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 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 babys 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 Can You Do If Youre At Risk For Gestational Diabetes
If youre at risk for gestational diabetes, there are a few things you can do to help lower your chances of developing the condition:
-Get regular exercise. Exercise can help your body use insulin more effectively.
-Eat a healthy diet. Eating lots of fresh fruits, vegetables, and whole grains can help your body control blood sugar levels.
-Maintain a healthy weight. If youre overweight, losing just 5 to 10% of your body weight can help lower your risk of gestational diabetes.
It is important to consider these things even before pregnancy, so Im glad youre thinking about it.
The Third Thing You Need To Do Is To Try And Get Adequate Sleep For The Majority Of Your Pregnancy
I love sleep :).
It is so important for so many things. Including your sugar levels.
Let me explain a little further.
Sleep deprivation is a highly stressful situation for your body.
High stress = high epinephrine and high cortisol levels.
These hormones can increase insulin resistance and increase the available amount of sugar in your blood.
In other words, a lack of sleep can impact how your body metabolizes sugar.
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Prevent Type 2 Diabetes
If your test results show you have prediabetes, ask your doctor or nurse if there is a lifestyle change program offered through the CDC-led National Diabetes Prevention Program in your community. You can also search for an online or in-person program. Having prediabetes puts you at greater risk for developing type 2 diabetes, but participating in the program can lower your risk by as much as 58% .
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What Is The Normal Range For The 1 Hour Glucose Test
A normal test result for the 1 hour 50-gram glucose test is lower than 140 mg/dL.
- Some clinics will use a lower threshold of 130 mg/dL. This lower level is used if the population is at increased risk of gestational diabetes.
If you happen to have a value greater than 200 mg/dL, then you meet the criteria for the diagnosis of gestational diabetes.
If you take the 2-hour 75g challenge, a normal result is less than 180 mg/dL at the 1-hour mark, and less than 155 mg/dL at the 2-hour mark
In addition, your fasting blood glucose level should be lower than 95 mg/dL for the 2-hour test.
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What Happens If Your Glucose Screening Test Is Abnormal
If your glucose screening test is elevated or “abnormal,” your body may not be producing enough insulin. Results over 130 mg/dL could be indicative of a problem. However, before your doctor can diagnose you with gestational diabetes, you will need to take a confirmatory three-hour glucose test.
To prepare for this three-hour gestational diabetes test, you will need to fast overnight and then drink a solution with an even higher dose of glucose. Your blood will then be sampled several times over a period of about three hours and tested for abnormal levels of glucose.
Three Hour Glucose Results:
Most often, they want to see two of this numbers higher than those specified. If they only see one, they often will just encourage you to make dietary changes.
Personally, my fasting level was too high and they called me glucose intolerant and encouraged me to follow a diabetic diet, even if my blood sugars didnt indicate it.
I have heard that there are some places that use the A1C test. This test measures your average blood sugar level over the past 3 months. If your A1C is 6.5% or higher, you have gestational diabetes. I think this might be used by someone who cant tolerate the glucose test. However, the gold standard is drinking the glucose drink and testing your blood sugar.
If you have gestational diabetes, its important to get treated. If not, it can lead to problems for you and your baby, such as preterm labor, excessive weight gain in your baby, and increased risk of cesarean delivery.
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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 youre 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 . Youre 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 youre between 24 and 28 weeks pregnant. If youve had gestational diabetes before, youll 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.
Do You Have To Take A Glucose Screening Test While Pregnant
The U.S. Preventive Services Task Force and American College of Obstetricians and Gynecologists recommend all pregnant people be screened for gestational diabetes. It’s more important now than ever before, given the increasing numbers of pregnant people affected by obesity and a sedentary lifestyle.
Detection and treatment of gestational diabetes can reduce the risk of pregnancy complications like preeclampsia, an overly large baby, high blood pressure, and C-section. “Studies show a significant reduction in serious complications with treatment of gestational diabetes,” reiterates American Family Physician in a review of ACOG guidelines.
Early gestational diabetes screening is recommended for people with certain risk factors, including a history of gestational diabetes, obesity, and known impairment to glucose metabolism, according to American Family Physician.
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What Are The Risks Of A Glucose Tolerance Test
I hear that there are no risks associated with a glucose tolerance test.
However, I have personally be affected by a VERY low blood sugar following the 3-hour test. Honestly, so low that I probably should have been in a coma.
SO, I always recommend that on both the 1-hour and the 3-hour test that you bring something that has a nice balance of carbs and protein to eat right after the test is over. I usually take a peanut butter and honey sandwich since its easy to keep in my bag or my car. And can easily be eaten quickly.
NOTE: This snack is for AFTER the test is over. Make sure you follow the instructions for the test during the procedure. It is really important.
If you have any questions or concerns about the test, talk to your doctor or midwife. Theyll be happy to answer any questions you have.
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:
| Interval |
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When Is The Glucose Screening Test Taken During Pregnancy
You typically get a glucose screening test between 24 and 28 weeks of pregnancy. However, your provider may want you to be screened earlier than 24 weeks if a routine urine test shows a high level of sugar in your urine or if you’re considered high risk. If the results are normal, you’ll be screened again at 24 to 28 weeks.
Of course, if you were diagnosed with diabetes before pregnancy, you won’t need to be screened. Instead, you’ll continue to work with your provider to manage your condition during pregnancy.
What Can I Expect From The Three Hour Test
When you arrive, you will have your blood taken to get your base/fasting level.
Right after this, you will be instructed to drink 100 grams of the glucose drink within five minutes. Depending on where you are getting it done, you may be given the drink before or after you arrive it tastes best when chilled.
