If I Am Diagnosed With Gestational Diabetes Will I Need To Monitor My Glucose Levels
If you have been diagnosed with gestational diabetes, your healthcare practitioner will recommend that you monitor your blood glucose levels to determine how far above or below normal your glucose is and to determine if you need diabetes medications.
Home glucose monitoring at regular intervals is typically recommended. This is usually done using a small instrument called a glucometer and testing strips. You would check your glucose by inserting the test strip into the glucometer and then placing a drop of blood from a skin prick onto the glucose strip. The glucometer then provides a digital readout of your blood glucose level. You will be given guidelines for how high or low your blood sugar should be at different times of the day. By checking your glucose regularly, you can see if the diet and medication schedule you are following is working properly for you.
What Are The Warning Signs Of Gestational Diabetes
Pregnant women have heard tales or experienced it themselves of the orange drink they have to take around 24 to 28 weeks of pregnancy. Its a story thats passed from woman to woman about the overly sweet, syrupy taste of the drink and having to sit in the doctors office for blood tests.
But this important screening is worth the inconvenience. It detects and diagnoses gestational diabetes in pregnant women. Gestational diabetes affects nearly 10 percent of pregnant women, according to the American Diabetes Association.
Gestational diabetes, left untreated and unmanaged, can pose serious health risks to your baby, including:
- Excessive birth weight
- Preterm birth and respiratory distress syndrome
- Low blood sugar at birth
- Increased risk of type 2 diabetes later in life
Fortunately, gestational diabetes is easy to diagnose and manage, says;Barbara E. Simpson, M.D., a board-certified obstetrician/gynecologist. The fasting blood sugar test can make sure mom and baby stay healthy and happy.
What Causes Gestational Diabetes
The pancreas makes a hormone called insulin. Insulin helps your body properly use and store the sugar from the food you eat. This keeps your blood sugar level in a target range. When you are pregnant, the placenta makes hormones that can make it harder for insulin to work. This is called insulin resistance.
A pregnant woman can get diabetes when her pancreas cannot make enough insulin to keep her blood sugar levels within a target range.
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What Is Gestational Diabetes
Gestational diabetes is a condition where a pregnant persons body cant properly regulate the level of glucose in their blood, so it gets unhealthily high. This is mainly due to the hormones and weight gain of pregnancy and should go away after you delivers .
But gestational diabetes is important to detect, since it can lead to complications for both parent and baby, including high birth weight, preterm birth and health problems later in life. And the CDC estimates that 2% to 10% of pregnant woman develop gestational diabetes.
Thats why everyone gets a gestational diabetes test around 24 weeks pregnant to 28 weeks pregnantsooner if you have history of diabetes in your family or youve been diagnosed as prediabetic in the past.
When Is It Ordered
Pregnant women are usually screened for gestational diabetes between their 24th and 28th week of pregnancy. You may be screened earlier in your pregnancy if you have signs and symptoms of diabetes or have had gestational diabetes with a previous pregnancy.
You may also be tested earlier in your pregnancy if you are at risk of type 2 diabetes . You may be at risk if you:
- Are overweight, obese, or physically inactive
- Have a first degree relative with diabetes
- Delivered a baby weighing 9 pounds or more or had gestational diabetes with a previous pregnancy
**Some labs may use different numbers.
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How Is It Treated
Some women with gestational diabetes can control their blood sugar level by changing the way they eat and by exercising regularly. These healthy choices can also help prevent gestational diabetes in future pregnancies and type 2 diabetes later in life.
Treatment for gestational diabetes also includes checking your blood sugar level at home and seeing your doctor regularly.
You may need to give yourself insulin shots to help control your blood sugar. This insulin adds to the insulin that your body makes. Diabetes medicines may be used to control gestational diabetes in some women.
What Do The Oral Glucose Tolerance Test Results Mean
A blood glucose level of 140mg/dL or higher will identify 80% of women with gestational diabetes. When that cutoff is lowered to 130mg/dL, the identification increases to 90%. If your blood glucose level was greater than 130 mg/dL, your provider will likely recommend you take another diabetes screening test that requires you to fast before the test.;
During this second test, called the 100-gram oral glucose tolerance test, your blood glucose level will be tested four times during a three-hour period after drinking the sweetened cola-like drink. If two out of the four blood tests are abnormal, you are considered to have gestational diabetes.
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Treatments For Gestational Diabetes
If you have gestational diabetes, the chances of having problems with your pregnancy can be reduced by controlling your blood sugar levels.
You’ll be given a blood sugar testing kit so you can monitor the effects of treatment.
Blood sugar levels may be reduced by changing your diet and exercise routine.;However, if these changes don’t lower your blood sugar levels enough, you will need to take medicine as well. This may be tablets or insulin injections.
