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.
Why Do I Need A Glucose Tolerance Test
In pregnancy, women who will be offered a GTT will have been identified as having one of the following:
- A raised body mass index over 30kg/m². BMI is a measurement of your weight in kilograms and your height in metres.
- A previous baby over 4.5kg .
- Confirmed gestational diabetes in a previous pregnancy.
- Family origin .
- First degree relative that has diabetes .
Delivery When You Have Gestational Diabetes
When planning for the babyâs arrival, the doctor will access the size of the baby to determine if you can deliver vaginally. If you have been able to keep your blood glucose well-controlled, your babyâs weight is within an appropriate range, you donât have any other pregnancy concerns such as high blood pressure, and you are not on medication, than your labor should proceed just as it would if you didnât have gestational diabetes. Of course, your delivery team will monitor your blood sugar throughout.
If your baby is considered too large for you to deliver vaginally then you will likely be induced at week 38 or 39. You and your doctor may also decide that a cesarean section may be a better route for delivering the baby. Should blood sugar levels get too high during labor, the baby may release more insulin in response. That increases the risk of the baby developing low blood glucose after birth so a C-section may be considered.
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When Should I Measure My Blood Glucose
Throughout the rest of your pregnancy, you will need to measure your blood glucose levels at various points through the day, to check that they are within the limits you have been given at each of those times:
When you get up You need to measure your blood glucose levels each morning when you get up, before you have anything to eat or drink. This blood glucose level is called your fasting blood glucose level because you will have an empty stomach. You must not have eaten or drunk anything apart from water overnight, for at least eight hours.
Your team should have discussed this with you and agreed the ideal morning blood glucose level for you to aim for.
Before or after every meal You will probably be asked to measure your blood glucose level around the time of a meal. Some services measure before eating while others measure one or two hours after a meal .
Again, you will have discussed and agreed an ideal blood glucose level after meals with your diabetes team. These levels will be higher than your fasting blood glucose levels, as you will just have eaten.
If you are taking insulin to help to control your blood glucose levels, you may need to do a separate test before you go to bed, or even during the night, although this is unusual.
âWhen we did go out for a special meal or two, and Iâd have a little bit of cheesecake or something, it really affected my sugar levels. But that wouldâve been just twice in the whole pregnancy.âGemma, mum of one
Oral Glucose Tolerance Tests
The purpose of the oral glucose tolerance test is to measure the bodys ability to use a type of sugar, called glucose. Glucose is the bodys main source of energy. An OGTT can be used to diagnose prediabetes and diabetes. An OGTT is most commonly done to check for diabetes that occurs with pregnancy, called gestational diabetes.
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How To Prepare 3 Hour Test
If your doctor would like to see additional testing, based on your results from the 1 hour test, you may be asked to have a 3 hour OGTT. It is important to follow all of the instructions very carefully, as it will affect the results of the test.
When you arrive at the office a sample or baseline glucose test will be run and used for comparing other glucose values. You will be asked to drink a sweet liquid containing a measured amount of glucose, it is best to drink it quickly. Then blood samples will be collected at timed intervals of 1,2, and 3 hours after you drink the glucose.
Here is the best method of preparation:
What Will Happen After The Baby Is Born
You can stop sugar monitoring and/or insulin after the baby is born.Your family doctor will do another GCT about three months after the baby is bornto make sure that your sugar is normal again. Remember, even if the GCT after the baby is born is normal, you are still at a 10-50% higher risk in the future of diabetes. You can reduce this risk by exercising, eating a healthy diet and maintaining a healthy body weight.
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What Does It Involve
In the challenge test, you drink a glass of water with 50 grams of sugar dissolved in it. One hour later, blood is taken from a vein in your arm to measure your blood sugar levels. If the value is below 7.5 millimoles per liter , the results are considered to be normal and no more tests are done.
If the results of the challenge test are abnormal, a glucose tolerance test is done. Unlike the challenge test, it has to be done on an empty stomach. In other words, you shouldnt eat anything for at least eight hours beforehand. Youâre only allowed to drink still mineral water or tap water during this time. At the beginning of the test, a blood sample is taken. You then drink a sugar solution containing 75 grams of glucose dissolved in 300 ml of water. A blood sample is taken from a vein in the arm one hour later, and then again after two hours. If any of the following three blood sugar levels is reached or exceeded, gestational diabetes is diagnosed:
- After fasting: 5.1 mmol/l
- After one hour: 10.0 mmol/l
- After two hours: 8.5 mmol/l
The test results are documented in your maternity records. In Germany, the costs of the glucose challenge and tolerance tests are covered by statutory health insurers.
There are no known risks to the baby. Some women find the sugar solution unpleasantly sweet.
What Is The Difference Between Blood Glucose Screening And Tolerance Tests
Glucose screening and tolerance tests help healthcare providers check the way your body processes glucose . The screening test is used to determine if you are at risk of having gestational diabetes, and the tolerance test can help determine whether you actually have the condition. This information, and the steps taken in response, are crucial for the health of you and your baby. Youâll need to have your blood drawn, so you might feel dizzy or lightheaded, and you may have slight bruising or bleeding around the spot where blood was drawn, but otherwise the risks associated with these tests are minimal.
