What Is The Glucose Challenge Screening Test
No preparation is required prior to the test. During the test, the mother is asked to drink a sweet liquid and then will have blood drawn one hour from having the drink, as blood glucose levels normally peak within one hour. No fasting is required prior to this test.
The test evaluates how your body processes sugar. A high level in your blood may indicate your body is not processing sugar effectively . If the results of this screen are positive, the woman may have the Glucose Tolerance Test performed. It is important to note that not all women who test positive for the Glucose Challenge Screening test are found to have diabetes upon further diagnosis.
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What About Glucose Tolerance Testing During Pregnancy
As mentioned previously, the glucose tolerance test is used for the diagnosis of gestational diabetes . It may be used if there are equivocal fasting or random blood glucose results, or to screen for gestational diabetes in pregnant women between 24 to 28 weeks of gestation who are not known to have diabetes.
The test may also be used in the postpartum period to detect diabetes in women who had gestational diabetes during pregnancy. Women who had gestational diabetes do not always develop diabetes later in life, but they should undergo diabetes screening at least every three years throughout their life.
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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 wonÃ¢t 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 Are The Preparations Needed For Gtt
GTT is an elaborate blood test, that requires frequent testing and as the special requirements need for GTT are as follows
- Have a normal diet like any other day.
- Inform the doctor about the varied prescription drugs you are taking, as certain drugs like corticosteroids, diuretics and anti- depressants can cause false results.
- Fasting is required for 8 to 10 hours prior to the test and only water is allowed during this period.
- You might want to avoid using the washroom prior to testing as urine samples might be needed
- On the morning of the test do not smoke or have coffee or caffeine based product.
- The GTT is not to be done on a sick person
What Do Abnormal Glucose Test Results Mean
The results of your glucose test show how well your body breaks down sugar. If your glucose test results are higher than the standard limit, your body is not processing sugar properly, a sign of gestational diabetes.
Gestational diabetes usually occurs due to pregnancy-related hormonal changes. Its important that patients not blame themselves or feel guilty for results of the hormonal changes of pregnancy, this is precisely why we screen all patients for gestational diabetes, shares Dr. Juusela.
The good news is that for the most part, gestational diabetes can be successfully managed through diet, exercise and careful monitoring, Dr. Wool says. In cases where that is not enough, medications, such as insulin or metformin, can be used to help control blood sugar levels. In other words, you can have a healthy pregnancy and a healthy baby with this condition.
If you do need medication, SingleCare can help you save on your prescriptions. The free search tool allows patients to compare prices at pharmacies nearby to be sure youre getting the best deal. Simply enter your medication and location to get started today.
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Are You At Risk For Gestational Diabetes
According to the American Diabetes Association, gestational diabetes mellitus affects almost 10% of pregnancies in the United States.
Pregnant women are at an increased risk of developing gestational diabetes due to the following characteristics :
- Previous diagnosis of GDM
- Previous birth of a baby over 9 lbs
- A medical condition associated with the development of diabetes
- Pregnant with multiples
Just because you have one or more risk factors does NOT mean you will develop gestational diabetes. However, you are at a higher risk and its even more important to screen for GDM with the one-hour test, followed by the three-hour test if necessary.
Laboratory Test For Diabetes Mellitus
A glucose tolerance test is designed to assess the patient’s metabolism when given oral carbohydrate under controlled conditions. The findings of the laboratory examination provide a graph of blood sugar levels at regular intervals, combined with this are the result of urine tests at the same times to show the points at which glucose filters through the kidney and produces glycosuria .
Preparation of the patient includes an explanation of the procedure, its purpose and the method to be used. The nurse should aim at getting not just a passive obedience from the patient, but his active cooperation. In this instance it should be explained that the test is to confirm the diagnosis made by the patient’s own doctor that it will be necessary to take samples of the patient’s blood and urine at regular intervals, and that if the test is to be a success he must not eat or drink anything unless told to do so.
The result of the test is received in the form of a graph showing an estimation of blood sugar levels coupled with urinalysis. The curve of a normal subject starts at a lower level that the diabetic patient and will rise quickly during the first half hour, insulin then controls the blood sugar level by withdrawing any excess. Glycosuria will be negative in each specimen.
Miles J. Levy, Trevor A. Howlett, in, 2014
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How To Pass The 3 Hour Glucose Tolerance Test
Just like the 1 hour glucose test, there isnt any special way to ensure that you pass the 3 hour oral glucose tolerance test aka the ogtt.
Your best bet is to eat a well-balanced diet leading up to the test and minimize the consumption of simple carbs like cereal, white flour, juice, and soda.
Making these changes the night before or the week before is unlikely to make a big difference. You should make these changes months in advance.
