How Do You Manage Gestational Diabetes
If you are diagnosed with gestational diabetes it is important that you are supported and know what to do to manage it. Health professionals such as your doctor, a dietitian, a diabetes nurse educator or sometimes a diabetes specialist will help you understand what to do and will support you.
Family also can be a great support. It is important that your family understands about gestational diabetes and how it is managed.
Management of gestational diabetes aims to keep blood glucose levels in the recommended range during pregnancy. This can prevent problems during birth and also helps reduce the babys risk of being overweight in childhood and developing type 2 diabetes later in life.
Management of gestational diabetes involves:
- monitoring blood glucose levels
Some women may need insulin injections to help manage their gestational diabetes.
Random Blood Sugar Test
This measures your blood sugar at the time youre tested. You can take this test at any time and dont need to fast first. A blood sugar level of 200 mg/dL or higher indicates you have diabetes.
|140 mg/dL or below||N/A|
*Results for gestational diabetes can differ. Ask your health care provider what your results mean if youre being tested for gestational diabetes.Source: American Diabetes Association
If your doctor thinks you have type 1 diabetes, your blood may also tested for autoantibodies that are often present in type 1 diabetes but not in type 2 diabetes. You may have your urine tested for ketones , which also indicate type 1 diabetes instead of type 2 diabetes.
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Can Gestational Diabetes Be Prevented
Its not possible to prevent gestational diabetes entirely. However, adopting healthy habits can reduce your chances of developing the condition.
If youre planning to become pregnant in the near future and youre overweight, one of the best things you can do is work with your doctor to lose weight. Even losing a small amount of weight can help you reduce your risk of gestational diabetes.
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
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What Happens If I Fail My Glucose Test During Pregnancy
Around 24-28 weeks gestation, most practitioners will order a blood glucose test to see if the pregnant patient has gestational diabetes. Gestational diabetes is a high blood sugar condition that 2-5 percent of pregnant women develop during pregnancy. Because this condition rarely causes any visible symptoms, performing a glucose test is the only way to find out if a patient has it. If a patient tests positive for this screening, a glucose tolerance test is needed. A GTT is a longer more definitive test that will tell a patient definitively whether or not she has gestational diabetes.
What Happens Once Diagnosed with Gestational Diabetes?
There are many different plans that a practitioner could set a patient on depending how high the glucose levels were on the glucose tolerance test. Most patients are referred to a high-risk OB-GYN as additional screenings are needed to ensure the fetus is not in any distress and monitor the fetus growth, as a result of this condition.
Patients who are unable to control their glucose levels could need to try medication to aide throughout the rest of their pregnancy. It is important for a patient to discuss her feelings and any side effects of gestational diabetes medication with a doctor while on them.
Gestational Diabetes And Pregnancy
Gestational diabetes is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. Some women have more than one pregnancy affected by gestational diabetes. Gestational diabetes usually shows up in the middle of pregnancy. Doctors most often test for it between 24 and 28 weeks of pregnancy.
Often gestational diabetes can be controlled through eating healthy foods and regular exercise. Sometimes a woman with gestational diabetes must also take insulin.
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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.
Postpartum Screening For Type 2 Diabetes And Effect Of Gdm On Future Health
Women with GDM have a higher risk of developing glucose intolerance later in life, or an approximately 7-fold increased risk of developing type 2 diabetes compared with those without GDM. Among Hispanic women, nearly two-thirds may develop type 2 diabetes in 5 years after the index GDM pregnancy. By the time of postpartum testing between 6 and 12 weeks after delivery, about 1 in 3 women will receive a diagnosis of overt type 2 diabetes, impaired fasting glucose, or impaired glucose tolerance. The risk of subsequent type 2 diabetes increases when diabetes is diagnosed earlier in pregnancy or when maternal fasting glucose levels are higher. Some of these women may represent cases of unidentified preexisting type 2 diabetes.
Both the ADA and ACOG recommend postpartum glucose testing using either a fasting plasma glucose or a 75-g, 2-hour oral GTT at 4 to 12 weeks after delivery for a pregnancy complicated by GDM .5 And although thereafter the optimal testing frequency remains to be established, the ADA supports repeat testing every 3 years for women with prior GDM and normal postpartum screening results. The problem is that only about 1 in 5 women with GDM undergo postpartum screening, and innovative strategies are needed to increase its uptake.22
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When And How To Screen For Gdm
GDM is a state restricted to pregnant women whose impaired glucose intolerance is first discovered in pregnancy. Most of these women will have normal fasting glucose levels hence, a glucose challenge is required to unmask this state. Historically, risk factors including a family history of diabetes, history of macrosomia or stillbirth, obesity, chronic hypertension, and maternal age were used to screen women at the highest risk of GDM. The problem is that more than half of women with an abnormal GTT lack any risk factors.
