Are There Any Risks
While the test itself does not come with any real risk, there are certain risk factors for developing gestational diabetesincluding being over the age of 25, having a family history of diabetes, and/or being obese. That said, half of those who develop gestational diabetes have no known risk factors, making testing is so important.
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:
Your Glucose Test During Pregnancy: How To Pass It
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If youre pregnant and expecting to have a glucose test as part of your prenatal care, you might be wondering how to prepare for the test. What can you eat and drink before the test? And what should you do on the day of the test? Keep reading for all the information you need to know about glucose tests during pregnancy.
But first, how do I know all of this?
Hi Im Hilary The Pregnancy Nurse . I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind Pulling Curls and The Online Prenatal Class for Couples. I even helped in a diabetes clinic during my 3rd pregnancy. I have helped LOTS of diabetic moms, and fielded lots of questions about the glucose test during pregnancy.
Possibly, similarly important, I have taken the glucose test with my three pregnancies, and I understand your desire to PASS that test.
First, lets chat a bit about what it is.
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Understanding Your Glucose Challenge Screening Results
There are some standard benchmark numbers used to separate those considered at low-risk for gestational diabetes from those who need to graduate to the three-hour blood glucose tolerance test. So whats the one-hour glucose test normal range? According to the Mayo Clinic:
- Blood sugar level below 140 mg/dL is normal and considered passing.
- Blood sugar level between 140 mg/dL and 190 mg/dL is elevated, and requires the follow-up three-hour glucose tolerance test to confirm gestational diabetes
- Blood sugar level of 190 mg/dL or higher indicates gestational diabetes. Your doctor will advise about the need for repeat or secondary testing. When results are this high, though, they may skip this step altogether and begin monitoring and treatment
Dont panic if your doctor or midwife informs you that your one-hour glucose test number comes back elevated . It doesnt necessarily mean you have gestational diabetes. This is just a screening test, and nearly 25 percent of patients fail this initial test, says Pope. A confirmatory three-hour glucose test is next.
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.
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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Risks And Possible Complications
There are numerous risks when gestational diabetes is not properly controlled and blood glucose levels remain high.
For the mother:
- Excess amniotic fluid, increases the risk of premature birth
- Risk of caesarean section or a more difficult vaginal birth
- Gestational hypertension or preeclampsia
- Higher risk of staying diabetic after the birth or of developing type 2 diabetes in the future .
For the baby:
What Does The Blood Glucose Test Involve
All pregnant women are offered this screening test between 24-28 weeks gestation. When other risk factors are present, such as obesity, the test may be offered earlier and then repeated if initially normal. The screening test for GD is called a glucose challenge, which aims to see how your body is handling sugars. The measurement is taken 1 hour after you consume a glucose drink. This test can be conducted at any time of day as it is not a fasting test. If your blood sugar is normal after the challenge, you will not require any more testing. If it is high, you will have a second test. This test is done in the morning while you are fasting and will require you not to eat prior to the test. You will have your glucose tested before consuming a glucose drink and then tested again 1 and 2 hours later. If your glucose is higher than specific cut-off values, it means you have GD. See the table for more specific information.
Screening for gestational diabetes
|Higher than 9.0 mmol/L = GD|
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Are There Any Side Effects Associated With The Glucose Tests
Most pregnant women donÃ¢t have any side effects during or after either glucose test. Itâs possible that you may feel nauseous, lightheaded, or even sweaty after drinking the glucose solution. It tastes like a very sweet soda, which can be easier to stomach for some women than for others.YouÃ¢ll need to have your blood drawn, so you might feel dizzy, and you may have slight bruising around the blood withdrawal spot, but otherwise the risks associated with these tests are minimal.
How Do I Pass The Glucose Tolerance Test In Pregnancy
In many countries, its recommended you pay specific attention to your diet in the three days prior to your GTT, and make sure you have a balance of proteins, fats and carbohydrates in each meal.
Here are some great examples of healthy, balanced breakfast ideas to help keep blood glucose levels stable.
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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.
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.
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How Do I Prepare For My 1
The glucose challenge test, sometimes referred to as the 1-hour glucose tolerance test, assesses your body’s response to sugar . How you prepare for the 1-hour glucose test depends on which type has been requested by your physician.
If you are unsure about which test you need to prepare for, ask your doctor. They will inform you of the screening procedure and whether there are specific instructions you must follow to ensure that the findings of the tests are accurate.
