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.
Gestational Diabetes Test: The Aftermath
Like I said earlier, some women struggle to keep the drink down. This is rarer though- youll probably keep it down just fine. But that doesnt mean you wont have side effects!
I felt pretty shaky and had a pretty crazy sugar rush for a couple of hours. You may feel a little sick or nauseous after drinking it. Dont feel bad if you need to take some time off! Either way, the side effects arent too bad and youll feel better in no time.
After you get your blood drawn and the test is over, youll typically hear your results in a couple of days. More likely than not, youre all clear!
How To Prepare For The Gtt
Dont do excessive exercise: It wont give you better test results.
In fact, it will do the opposite.
Exercise demands more glucose to supply energy to your muscles.
When you have limited insulin available, like in pregnancy, your blood glucose level can actually increase with exercise.
Dont fast for more than 10 hours: Fast overnight and have your GTT first thing in the morning.
Its best to have a high protein late snack, because if you fast for more than 10 hours you can have a false spike of your blood glucose level due to the hormone glucagon being released.
Dont smoke, chew gum, exercise or eat or drink anything other than unflavoured water during the fasting period.
Dont exercise, walk around, vomit , or eat or drink during the test either. Sips of water are ok.
What you should do Book your GTT appointment at pathology prior to the day to prevent fasting and not being able to complete the test due to business.
Tell the pathology staff if you havent fasted appropriately or if you have been sick during the test as this will affect your test results.
Take a book or magazine with you so you can rest for the two hours you have to wait or even jump on The Empowered Mama Project website and get informed about all things pregnancy, birth and motherhood!
So What Is Gestational Diabetes
GDM is diabetes of pregnancy. That means once you have birthed, you are no longer considered diabetic.
That being said, history of GDM is linked to higher risk of Type 2 diabetes later in life, so it is important to have diabetes follow-up with your GP at 6-8 weeks post birth and ongoing.
The hormones produced by the placenta are vital in helping a baby grow and develop.
However, these hormones also block the action of insulin, which lowers blood glucose levels.
In pregnancy, the need for insulin is 2-3 times higher because of this insulin resistance.
In the case of GDM, the body isnt coping with the extra demand for insulin and the blood glucose levels are therefore higher.
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 you’re 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:
- if you have gestational diabetes, you will be offered more care during both pregnancy and labour, to help reduce the risk of problems
- for some women, gestational diabetes can be improved by changes in diet and doing more exercise
- if changes in diet and doing more exercise don’t improve gestational diabetes, youll be offered medication or insulin.
“I wasnt obviously skinny, but I wasnt massively obese either I had no symptoms whatsoever. I had no expectation that the test would be anything other than a formality.”
Beth, mum of two
Gestational Diabetes Test Alternatives
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If youre looking for an alternative to the traditional Gestational Diabaetes Test for pregnancy, I hope that sharing my own experience below might help. Keep in mind that I am not a doctor, so be sure to work with your own certified practitioner to develop a plan that is best for you.
Monitoring Blood Glucose Levels
Monitoring your blood glucose levels is essential. It gives you a guide as to whether the changes you have made to your lifestyle are effective or whether further treatment is required.
A diabetes nurse educator can teach you how and when to measure your blood glucose levels. They will discuss the recommended blood glucose levels to aim for.
Your doctor or diabetes educator can help you link in with the National Diabetes Services Scheme for cheaper blood glucose strips. Regular contact with your diabetes educator or doctor is recommended.
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 baby’s immune system. And it lowers your baby’s risk for many types of infections. Also, it may lower your chances of developing diabetes later in life.
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.
Do I Really Need To Take The Three Hour Test
I see a lot of people questioning if they really need to take the three hour test when they only failed by a few points.
Ive even been a bit surprised to see people ask if they even need to be tested for Gestational Diabetes to begin with.
Yes if you fail, you need to make sure you dont have it. There are some alternatives , but if theres any chance that you might have Gestational Diabetes you NEED to know.
Gestational Diabetes while it can be managed quite well is a serious pregnancy complication, especially if left untreated. While most if not all of the complications that can come with it can be avoided with proper treatment, its just irresponsible to not want to find out.
The screening is important as well. Theres a large percentage of women who will get Gestational Diabetes who have ZERO risk factors. Even if you exercise every day and eat healthy, you may still have it. So it is important that you are tested.
