Glucose testing – screening for gestational DiabetesWhat is gestational diabetes?Gestational diabetes (GD) is a type of diabetes that occurs during pregnancy. It happens when your body is not able to produce enough insulin to keep the amount of glucose (sugar) in your blood at proper levels. Untreated GD increases the likelihood of having a large baby, and is associated with birth complications as well as health risks for the newborn (e.g., preeclampsia, shoulder dystocia). Untreated GD also increases the risk of stillbirth late in pregnancy (36-40 weeks). Women who develop GD are at higher risk of developing type 2 diabetes in the future. However, there is excellent treatment for GD, and most women diagnosed with GD have normal deliveries and healthy babies. Show Why is it important to screen for gestational diabetes?All pregnant women should be offered blood glucose screening for GD between 24 and 28 weeks of pregnancy. If you have risk factors for GD, you will be tested earlier in your pregnancy. These risk factors include:
What does the blood glucose test involve? All pregnant women are offered this screening test between 24-28 weeks gestation. When other risk factors are present, such as obesity, the test may be offered earlier and then repeated if initially normal. The screening test for GD is called a ‘glucose challenge’, which aims to see how your body is handling sugars. The measurement is taken 1 hour after you consume a glucose drink. This test can be conducted at any time of day as it is not a fasting test. If your blood sugar is normal after the challenge, you will not require any more testing. If it is high, you will have a second test. This test is done in the morning while you are fasting and will require you not to eat prior to the test. You will have your glucose tested before consuming a glucose drink and then tested again 1 and 2 hours later. If your glucose is higher than specific cut-off values, it means you have GD. See the table for more specific information.
What if I have gestational diabetes?GD is increasingly common, with about 7% of women having the condition. If you are found to have GD, you will work closely with your health care provider(s) to keep your blood glucose levels in a healthy range. This involves choosing a healthy diet, gaining the recommended weight during your pregnancy, getting exercise, and if needed, taking insulin or pills to lower your blood sugar. Your baby’s wellbeing will be carefully monitored by regular measurements of growth and amniotic fluid volume. If you have GD you will be offered a repeat glucose tolerance test between 6 weeks and 6 months postpartum to detect prediabetes and diabetes. You may also be offered induction between 38-40 weeks of pregnancy. Finally, it is strongly recommended that women with GD breastfeed their infants. What is gestational diabetes? Gestational diabetes causes higher-than-normal blood sugar. It occurs only during pregnancy, and it usually goes away once you’ve delivered your baby. Women with gestational diabetes have higher-than-normal blood sugar because their bodies become resistant to insulin. The hormone insulin regulates blood sugar. Gestational diabetes can happen at almost any time during pregnancy, but it typically occurs between 24 to 28 weeks. This is also when testing typically takes place. Getting tested for gestational diabetes is an important part of prenatal care. All pregnant women are tested at least once during pregnancy. Your doctor will consider your risk factors to determine when you should have this test and how often you should have it. Learn what to expect during this test and how to prepare. The exact cause of gestational diabetes is unknown, but it may be due to hormones your placenta produces. These hormones help your baby grow, but they can also stop insulin from doing its job. If your body isn’t sensitive to insulin, the sugar in your bloodstream stays put and isn’t move out of your blood into your cells like it should be. The sugar is then unable to convert into energy in the cells. This is called insulin resistance. This causes the blood sugar levels to increase. If it’s left untreated, gestational diabetes can have significant consequences for both you and your baby. Once your doctor knows you have this condition, they’ll work with you on a treatment plan to ensure your and your baby’s health. Doctors use different types of screening tests. Many doctors use a two-step approach, starting with the glucose challenge test. This test determines your likelihood of having the disorder. Glucose challenge testYou don’t need to do anything to prepare for this test. You can eat and drink normally beforehand. When you arrive at your doctor’s office, you’ll drink a syrupy solution that contains glucose. One hour later, you’ll take a blood test. If your blood sugar is high, your doctor will schedule a glucose tolerance test. Glucose tolerance testThis test measures your body’s response to glucose. It’s used to determine how well your body handles glucose after a meal. Your doctor will ask you to fast overnight to prepare for this test. Ask your doctor if you can sip water during this time. You should remind your doctor of any medications you’re taking and ask if you should stop them during this time. The test is then performed as follows:
If two of the measurements show high blood sugar, your doctor will diagnose gestational diabetes. Some doctors skip the glucose challenge test and only perform the glucose tolerance test. Talk to your doctor about which protocol makes sense for you. If you have gestational diabetes, your doctor will monitor your condition frequently. They’ll use sonograms to pay close attention to your baby’s growth. During pregnancy, you may also self-monitor at home. You can use a tiny needle called a lancet to prick your finger for a droplet of blood. You then analyze the blood using a blood glucose monitor. People usually perform this test when they wake up and after meals. Learn more about diabetes home tests. If lifestyle changes with diet and increased exercise aren’t working to reduce blood sugar levels, your doctor may recommend that you administer insulin injections. According to the Mayo Clinic, between 10 and 20 percent of pregnant women with gestational diabetes need this type of help to bring their blood sugar down. Your doctor may also prescribe oral medication to control your blood sugar. It’s important to keep gestational diabetes under control. If it’s left untreated, possible complications include:
Untreated gestational diabetes can also result in the baby having a high birth weight. This is called macrosomia. Macrosomia may result in shoulder damage during birth and can require a cesarean delivery. Babies with macrosomia have a higher likelihood of childhood obesity and type 2 diabetes. Gestational diabetes usually goes away after delivery. Eating right and exercising continue to remain important for your health after delivery. Your baby’s lifestyle should also be healthy. Choose foods high in fiber and low in fat for the both of you. You should also avoid sugary sweets and simple starches whenever possible. Making movement and exercise a part of your family’s life is a great way to support each other in your pursuit of healthy living. Having gestational diabetes puts you at higher risk for developing type 2 diabetes later in life. Your doctor will have you do another glucose tolerance test 6 to 12 weeks after you deliver your baby to make sure you no longer have diabetes. Going forward, you should have screening blood tests at least every three years. Lifestyle changes may help prevent gestational diabetes or reduce its impact. These changes include:
DietYou should incorporate the following into your diet:
Simple, refined carbohydrates, found in sugary desserts and soda, tend to spike blood sugar. You should limit those types of foods in your diet. ExerciseWalking, swimming, and prenatal yoga can be great options for exercise. Check with your doctor before starting a new exercise regimen. |
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