You’ll also be more closely monitored during your pregnancy and birth to check for any potential problems.
If you have gestational diabetes, it’s best to give birth before 41 weeks. Induction of labour or a caesarean section may be recommended if labour does not start naturally by this time.
Earlier delivery may be recommended if there are concerns about your or your baby’s health or if your blood sugar levels have not been well controlled.
Find out more about;how gestational diabetes is treated.
Screening For Gestational Diabetes
During your first antenatal appointment at around week 8 to 12 of your pregnancy, your midwife or doctor will ask you some questions to determine whether you’re at an increased risk of gestational diabetes.
If you have 1 or more risk factors for gestational diabetes;you should be offered a screening test.
The screening test is called an oral glucose tolerance test , which takes about 2 hours.
It involves having a;blood test in the morning, when you have not had any food or drink for 8 to 10 hours .;You’re then given a glucose drink.;
After resting for 2 hours, another blood sample is taken;to see how your body is dealing with the glucose.
The OGTT is done when you’re between 24 and 28 weeks pregnant.;If you’ve had gestational diabetes before, you’ll be offered an OGTT earlier in your pregnancy, soon after your booking appointment, then another OGTT at 24 to 28 weeks if the first test is normal.
Find out more about an OGTT.
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Symptoms Of Gestational Diabetes
Gestational diabetes does not usually cause any symptoms.
Most cases are only discovered when your blood sugar levels are tested during;screening for gestational diabetes.
Some;women may develop;symptoms if their blood sugar levels gets too high;,;such as:
- needing to pee more often than usual
- a dry mouth
- tiredness
But some of these symptoms are common during pregnancy and are not necessarily a sign of gestational diabetes. Speak to your midwife or doctor if you’re worried about any symptoms you’re experiencing.
How Accurate Is The Test
One study found that the test had a sensitivity rate of 76%. Which means out of 100 mothers-to-be who got tested, 24 of them actually had elevated glucose levels but the test showed that they were within the normal range.
That didnt give me a whole lot of confidence that the test wasnt accurate for diagnosing gestational diabetes. It sounded a lot more like a screening test.
So reading what it was and gathering the information I had, I didnt see why this would be routine for everyone. I mean, its kind of strange if you dont have any risk factors for something and they want to test you, right?
I talked with my doctors and we ended up on a solution since they still wanted me to check my sugar levels but I didnt want to rely on the glucose test given the information and research that I had found.
We ended up on the solution for doing finger sticks four times a day for a couple weeks. Simple, non-invasive, and not that big of a deal. To me, monitoring blood sugar levels this way was a more realistic approach anyway considering it would be testing the glucose from what I would eat daily.
My husband supported me and so did my family. I was proud and empowered because I had stuck to what I wanted to do and what kind of healthcare I would get.
In the end, YOU are your number one advocate for your healthcare and you can decide whats right for you! Do your research, explore your options, and be happy with whatever your choose!
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Education About Insulin Commencement
It is very important that you get information and support from your diabetes educator or doctor on how insulin works, how to give insulin and how to store it.;
Insulin sometimes causes blood glucose levels to go too low , so it is very important that you learn the signs and symptoms of this and how to prevent and treat it .
What To Think About
Most of the time, the blood sugar levels of women who have gestational diabetes return to normal in a few hours or days after delivery.
If you have had gestational diabetes, you are at risk for having it again in a future pregnancy. You are also at risk of type 2 diabetes, a permanent type of diabetes. The healthy choices and changes you made during your pregnancy, if continued, will help you prevent diabetes in the future. If you are worried about type 2 diabetes in yourself or in your child, talk to your doctor about your concerns.
Most doctors will recommend that you breastfeed, if possible, for the health benefits for you and your baby. For example, breastfeeding can help keep your child at a healthy weight, which may reduce his or her chances of developing diabetes. It provides antibodies to strengthen your babys immune system. And it lowers your babys risk for many types of infections. Also, it may lower your chances of developing diabetes later in life.
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If Youve Had Gestational Diabetes Before
You will be offered a choice of the following 2 tests to see if you have it again:
- a kit you can use to check your own blood glucose levels from early pregnancy
- an oral glucose tolerance test , which you will have as soon as possible after your booking appointment, and again at 24-28 weeks if the first test is normal.
My Alternative Gestational Diabetes Test
Instead of consuming the glucose drink, my doctor recommended that I test my blood sugar four times a day using a glucose monitor. I did this every day for one week, when I hit the 30-week-mark in my pregnancy.