Three Hour Glucose Results:
- 2 hour < 155
- 3 hour < 140
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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What Is The Optimal Method Of Diagnosis
Since there is no clear glucose threshold above which pregnancy outcomes responsive to glycemic management occur , controversy persists as to the best diagnostic thresholds to define GDM. The International Association of the Diabetes and Pregnancy Study Groups Consensus Panel decided to create new diagnostic thresholds for GDM based on data from the Hyperglycemia and Adverse pregnancy Outcome study. IADPSG thresholds are the maternal glucose values from HAPO associated with a 1.75-fold increase of LGA, elevated C-peptide, high neonatal body fat or a combination of these factors, compared with the mean maternal BG values of women studied in HAPO. These arbitrary thresholds, when applied to the HAPO cohort, led to a GDM incidence of 17.8%. The National Institute of Health 2013 Consensus Conference summary statement stated that at present, the panel believes that there is not sufficient evidence to adopt a 1-step approach, such as that proposed by the IADPSG . However, since this publication, national organizations have published guidelines that are divergent in their approach to screening and diagnosis of GDM , thus perpetuating the international lack of consensus on the criteria for diagnosis of GDM.
Figure 1Preferred approach for the screening and diagnosis of gestational diabetes.
Figure 2Alternative approach for the screening and diagnosis of gestational diabetes.
Final Thoughts On Glucose Screening
The glucose test in pregnancy is an easy way to check your bodys ability to tolerate sugar.
Theres no way to cheat this test, and you should prepare for it by eating a well-balanced diet as soon as you find out youre pregnant.
If you fail the test, make sure that you follow up very closely with your doctor to try and prevent the development of type 2 diabetes mellitus.
Now I want to hear from you.
Did you fail your glucose test?
What did you do to prepare for it?
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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.
Screening And Diagnosis Of Gdm
Early screening. Screening for diabetes in the first trimester should be considered for diagnosing overt diabetes in women who are at risk , including those with a history of previous GDM. The ability to predict abnormal results on glucose screening tests at 24 to 28 weeks and risk of continued dysglycemia postpartum are other, but less compelling, reasons cited to screen in the first trimester.
The test of choice for early screening should be based primarily on the ability to predict poor obstetrical outcomes, which may be modifiable by lifestyle or pharmacological intervention. There are 2 strategies for testing glucose levels in early pregnancyusing the nonpregnancy-recommended screening tests or using the typical 24- to 28-week gestational diabetes screening criteria . To apply nonpregnant FPG or A1C criteria in early pregnancy does not take into account that both decrease early in pregnancy and may lead to underdiagnosis in women with pre-existing diabetes. On the other hand, there has been no rigorous validation that criteria accepted for the diagnosis of GDM in the second or third trimester are appropriate for use in the first trimester.
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How To Prepare For The Glucose Challenge Screening Test
The good news is that you dont really need to do much of anything to get yourself ready for this glucose screening test. We want to see how your body responds naturally to glucose, so just eat what you would regularly eat or drink, advises Greves.
Pope echoes this recommendation, but stresses that having long-term healthy lifestyle habits can ultimately improve your chances of passing: There really is no preparation besides trying your best to always eat as healthy as you can, and exercise routinely. This helps with glucose metabolism.
Still, if youve been doing your own internet sleuthing to figure out what to eat before your glucose testor in the hopes of sourcing hacks to help you pass the testknow that any touted tips are unproven and ill-advised. Patients always try and trick the system to try and pass the test. Theres no secret to this, says Pope. Whats more, you shouldnt want to cheat if youre at risk for gestational diabetes, you need to know so you can take the necessary next steps.
Who Needs To Have Glucose Tolerance Testing In Pregnancy
All pregnant people are advised to be screened for their risk of GDM. Anyone is at risk of developing GDM but youre at increased risk if:
- Your BMI is obese
- You have a family history of diabetes
- There is a high HbA1C test result in your early antenatal blood work
- You are aged over 35, and particularly if you are over 40
- You had GDM in a previous pregnancy
- You are having a multiple pregnancy with twins or triplets
- You have polycystic ovarian syndrome
- Are of Aboriginal and Torres Strait Islander, Melanesian, Polynesian, Indian subcontinent, Middle Eastern or Asian background.
If youre high risk you can skip the glucose challenge test and go straight to diagnostic glucose tolerance testing.
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