Its also a good idea to try and maintain these habits postpartum as well. Unfortunately, 60% of women with gestational diabetes will develop Type 2 diabetes later in life.
Risk Factors For Developing Diabetes During Pregnancy
There is an increased risk of diabetes during pregnancy if:
- The woman is overweight
- There is a family history of diabetes
- The woman is from an ethnic minority
- There is previous history of the birth of a large baby
There is a routine antenatal test used to measure glucose levels in urine however it has been noted it is relatively unreliable for diagnosing diabetes.
Therefore blood sugar levels are checked between 26 and 30 weeks of gestation. This is done of two separate occasions using one of two tests, either the fasting glucose test or the random glucose test. In addition to this if there are any abnormal results of these tests or there is a family history of diabetes, or a woman is regarded as obese she will be offered a glucose tolerance test.
Often with gestational diabetes, the woman is advised to take a number of steps to change their diet and exercise habits to ensure the best possible pregnancy.
It is reportedly advisable to increase participation in low-impact activities such as walking, swimming, yoga and pilates. In addition to this it is advisable to eat regular meals watching the amount of fat being eaten, remembering it is controlling the amount of fat not cutting it out of the diet completely.
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What Is Gestational Diabetes
Gestational diabetes starts when the body is unable to make all of the insulin it needs for pregnancy.
Low insulin levels, combined with hormonal changes, can lead to insulin resistance. When this happens, high levels of glucose build up in the blood.
This can lead to the following complications:
- high blood glucose in the fetus and low levels after birth
- difficulties during labor and the need for a cesarian delivery
- a higher risk of vaginal tearing during the birth and bleeding after delivery
- a risk of developing type 2 diabetes in the future
Doctors usually recommend a glucose tolerance test between weeks 2428 of pregnancy. Those with a higher risk may need a test earlier in the pregnancy.
I Have The Results Of My Glucose Screening Test What’s The Normal Range For Blood Sugar
Different providers use different standards for determining whether your level is too high. Some will say that if your one-hour blood sugar level is 140 milligrams of glucose per deciliter of blood plasma or more, you need to have the glucose tolerance test. Others put the cutoff at 130 mg/dL to catch more women who may have gestational diabetes, even though there are likely to be more false positives this way.
If your blood glucose level for this screening is higher than 200 mg/dL, most providers will consider you diabetic and you won’t be required to take the glucose tolerance test.
But any score between 140 and 200 means that you’ll have to take the three-hour glucose tolerance test for a definite diagnosis.
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What Do The Results Mean
Your blood glucose level should rise after you finish the sugary drink. Then it should go back to normal, as insulin moves glucose into your cells. If your blood sugar takes a long time to go back to normal, you could have diabetes.
You might see a measurement from the test written out as âmg/dL.â It stands for milligrams per deciliter. Two hours after you finish the glucose drink, this is what your results mean:
Below 140 mg/dL:normal blood sugar
Between 140 and 199: impaired glucose tolerance, or prediabetes
200 or higher: diabetes
When you’re pregnant, a blood glucose level of 140 mg/dL or higher is abnormal. Your doctor will recommend that you take a 3-hour OGTT. During this longer test, you’ll have blood drawn before you drink a sugary solution. Then you’ll have your blood tested every hour for three hours.
What You Should Do
Do exactly what your doctor tells you to do before this test.
Some doctors want you to load up on carbs for a few days before the test, others want you to avoid sugar, and almost all of them will want you to be fasting from midnight until the time of the test in order to make sure that your body is clear of everything.
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Is Gestational Diabetes High Risk Pregnancy
Women who develop diabetes during pregnancy, known as gestational diabetes mellitus , may need high-risk pregnancy care due to complications that can arise during pregnancy and childbirth. Women with GDM have an increased risk of preeclampsia, a condition that leads to pregnancy-induced high blood pressure.
How Can I Measure My Blood Sugar Levels
You can measure your blood glucose levels with a glucometer. First, you prick your finger with a small device called a lancet to get a drop of blood. Your blood goes on a test strip which you put into the glucometer. Then, the device tells you your blood sugar levels.
You can also use a continuous glucose monitoring device, which uses a sensor thatâs placed under your skin to automatically check your levels every few minutes.
