Gestational diabetes, GD is a common type of diabetes that occurs during pregnancy. It means there is too much sugar or glucose in the blood. This happens when the body cannot produce the required insulin to maintain blood glucose at optimal levels. Left untreated, this can lead to birth complications like shoulder dystocia, preeclampsia and also increase the chances of stillbirth. Women with gestational diabetes are more likely to have type 2 diabetes later. But with treatment, most women with GD can have healthy babies.
So how to detect if you have this type of diabetes? A glucose test is how gestational diabetes is diagnosed. All expectant mothers - whether at risk of developing it or not are offered glucose screening between 24 to 28 weeks of their pregnancy. Two tests are available; a glucose tolerance test and a glucose challenge test. Continue reading to learn how these tests are administered and treatment options if GD is confirmed.
Expectant mothers who are 24 to 28 weeks pregnant are offered blood glucose screening. If the healthcare provider feels you are at risk of GD, glucose tests are conducted earlier. The risk factors are:
This is a screening which detects a probability of having GD. This test is also called the one-hour glucose test, glucose screening or gestational diabetes screening test. This is done routinely in prenatal care. A negative result means that there is a risk of gestational diabetes; however, this screening does not diagnose it. It is important to know that if you fail the test, a second test is performed to confirm it.
Insulin resistance in pregnancy is used to diagnose GD. It involves drawing blood a few times at intervals and also requires fasting. This is called a three-hour glucose test.
Diagnosing for GD is a two-step process. The first step is the glucose screening test.
There is no need to change the diet or prepare in any manner.
If the glucose level is high, a glucose tolerance test is recommended. For this screening:
If the results of the glucose screening are negative, meaning if you fail the test, your healthcare provider will recommend a second test. This test also requires blood draws and needs you to follow specific instructions like:
The first step in this screening is a blood test to check your fasting blood glucose levels. A phlebotomist takes your blood sample, and you are given a sweet liquid (100 grams of glucose) to drink within five minutes. Another blood sample is done after 1, 2 and 3 hours. You will not be allowed to eat anything until your last sample is taken, only sips of water are allowed during the testing.
No side effects of this screening test are seen in most women. Drinking this solution is like drinking sweet water. Some women may feel lightheaded, nauseated or sweaty after the drink. But these subside quickly and serious side effects are very uncommon.
The normal blood sugar range is between 135 and 140 mg/dL. No additional test is needed for GD if the tests show less than 140 mg/dL. However, if it is higher than 140 mg/dL a 3-hour glucose tolerance test is recommended.
The blood sugar levels during pregnancy for a 3-hour glucose test are:
Fasting blood sugar should be < 95 mg/dL
Typically, if the blood sugar levels are higher in two out of three results, you will be diagnosed as having gestational diabetes. If you have one elevated result, another screening may be done after a few weeks.
Managing gestational diabetes helps you and your baby stay healthy. Close monitoring and management can avoid undue complications during your pregnancy and childbirth. Managing GD includes:
Your lifestyle depends on what you eat and how you move. Exercise and diet are important aspects of maintaining optimal blood sugar levels. Weight loss is not recommended during pregnancy as the body needs the energy to support the growing fetus, but lifestyle changes are advised.
When you are pregnant and have gestational diabetes, your doctor may ask you to check your blood sugar levels a few times a day, including before breakfast and after meals. This helps you to keep a check and ensure the levels are in a healthy range.
If exercise and diet do not help maintain normal range, you may need medications to lower insulin levels. It can be oral medication or insulin injections. While some doctors prescribe oral tablets, others prescribe insulin injections to manage GD as it is deemed more effective and safe.
Closely monitoring the baby’s health is an important aspect of the treatment plan. The doctor may check the baby’s development with frequent tests and ultrasounds. Labour may be needed if you do not go to labour before your due date. Delivering the baby after the due date may cause complications for women with GD.
Gestational diabetes is common in pregnancy. If diagnosed with high blood sugar during pregnancy, work with your doctor to manage it to avert any complications and deliver a healthy baby.