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How To Prepare 1 Hour Test
Alternatives To The Glucose Test During Pregnancy
Glucose tests are considered the gold standard for diagnosing gestational diabetes, and doctors strongly recommend that all women get the initial screening. However, we recognize that in some circumstances, including women whove had bariatric surgery, performing these tests may not be possible, says Greves.
Klein acknowledges that people may have trouble tolerating the highly concentrated drink. She says that, instead, they may be able to use a glucometer at home to regularly self-monitor their levels and assess if theres any blood glucose dysregulation. She adds that some doctors will allow alternatives to the Glucola beverage if its something equivalent to 50 or 100 grams of glucose. Another form of simple sugar, such as jelly beans or fruit juice may be acceptable, she says. Of course, protocols vary by practice, and Klein and Greves stress that youll want to discuss options with your doctor. They may want you to stick with the tried-and-true oral glucose tolerance test.
The initial glucose test during pregnancy is par for the course for moms-to-be. And those that need to carve out the time for the three-hour glucose tolerance test will come to realize that some minor unpleasantness is no big thing if it means keeping you and your little one on the path to a healthy delivery. Well drink to that.
About the experts:
Stephanie Klein, RD, LDN, CDCES, is a registered dietitian and the clinical director of diabetes prevention and reversal at Simplex Health.
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Is Gestational Diabetes My Fault
IT IS NOT YOUR FAULT!
This is due to the hormones released from the placenta. Those who are not diabetic are able to increase insulin production sufficiently enough. Those who cannot increase insulin production enough, or cannot use the insulin that is there effectively enough, are diagnosed with gestational diabetes.
How Can I Reduce My Risk Of Type 2 Diabetes
Women who have gestational diabetes have a high chance of developing type 2 diabetes at some point later in their lives. However, type 2 diabetes can be prevented. The following steps can reduce your risk:
- maintain a healthy eating plan
- maintain a healthy weight for your height
- do regular physical activity
- have regular follow-up blood tests every one to 3 years to check your blood glucose levels, especially if you have further pregnancies.
Talk to your doctor about follow-up blood tests to check for diabetes. The frequency of the tests will depend on your risk for developing diabetes.
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Who Is At Risk Of Gestational Diabetes
Between 3% and 8% 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. It is important to reach out and get support and help with managing it.
Some women are at increased risk of developing gestational diabetes. This includes women who:
- are over 40 years of age
- thrush .
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.
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What Are The Complications Of Gestational Diabetes
If your blood sugar levels remain high during your pregnancy, this may lead to pregnancy problems such as a large baby, miscarriage or stillbirth. Having a large baby can lead to complications and injury during the birth, and increase the chances of having intervention in labour such as a caesarean birth. But the baby will not be born with diabetes.
If you have gestational diabetes, you are at higher risk of developing high blood pressure while you are pregnant and a 50% increased risk of developing type 2 diabetes in the future. Your baby is also at greater risk of developing type 2 diabetes in later life.
To reduce your risk of developing type 2 diabetes:
- keep to a healthy weight
- eat a healthy diet
- be physically active
- check your blood glucose levels
You can also call Pregnancy, Birth and Baby on 1800 882 436 to speak to a maternal child health nurse for advice and support.
If I Have Gestational Diabetes How Will It Be Treated
Treating gestational diabetes comes down to one key factor: controlling your blood sugar. The goal is to manage your blood glucose level so that it doesnt go too high and stay high. This is accomplished by eating wisely, remaining physically active, and if needed taking medication to help keep your blood sugar levels in your target range.
The importance of treating gestational diabetes gained attention following the Hyperglycemia and Adverse Pregnancy Outcomes trial, which demonstrated a direct link between continuous treatment of the maternal glucose levels and reducing negative outcomes.²
What Should I Do Before Coming For The Gtt
As your midwife has identified a risk factor for gestational diabetes you will have been given an appointment for an oral Glucose Tolerance Test, usually at around 26/28 weeks of pregnancy.
You will need to have two blood tests taken. The second blood test will be taken two hours after the first. You will need to remain within the clinic until the test is completed. If you walk around or go home the test will become invalid as you will be burning off the sugar you have been given.
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What Is A Glucose Tolerance Test During Pregnancy And Why Is It Done
A glucose tolerance test is usually done during the second trimester of pregnancy, between 24 and 28 weeks. However if you have certain risk factors, like weight, or having a previously large baby they may test you earlier .
The test is used to screen for gestational diabetes, which is a type of diabetes that can develop during pregnancy.
Gestational diabetes happens when your body cant make enough insulin to handle the extra glucose in your blood during pregnancy. Insulin is a hormone that helps your body use or store glucose for energy.
For most women, gestational diabetes doesnt cause any noticeable symptoms. Thats why its important to get screened for the condition with a glucose tolerance test. If Gestational diabetes is not treated, it can lead to high blood sugar levels during pregnancy. This can cause problems for you and your baby, such as:
-Excessive weight gain in your baby
-Increased risk of cesarean delivery
-Breathing problems in your baby after birth
I want to be really clear on the fact that most often there is no way for you to know if you have gestational diabetes. These women dont tend to feel much different than other pregnant women so taking this test is truly the only way!
Hey, did you know that you are also at the perfect spot to take this too?