What I love about this approach is that I get to see how my body handles the real food I eat on an everyday basis, which seems like it will provide a more accurate result compared to drinking a glucose beverage that I would have never chosen on my own.
The only downside is that I hate needles, and poking my finger 4 times a day isnt fun. But, after the first few times Ive finally gotten the hang of it and it really isnt that bad. This alternative;simply involves testing my blood first thing in the morning , and then I have to test it again 2 hours after each meal, for a total of 4 times each day.
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Testing For Gestational Diabetes
There are some risk factors that increase your chance of developing gestational diabetes. Your midwife will ask you about these at your booking appointment, which happens around 8-12 weeks of pregnancy. If you have any of the risk factors, youll be offered a test for gestational diabetes when youre between 24 and 28 weeks pregnant.
Gestational diabetes does not usually cause any symptoms, but some women may have some if their blood glucose levels get too high. Speak to your midwife if you have any concerns. Talk to your midwife if you think you are at risk of developing gestational diabetes, but you havent been offered a screening test.
You dont have to take the test if its offered, but there are a few things to keep in mind:
Causes Of Gestational Diabetes
Gestational diabetes is hypothesized to develop as a result of numerous hormonal and non-hormonal changes. It occurs in the body during pregnancy, which predisposes certain women to become insulin resistant. Insulin is a hormone produced in the pancreas by specialized cells that allow the body to effectively digest glucose for later use as fuel . Blood glucose levels rise when insulin levels are low or when the body is unable to utilize insulin effectively .
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Why Its Important To Keep Monitoring Blood Sugar
To be on the safe side, my doctor asked me to continue testing my blood sugar every few weeks until the baby was born. I love that this alternative test allowed for me to continue monitoring my blood sugar levels throughout the rest of my pregnancy, since gestational diabetes can develop late in the game. Luckily, that wasnt the case for me and I went on to have a healthy, unmedicated childbirth.
Types Of Gestational Diabetes Tests
There are two main gestational diabetes tests given during pregnancy: the glucose challenge test and the glucose tolerance test. Youll definitely get one but may end up getting both. Heres the scoop:
- Glucose Challenge Test: The glucose challenge test is a screening test, meaning it tells doctors if you have signs of gestational diabetes. For this 1-hour glucose test, youll drink a sweet Gatorade-like drink called glucola, then wait an hour and have your blood drawn. If your blood sugar level is high, it can be a sign of gestational diabetes, so youll likely get a follow-up test.
- Glucose Tolerance Test: The glucose tolerance test is the follow-up test that can diagnose gestational diabetes, but some women take this one from the start. For the glucose tolerance test, you have to fast for eight hours before the test. Youll have your blood taken when you arrive, and then at 1 hour, at 2 hours and then at 3 hours. So that means four blood draws and 11 total hours of no eating. If two or more of the blood samples from your glucose tolerance test have high levels of glucose, youll be diagnosed with gestational diabetes.
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Gestational Diabetes Is Often Controlled Through Diet And Exercise
The goal of treating gestational diabetes is to get blood glucose close to those of women without gestational diabetes. First, your doctor will help you with a specific meal plan. You will also need to schedule regular physical activity. Sometimes this is enough to lower blood glucose and manage gestational diabetes. Other times, gestational diabetes needs to be treated with insulin. You may also need to do daily blood glucose testing.
You may be able to decrease your chances of developing gestational diabetes by making the same basic lifestyle changes before you get pregnant. Losing weight can lower the risk for type two diabetes in people who are not pregnant, and one of the risk factors for gestational diabetes is being overweight. Eliminating that risk factor before it can become a problem might be helpful.
What Is The Oral Glucose Tolerance Test
Gestational diabetes is tested with the oral glucose tolerance test . The test is simple and will not harm you or your baby. It may be carried out at your usual clinic or at a special diabetes clinic.
Step 1;You will usually be asked not to eat anything and drink only water the night before and on the morning of the test.
Step 2;A nurse takes a blood sample from you to measure your blood glucose level.
Step 3;You drink a glucose drink.
Step 4;After 2 hours, the nurse takes another blood sample and measures your blood glucose level, to see how your body processed the sugars in the glucose drink.
You shouldnt eat anything before or during the glucose tolerance test. But if you dont live near the clinic its a good idea to bring a snack with you, as you will probably be hungry afterwards.
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It Might Develop Due To Pregnancy Hormones
According to the American Diabetes Association, there is no universally proven and agreed-upon cause for gestational diabetes. However, there are certain things that point to why a woman without diabetes develops diabetes while pregnant.;
During pregnancy, the placenta produces hormones needed for the baby to develop properly, which is a good thing for the baby. But these hormones can cause insulin resistance in the mother. This makes it difficult for the body to use its insulin.