'>&nbsp;&nbsp; </span>Obtain the fasting blood spec=
imen
and send to the lab STAT</p>

<p class=3DMsoBodyText style=3D'margin-left:.25in;text-indent:-.25in'>4.<sp=
an
style=3D'mso-tab-count:1'>&nbsp;&nbsp; </span>A tech will evaluate the fast=
ing glucose
and tell you whether to continue to procedure or not.<span
style=3D'mso-spacerun:yes'>&nbsp; </span>If the fasting glucose is &gt;=3D1=
26 mg/dl
the glucose tolerance testing will be considered completed and the patient =
will
<b style=3D'mso-bidi-font-weight:normal'>not</b> be given the glucose bever=
age.</p>

<p class=3DMsoBodyText style=3D'margin-left:.25in;text-indent:-.25in'>5.<sp=
an
style=3D'mso-tab-count:1'>&nbsp;&nbsp; </span>Do <b style=3D'mso-bidi-font-=
weight:
normal'>not </b>give the patient the glucose beverage until after you have
gotten the result of the fasting glucose.</p>

<p class=3DMsoBodyText style=3D'margin-left:.25in;text-indent:-.25in'>6.<sp=
an
style=3D'mso-tab-count:1'>&nbsp;&nbsp; </span>If the test is to continue, g=
ive
the adult pregnant patient a dose of 100 gm of the glucose tolerance bevera=
ge.</p>

<p class=3DMsoBodyText style=3D'margin-left:.25in;text-indent:-.25in'>7.<sp=
an
style=3D'mso-tab-count:1'>&nbsp;&nbsp; </span>Instruct the patient to drink=
 the
dose within five minutes. Record the time of intake completion.</p>

<p class=3DMsoBodyText style=3D'margin-left:.25in;text-indent:-.25in'>8.<sp=
an
style=3D'mso-tab-count:1'>&nbsp;&nbsp; </span>Draw plasma glucoses at 1 hou=
r, 2
hours and 3 hours after time of ingestion. Label with the appropriate PathN=
et
labels and send to the lab ASAP as they are collected. </p>

<p class=3DMsoBodyText style=3D'margin-left:.25in'><o:p>&nbsp;</o:p></p>

<div style=3D'mso-element:para-border-div;border:none;border-bottom:solid w=
indowtext 1.0pt;
mso-border-bottom-alt:solid windowtext .75pt;padding:0in 0in 1.0pt 0in'>

<h1>Procedural Notes</h1>

</div>

<p class=3DMsoBodyText style=3D'margin-left:.25in;text-indent:-.25in;mso-li=
st:l3 level1 lfo3;
tab-stops:list .25in'><![if !supportLists]><span style=3D'mso-fareast-font-=
family:
Arial;mso-bidi-font-family:Arial'><span style=3D'mso-list:Ignore'>1.<span
style=3D'font:7.0pt "Times New Roman"'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;=
 </span></span></span><![endif]>Patient
reactions are not uncommon with the glucose tolerance test. These reactions=
 may
include nausea, vomiting, fainting or sweating. If a reaction occurs, make =
the
patient as comfortable as possible. Notify a supervisor, charge person, the
Emergency Department physician or pathologist.</p>

<p class=3DMsoBodyText style=3D'margin-left:.25in;text-indent:-.25in'><span
style=3D'mso-bidi-font-family:Arial'>2.<span style=3D'mso-tab-count:1'>&nbs=
p;&nbsp; </span>Many
drugs may interfere with the test results if taken within 3 days of testing.
Possible interfering drugs include: thiazide diuretics, beta-blockers, oral
contraceptives, corticosteroids and some psychiatric medications.<o:p></o:p=
></span></p>

<p class=3DMsoBodyText style=3D'margin-left:.25in;text-indent:-.25in'><span
style=3D'mso-bidi-font-family:Arial'>3.<span style=3D'mso-tab-count:1'>&nbs=
p;&nbsp; </span>Extended
glucose tolerance tests are no longer indicated. Contact the pathologist for
additional information if necessary.<o:p></o:p></span></p>

<p class=3DMsoBodyText>4.<span style=3D'mso-tab-count:1'>&nbsp;&nbsp; </spa=
n>Reasons
for invalid results include emesis and conditions which delay stomach empty=
ing.</p>

<p class=3DMsoBodyText><o:p>&nbsp;</o:p></p>

<p class=3DMsoBodyText style=3D'margin-top:0in;line-height:normal'><!--[if =
supportFields]><span
style=3D'mso-element:field-begin'></span><span
style=3D'mso-spacerun:yes'>&nbsp;</span>INCLUDETEXT
\\\\cmmc1nt\\data\\LABGEN\\PROC\\LabHelp_Web_Docs\\_LabHelp_Doc_Control.DOC=
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eparator'></span><![endif]--><span
style=3D'font-size:7.0pt;mso-bidi-font-size:10.0pt'>Document Control<o:p></=
o:p></span></p>

<p class=3DMsoBodyText style=3D'margin-top:0in;line-height:normal'><span
class=3DMsoLineNumber><span style=3D'font-size:7.0pt;mso-bidi-font-size:10.=
0pt'>Facility:<span
style=3D'mso-tab-count:1'>&nbsp;&nbsp;&nbsp;&nbsp; </span>Central Maine Med=
ical
Center, 300 Main Street, Lewiston, Maine<span style=3D'mso-spacerun:yes'>&n=
bsp;
</span>04240<span style=3D'mso-spacerun:yes'>&nbsp; </span><o:p></o:p></spa=
n></span></p>

<p class=3DMsoBodyText style=3D'margin-top:0in;line-height:normal'><span
class=3DMsoLineNumber><span style=3D'font-size:7.0pt;mso-bidi-font-size:10.=
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Path\Filename: <span style=3D'mso-field-code:" FILENAME \\p \\* MERGEFORMAT=
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style=3D'mso-no-proof:yes'>L:\LABGEN\PROC\LabHelp_Web_Docs\Under
Development\GTTGestationalCollectionInstructions.mht</span></span><o:p></o:=
p></span></span></p>

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<p class=3DMsoBodyText2 style=3D'margin-left:0in'><!--[if supportFields]><s=
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style=3D'mso-element:field-end'></span><![endif]--><span class=3DMsoLineNum=
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<p class=3DMsoHeader><span style=3D'mso-field-code:" TITLE  \\* MERGEFORMAT=
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Gestational Collection Instructions</span><span style=3D'mso-tab-count:2'>&=
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