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Glucose Tolerance And The Insulin Response
The glucose tolerance test is the most important test of carbohydrate function and is of particular value in those cases of diabetes in which the fasting blood glucose level is only moderately elevated and the diagnosis is equivocal. The blood glucose curve in diabetes characteristically shows a decreased tolerance for glucose , as evidenced by the long T½ or low k value, which reflects the inability of the animal to dispose of a test dose of glucose. The insulin response curve in Type I diabetes clearly demonstrates the inability of the pancreas to release insulin in response to the glucose load. The absence of an insulin response plays the primary role in the failure of the diabetic animal to utilize the added glucose. An equally important contributory factor is the overproduction of glucose by the diabetic liver in the presence of hyperglycemia. The test dose of glucose is in effect added to the burden of an already existing oversupply of glucose. Since the steady-state level at which the liver ceases to supply or remove glucose is elevated in diabetes, the liver continues to supply glucose, which contributes to the delayed return of the tolerance curve to its original level.
Robert Resnik MD, inCreasy and Resnik’s Maternal-Fetal Medicine: Principles and Practice, 2019
What Is A Glucose Test During Pregnancy
Glucose tests are used to screen for and diagnose gestational diabetes. They measure how efficiently your body processes sugar, which is key, since pregnancy hormones can affect this natural regulation process. Gestational diabetes is one of the most common pregnancy conditions up to 10 percent of pregnant women in the US develop it, according to the Centers for Disease Control and Prevention . Left untreated, gestational diabetes has some potentially dangerous consequences. An increased chance of preeclampsia, preterm labor and c-section are among the risks Mom may face. Whats more, baby may be born at a higher birth weight or with complications, such as respiratory distress or low blood sugar. Fortunately, proactive monitoring and treatment can help ensure you and baby stay healthy and safe. Suffice to say, the glucose test is a small price to pay.
So exactly what is a glucose testand what does it entail? First, its important to clarify that there are actually two different glucose tests during pregnancy: The first is a screening that identifies if youre at an elevated risk for gestational diabetes. If the initial glucose blood test shows that youre not processing sugar quickly, youll move on to the second, more involved glucose tolerance test. The latter is diagnostic, meaning youll have a definite answer.
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Get 150 Minutes Of Physical Activity Each Week
Several studies have shown a relationship between physical activity before or during pregnancy and a lower risk for developing gestational diabetes.
The American College of Obstetricians and Gynecologists recommend pregnant women get 150 minutes of moderate-intensity aerobic exercise each week. This can be split up in many different ways depending on what works best for your schedule.
Walking and swimming can be great activities for pregnant women. Prenatal yoga and pilates are also great options. However, you should talk to your doctor first about what kind of exercise is safe for you while pregnant.
If you havent been exercising regularly already, start out slowly and gradually increase your activity. Even just five minutes a day can be beneficial.
You can find more great tips onfinding time to exercise here.
How To Reduce Blood Sugar Levels During Pregnancy
If you neglect your body and make it a haven for unwanted glucose in it then for sure youre inviting risks both to you and your baby. Anything more and anything less than the needed sugar levels in the body during pregnancy invites unwanted complications warns the doctors. To reduce blood sugar levels knowing risk factors is important and the risk factors include
- Overweight which means having a body mass index above 30.
- Aged 25 or above.
- Delivered a baby weighed above 9 pounds.
- Having a high glucose level in blood and urine.
- The family has type 2 diabetes history.
- You previously had gestational diabetes.
Check for these risk factors and if needed consult your family doctor and take necessary screening tests. Based on his/her advice follow the stipulated advice in addition to knowing what to eat and not to eat. Have a proper diet plan in addition to being physically active. This way you can reduce additional sugar levels.
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Oral Gtt In Pregnancy
Oral GTTs are commonly used to screen women for gestational diabetes. There is a strong correlation between increasing maternal glucose levels at 2432 weeks gestation and a range of adverse maternal and fetal outcomes. Several different strategies are used worldwide in the screening and diagnosis of gestational diabetes.
The American Diabetes Association offers two approaches to gestational diabetes screening a one-step approach with a single 2 hour 75 g OGTT, or a two-step approach with a 1 hour 50 g screening OGTT followed by a confirmatory 3 hour 100 g OGTT in patients who screen positive.
The Australian Diabetes in Pregnancy Society Consensus Guidelines for the Testing and Diagnosis of Gestational Diabetes Mellitus in Australia recommend early testing for gestational diabetes mellitus in women with risk factors, in a tiered approach to early glucose testing.
Moderate risk factors include the following:
Ethnicity: Asian, Indian subcontinent, Aboriginal, Torres Strait Islander, Pacific Islander, Maori, Middle Eastern, nonwhite African
Body mass index of 2535 kg/m2
High risk factors include the following:
Previous gestational diabetes mellitus
Contributor Information and Disclosures
Jiun-Lih Jerry Lin, MBBS, MS Clinical Associate Lecturer, MD Program Research Supervisor, Sydney Medical School, University of Sydney Orthopaedic Registrar, Mona Vale Hospital, AustraliaDisclosure: Nothing to disclose.
The GTT procedure is as follows