Of course, no one can make you do anything. But be aware that many practices will not continue to see a patient who refuses the test.
What Are The Risk Factors
The people who would be most at risk for gestational diabetes are women who:
Women who have one or more of these risk factors are usually encouraged to test.
Random Blood Sugar Test
A physician takes a blood sample at any time, and not necessarily when fasting. People who have serious diabetes symptoms may have this test. If blood glucose levels are 200 mg/dL at any time, this indicates that diabetes is present.
People with diabetes should monitor their blood glucose levels regularly, using a home testing kit or continuous glucose monitor.
How Is The Test Used
Glucose tolerance testing may be used to screen pregnant women for gestational diabetes. Several health organizations recommend a glucose tolerance test, using either a one-step or two-step approach.
In most cases, gestational diabetes will go away after delivery, but women who have gestational diabetes will be at an increased risk of having it again with subsequent pregnancies and of developing diabetes in the future. Some organizations, including ACOG and the ADA, recommend that women diagnosed with gestational diabetes be tested 4 to 12 weeks after delivery for diabetes that persists. A fasting blood glucose or hemoglobin A1c test may be used for this purpose.
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.
My Gestational Diabetes Test
If you followed along with my first pregnancy, youll recall that I was required to consume the neon-orange colored glucose drink not once, but twice, to test for gestational diabetes. I failed my first test by a few points, so I had to follow that one up with the 3-hour test, which is even worse! Luckily, I passed my 3-hour test with flying colors, but I nearly fainted during the process.
During my second pregnancy, I was determined to find a better way! Though I worked with a very traditional doctor for my next pregnancy, she was open minded to trying an alternative as long as it would be accurate.
Gestational Diabetes Risk Factors
More important than looking for the signs and symptoms of gestational diabetes is knowing if youre at risk. Certain women may be more likely to develop the condition, including:
- Women older than 25 years old
- Family history of type 2 diabetes
- Personal history of prediabetes
- Gestational diabetes in previous pregnancies
- Overweight or obese
- Non-white race
Why Did I Fail
There are many reasons why a mom-to-be has failed the first glucose test.
The first one being that you do actually have Gestational Diabetes.
The second being that the levels for failing are actually pretty low depending on your office, to fail, you have to have a level above 130 or 140.
When you take the three hour test , the level to fail the one hour is 180.
The point of the screening is to catch a wide net to make sure they dont miss anyone who *might* have Gestational Diabetes.
Because if theres any chance you do have it it needs to be caught and treated. Unmanaged Gestational Diabetes typically has the worst outcomes.
Do I Wish I Wouldnt Have Eaten
Kind of. Part of me wishes I would have just had eggs and toughed it out so I wouldnt have had to sit through 3 hours of starvation at the hospital, but on the other hand, I didnt want to try and trick a test that is put in place for the sake of my and Baby Ds health. If I had GD, I didnt want to dupe the test and put our health at risk.
The Dreaded Gestational Diabetes Test: What To Expect
I remember sitting with my mom at the doctors office as a little girl. She had a big bump and was drinking some weird orange punch. When I asked if I could try it too, she told me, no, its for me and the baby. Besides, its really gross anyways. Ah the gestational diabetes test.
I watched her gulp down this syrupy drink and I remember feeling so bad for my poor mama, who had to drink it even though it was gross.
Fast forward a few years, and I was being handed the same drink- but this time for me. I wasnt sure what to expect, and all I knew was that this drink is known to be really gross. I was nervous about it and dreading having to go through this test.
But after going through it personally, I realized that its really not anything to be too worried about. Here is what to expect with your gestational diabetes test, with some tips on how to pass it!
If you havent already, please feel free to join over 375k new moms and for awesome pregnancy + birth tips!
Who Is At Risk Of Gestational Diabetes
Between three and eight per cent of pregnant women develop gestational diabetes. It is usually detected around weeks 24 to 28 of pregnancy, although it can develop earlier. Being diagnosed with gestational diabetes can be both unexpected and upsetting.
Certain women are at increased risk of developing gestational diabetes. This includes women who:
- are over 40 years of age
- have a family history of type 2 diabetes
- are overweight or obese
- thrush .
Is The Glucose Test During Pregnancy Optional
Doctors recommend having a glucose test for gestational diabetes, but it’s not mandatory. Here’s what you need to know to make an informed choice.