As soon as you are done drinking, the clock starts, and you will have your blood drawn every hour for the next three hours. You will not be allowed to leave, and you are generally not allowed to walk around.
After your test is over, you will be allowed to eat and drink normally make sure you bring some kind of snack. I would recommend something high in protein and low in sugar/carbs, since the drink contained a lot of that.
Its pretty common to feel unwell or nauseated from the test. If you think you are going to throw up, make sure you tell someone in the office. If you do throw up, you will be asked to leave and come back another time.
The results can be processed pretty quickly. I had mine done at LabCorp, and they were sent to my doctor by the next morning. They werent posted on the LabCorp website for several days.
Here are the reference values for the three-hour test. In general, you have to fail at least two values to be diagnosed with Gestational Diabetes, but this may vary on how much you failed by and your doctors office protocol.
Fasting under 95 mg/dL
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What About The 3
Most people start with the 1-hour glucose test . However if your numbers on that test are too high, they will ask you to take a 3-hour glucose test. This test is very similar except that the glucose amount is more and your blood will be taken 4 times:
- Fasting, when you first come in
- 1 hour after you drink the drink
- 2 hours after you take the drink
- 3 hours after you take the drink
They almost always have you fast before this test because of the importance of having a true fasting glucose number .
Prep Before The Glucose Tolerance Test
If your provider has scheduled a glucose tolerance test during your pregnancy, you will be given fasting instructions. This means you probably wonât be able to eat or drink anything except for small sips of water for about 8 to 14 hours before the test.You may find it convenient to schedule a morning appointment for the glucose tolerance test so that you can fast overnight. You will need to stay at the lab or clinic for the full procedure, so you might consider bringing something to read or do or having your phone fully charged so that you can occupy yourself during that time.
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What Is A Glucose Test In Pregnancy
There are two glucose tests that are typically offered during pregnancy as part of your prenatal care. Both the glucose challenge test and the glucose tolerance test measure how your body responds to glucose and help determine if you have gestational diabetes, which may develop during your pregnancy.These glucose tests are routinely done during pregnancy and are recommended by the American College of Obstetricians and Gynecologists for all pregnant women.
One Hour Glucose Results:
- Glucose test 1 hour after drinking glucose solution < 140
- If they take a fasting test, they likely want it to be less than about 95
Again, if your numbers are greater than this, they will likely ask you to take the 3 hour test.
I have seen people who the numbers were SO high with the 1-hour test, that they just diagnosed them with diabetes and sent them to a dietician for a consult and further testing.
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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.
Is There Anyway To Cheat A Fasting Blood Sugar Test
There is no way to cheat the test. You wont be able to manipulate the way your body processes sugar unless you have access to specific medications.
I wont go into any more details because YOU SHOULD NOT try to cheat the glucose pregnancy test.
This test is really important if you care about the health of your pregnancy and baby.
We need to be able to see how youre body processes sugar.
If you have gestational diabetes and try to falsify your results, you will increase
- the risk of your baby having birth defects
So get tested and do it right!
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How Is Gestational Diabetes Diagnosed
A routine test can help to find out whether a woman has developed diabetes in pregnancy. This kind of diabetes, known as gestational diabetes, can then be treated early enough. But the test can also cause women to worry for no reason.
Women who have gestational diabetes temporarily have high blood sugar levels during pregnancy. This is usually not a problem and nothing to worry about. But in some women it will lead to an increased risk of particular complications during pregnancy and birth. High blood sugar levels can usually be lowered enough by changing your diet and doing more exercise. If necessary, women can also inject insulin during pregnancy.
How To Pass The Glucose Tolerance Test In Pregnancy
So youre 24+ weeks, and you were told to take the glucose test.
If youre anxious, youre not alone.
After reading this post, youre going to learn how to pass the glucose tolerance test in pregnancy.
Specifically, youll learn:
- How to prepare for the 1 hour test, ,
- What you should eat before taking the glucose test, and
- What happens if you fail the 3 hour test.
Lets get started.
Disclaimer
***READ FIRST***
Although I am a doctor, I am not your doctor. This information is for informational purposes only and should not substitute the advice from your healthcare professional. All kinds of exercise and dietary changes are potentially dangerous, and those who do not seek counsel from the appropriate health care authority assume the liability of any injury which may occur. Please read my full Disclaimer for more information. Also, this post may contain affiliate links: meaning I may receive a commission if you use them.
Ok, moving on.
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What Happens If You Fail The 3 Hour Glucose Test
Then you now have yourself a diagnosis of Gestational Diabetes.
If you are like me, you might feel pretty devastated and depressed at first. I felt like I had totally failed my child and my body.
I do my best to exercise regularly and be healthy though Id be lying if I said I didnt enjoy a Lindor Lindt truffle from time to time.
A month before I got pregnant, my A1C was 4.7%, which is actually just above being too low. My fasting blood sugar was excellent.
However, the first thing my dietician said to me was, I want you to know that this is NOT your fault. While there are risk factors, you really dont fit into those categories, so Im confident that this is purely a placenta issue.
The Mayo Clinic says:
During pregnancy, the placenta, which connects your baby to your blood supply, produces high levels of various other hormones. Almost all of them impair the action of insulin in your cells, raising your blood sugar. Modest elevation of blood sugar after meals is normal during pregnancy.
As your baby grows, the placenta produces more and more insulin-counteracting hormones. In gestational diabetes, the placental hormones provoke a rise in blood sugar to a level that can affect the growth and welfare of your baby. Gestational diabetes usually develops during the last half of pregnancy sometimes as early as the 20th week, but generally not until later.