The American College of Obstetricians and Gynecologists recommends universal screening for all pregnant women. Screening generally is performed between 24 and 28 weeks when the diabetogenic state of pregnancy has been established. Two commonly used screening strategies include a 1-step test as endorsed by IADPSG versus a 2-step test as endorsed by ACOG .4 A 1-step test includes a 75-g, 2-hour oral GTT in which a GDM diagnosis can be made when a single value was met or exceeded.
Screening Glucose Challenge Test
The screening glucose challenge test is performed between 24â28 weeks, and can be seen as a simplified version of the oral glucose tolerance test . No previous fasting is required for this screening test, in contrast to the OGTT. The O’Sullivan test involves drinking a solution containing 50 grams of glucose, and measuring blood levels 1 hour later.
If the cut-off point is set at 140 mg/dL , 80% of women with GDM will be detected. If this threshold for further testing is lowered to 130 mg/dL, 90% of GDM cases will be detected, but there will also be more women who will be subjected to a consequent OGTT unnecessarily.
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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.
Glucose Tests For Gestational Diabetes
- Also Known As:
- Glucose Tolerance Test for Gestational Diabetes
- Formal Name:
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To screen for and diagnose diabetes that develops during pregnancy, also known as gestational diabetes
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Signs And Symptoms Of Gestational Diabetes
Most pregnant women dont experience signs or symptoms of gestational diabetes. In fact, the only way to know is with a blood sugar test, typically given around 24 to 28 weeks gestation.
A few women may notice subtle signs and symptoms of gestational diabetes, including:
- Increased thirst. Drinking more than normal and feeling like youre always thirsty may be a sign of gestational diabetes.
- Fatigue. Pregnant women are tired, after all its a lot of work to grow and support a baby! However, gestational diabetes can make you feel even more tired than normal.
- Dry mouth. A parched mouth despite drinking a lot can be another sign of gestational diabetes.
What Complications Are Associated With Gestational Diabetes
If your gestational diabetes is poorly managed, your blood sugar levels may remain higher than they should be throughout your pregnancy. This can lead to complications and affect the health of your child. For example, when your baby is born, he or she may have:
- a high birth weight
- low blood sugar
- shoulder dystocia, which causes their shoulders to get stuck in the birth canal during labor
They may also be at higher risk of developing diabetes later in life. Thats why its so important to take steps to manage your gestational diabetes by following your doctors recommended treatment plan.
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 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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What Is Gestational Diabetes
Gestational diabetes 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 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 . Untreated GD also increases the risk of stillbirth late in pregnancy . 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.
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.
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What Is The Glucose Tolerance Test
Prior to the taking the glucose tolerance test, your doctor will ask you to make sure and eat at least 150 mg of carbohydrates for three days prior to the time you will be asked to fast. You will not be permitted to eat or drink anything but sips of water for 14 hours prior to the test, so it is best to schedule the test for first thing in the morning.
Additionally, you should plan to have someone drive you to and from the test since your energy levels may be low and there is a slight possibility you may feel light-headed.
3-Hour Glucose Test
When you arrive, the technician will draw blood to measure your baseline fasting blood glucose level. You will be asked to drink a larger volume of the glucose drink than was used in the initial Glucose Challenge Screening test. Your blood will be drawn and tested every hour for the next three hours.
The following are the values that the American Diabetes Association considers to be abnormal during the Glucose Tolerance Test:
What If I Fail The 1 Hour Test
If you fail the 1-hour glucose test, your provider will most likely have you come back and repeat a 3-hr test. This time, youll be asked to fast before-hand, and drink a little bit more liquid . Youll stay at your providers office for three hours after drinking the solution, and have your blood drawn three times .
This three-hour test gives a much more accurate representation of how your body metabolizes sugar, and if you fail this test too, then you will be diagnosed with gestational diabetes.
Overall, for me, the 1-hour test was way over-hyped. Drinking that drink is the least of your pregnancy worries! Youve got this, mama!
mamaand.co, she takes the day-to-day of home life and shares tips, tricks, and experiences to make mom life a little bit more wonderful. Follow along her story on Instagram-
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What Happens During A Glucose Screening
This screening test involves drinking a sugary liquid, followed by a blood test an hour later to check glucose levels. If the level is high, you’ll have a glucose-tolerance test. For this test, you’ll drink a glucose solution on an empty stomach and have your blood drawn once every hour for 3 hours.