August 30, 2017
Photo: Erik Putz
Its an appointment on the calendar most pregnant women dread: the glucose test , usually scheduled around week 26 to week 28 of pregnancy. Youve no doubt seen many Instagram or Facebook pics posted by women tasked with drinking the super-sweet, typically orange liquid to gauge their bodys ability to handle glucose.
This test is one of the ways to screen for gestational diabetes, a temporary form of diabetes that occurs only in pregnancy and typically resolves after delivery.
The mama-to-be drinks the juice, hangs out for an hour in the waiting room, and then has blood taken to measure her glucose levels. Your care provider may also specify a time constraint, like drinking the whole bottle in three to five minutes.
A reading higher than 7.7 millimoles/L on the gestational diabetes chart calls for further follow-up testing, often called the glucose tolerance test. A reading higher than 11.1 millimoles/L likely means a gestational diabetes diagnosis.
The night before my third visit to the lab, my husband asked me what would happen if I just skipped the test. I didnt knowI assumed it was mandatory.
Read more:
What Is Being Tested
Glucose is the primary energy source for the bodys cells and the only energy source for the brain and nervous system. A steady supply must be available for use, and a relatively constant level of glucose must be maintained in the blood. Glucose tolerance tests help diagnose gestational diabetes, which is high blood glucose that develops during pregnancy.
Women diagnosed with gestational diabetes and their babies can receive
Glucose is the primary energy source for the bodys cells and the only energy source for the brain and nervous system. A steady supply must be available for use, and a relatively constant level of glucose must be maintained in the blood. Glucose tolerance tests help diagnose gestational diabetes, which is high blood glucose that develops during pregnancy.
Women diagnosed with gestational diabetes and their babies can receive appropriate treatment during pregnancy as well as after delivery. If untreated, mothers with gestational diabetes can pass more glucose to their developing babies than they need, and their fetuses may gain a lot of weight. These mothers may give birth to large babies , which can cause complications for the mothers and their babies, such as difficult labor and delivery, heavy bleeding after delivery, or need for a cesarean delivery. Women with gestational diabetes are more likely to have other conditions, such as high blood pressure. There is an increased risk of preeclampsia for women with gestational diabetes.
What To Expect From Gestational Diabetes Testing
editorial processBrian Levine, MD, MS, FACOG
Brian Levine, MD, MS, is board-certified in obstetrics and gynecology as well as in reproductive endocrinology and infertility.
If you are pregnant, your obstetrician has probably told you that you will need gestational diabetes testing. Don’t worrygestational diabetes testing is an important part of routine prenatal care. Most women are tested during weeks 24 through 28 of pregnancy. If you have any risk factors for diabetes, your doctor may consider testing your blood sugar as early as your first prenatal visit.
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.
Gain The Right Amount Of Weight
Gaining too much or too quickly during pregnancy can increase the chances for GD, so talk to your doctor about what you should be seeing on the scale. In general, you should aim to gain 25 to 35 pounds if your pre-pregnancy body mass index was in the normal range, 15 to 25 pounds if you were overweight before becoming pregnant, and 11 to 20 pounds if you were obese before coming pregnant.
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.
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!
Resources:
How Can I Prepare For The Three Hour Test
Honestly, I think the best thing you can do is just eat your normal diet. You shouldnt try and trick the test because if you have Gestational Diabetes, then you NEED to know so you can treat is as effectively as possible.
Some medical providers will recommend carb loading in the days leading up to the test, but for the most part, the recommendation is to just eat normally and then fast for 10-12 hours before you actually take the test.
You need to take the test as early in the morning as you can so you wont have to fast all day. Plus, if you are taking it at a lab , many of them require you start the test at 8:00 AM so you are done before the employees need to take a lunch break.
When I failed the one-hour test, I tried to limit sugar and carbs substantially and part of me wonders if that affected my results. Its easy to read into things, and I have heard that women who eat a lower-carb diet have a higher rate of a false positive. I dont know how much truth there is to that, though.
What Are The Glucose Screening Tests
Its a test where the mom-to-be would ingest a sugary drink and wait a couple hours. After that, theyd check the blood and see how well the body handled the sugar. If the results are equal to or less than 140 mg/dL after that time, you most likely do not have gestational diabetes.
Theres also a two part test that is much like the one Ive talked about above. They both contain a sugary solution and both check for the same condition. Your healthcare provider will pick the one suitable for you.
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.