How Is Diabetes During Pregnancy Diagnosed
Nearly all nondiabetic pregnant women are screened for gestational diabetes between 24 and 28 weeks of pregnancy. A glucose screening test is given during this time. For the test, you drink a glucose drink and have your blood glucose levels tested after 2 hours.
If this test shows a high blood glucose level, a 3-hour glucose tolerance test will be done. If results of the second test are not normal, gestational diabetes is diagnosed.
When Do You Have The Glucose Tests During Your Pregnancy
The glucose challenge test is usually performed between 24 and 28 weeks of pregnancy in women who are determined by their healthcare providers to be at low risk of gestational diabetes.If your healthcare provider has determined that you are at high risk of developing gestational diabetes, the provider may order the glucose challenge test for you earlier than the aforementioned range.If the result of the glucose challenge test comes back indicating a high level of glucose, your provider may order another testâcalled a glucose tolerance testâto more accurately diagnose your chance of developing gestational diabetes during pregnancy.If the result of an early glucose challenge test comes back indicating a normal level of glucose in your blood, your provider may order an additional glucose challenge test between 24 and 28 weeks of pregnancy.
Are There Any Risks And Precautions
Although the glucose tolerance test is considered safe, it does have some risk of side effects or complications. Though rare, the side effects or complications may include:
- infection, if the area is not properly sterilized before the sample is taken
- excess bleeding from the area that was punctured
- bruising and swelling where the needle was inserted
- feeling light-headed
You will be monitored throughout the test to make sure that your blood glucose level does not drop too low. You may experience weakness, sweating, anxiety, hunger, or other symptoms if this happens. Be sure to tell the person performing the test if you experience any of these symptoms.
People with bleeding disorders or anyone taking medication that reduces the ability of the blood to clot should tell the technician before the samples of blood are taken. These conditions and medications may require special attention at the time of testing.
If you are concerned about any symptoms following this test, speak to your doctor. Take the time to be sure you understand all the risks of complications and side effects as well as any precautions you or your doctor can take to avoid them. Be sure your doctor understands all your concerns.
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How Do I Get Ready
To get an accurate result on the OGTT, eat about 150 grams of carbohydrates each day for 3 days before the test. Don’t eat or drink anything except water after about 10 oâclock the night before.
You don’t need to do any special prep before the pregnancy glucose challenge test. You can eat in the morning. Just avoid foods with a lot of sugar, such as doughnuts or orange juice.
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How The Test Will Feel
Drinking the glucose solution is similar to drinking very sweet soda.
Serious side effects from this test are very uncommon. With the blood test, some people feel nauseated, sweaty, lightheaded, or may even feel short of breath or faint after drinking the glucose. Tell your doctor if you have a history of these symptoms related to blood tests or medical procedures.
When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon goes away.
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.
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Why Do I Need A Glucose Screening Test During Pregnancy
Most healthcare providers routinely recommend a glucose screening test to check for gestational diabetes.
Gestational diabetes is a high blood sugar condition that some women get during pregnancy. Between 2 and 10 percent of expectant mothers develop this condition, making it one of the most common health problems during pregnancy. And because the condition rarely causes any symptoms, testing is the only way to find out whether you have it.
The GCT is a screening test, which means it won’t give you a diagnosis. Instead, it’s designed to identify as many women as possible who might have gestational diabetes but need more testing to find out. So a positive result doesn’t mean that you have gestational diabetes.
In fact, only about a third of women who test positive on the glucose screening test actually have the condition. If you test positive, you’ll need to take the glucose tolerance test a longer, more definitive test that tells you for sure whether you have gestational diabetes.
Some providers skip the glucose screening test altogether and instead order a shortened version of the glucose tolerance test, which is also called a one-step test .
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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How Does Your Body Handle Carbohydrates
When you eat or drink something, your body breaks it down into its constituent chemical building blocks. For carbohydrates, these molecules are simple sugars, mainly glucose. During digestion, the glucose from your food travels into your bloodstream and your blood sugar levels increase.
The hormone insulin is responsible for regulating your blood sugar levels. Produced in the pancreas and released into the bloodstream in response to rising sugar levels, it acts as a key that âunlocks the doorâ to your cells, so glucose can go in and either be used for energy now or stored for later.
When your body is working well, you produce enough insulin to handle all the sugar in your food, rapidly returning your blood sugar levels to where they were before you ate.
But this isnât always the case.
Whats In The Glucose Test Drink
If you just do the first test, theres 50 grams of sugar in the bottle. For the second test, the amount of glucose is higher 100 grams in the glucola drink. The sugar in glucola is typically dextrose . Glucola also contains purified water and preservatives like citric acid or sodium benzoate, food colorings, and soybean oils, but ingredients vary by the brand your lab uses.
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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.
How Is Gestational Diabetes Diagnosed
Most women are diagnosed using a pathology test, which requires blood samples to be taken before and after a glucose drink. This is known as a pregnancy oral glucose tolerance test . This test is usually performed between 24 and 28 weeks into the pregnancy, or earlier if you are at high risk.
A pregnancy oral glucose tolerance test involves:
- fasting overnight
- having a blood test in the morning
- having a drink containing 75 grams of glucose
- having a blood test one hour after having the drink
- having a blood test 2 hours after having the drink.
Gestational diabetes is diagnosed if any of the results from the test show that your blood glucose is raised.
During COVID-19, further diagnostic guidelines have been added as alternatives to the OGTT where this cannot be performed due to a contagion risk. Check with your doctor or hospital about current guidelines.
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What Happens After My Baby Is Born
If you have been injecting insulin to help manage gestational diabetes this usually stops once your baby is born. This is because womens blood glucose levels usually return to the optimal range quite quickly after their babys birth.
Following the birth of your baby, it is important that your babys blood glucose levels are measured to check that their blood glucose is not too low. If it is, this can be treated by feeding your baby breast milk or formula. Breastfeeding is encouraged as this is best for you and your baby.
Your blood glucose levels will be measured for a few days after your baby is born to make sure that they are within the recommended range. Glucose checking times are usually before breakfast and 2 hours after meals. An oral glucose tolerance test is done 6 to 12 weeks after the baby is born to check that your diabetes has gone away.
During COVID-19, recommendations are to delay the OGTT testing for 6 months, if you are not able to social distance at the pathology centre or living in a high-risk area. It is recommended to have an OGTT before your baby is 12 months old or if planning another pregnancy. Be guided by your doctor.
A baby whose mother had gestational diabetes will not be born with diabetes, but they may be at higher risk of developing type 2 diabetes later in life.
What Is The Glucose Tolerance Test Like Do I Have To Fast
Fast overnight: Typically you’re instructed to eat a late meal the night before the test and then to eat or drink nothing after that, except for sips of water. The fasting period is usually 8 to 14 hours before the test, so you’ll want to schedule the test for first thing in the morning.
Here’s what to expect at the lab:
- First blood draw: When you arrive for the test, a blood sample is taken to measure your fasting blood glucose level.
- An even sweeter drink: Next, you’ll drink either a more concentrated dose or a larger volume of glucose solution.
- Three more blood draws: Brace yourself for three more arm pricks, as your blood is tested every hour for the next three hours. The lab tech should alternate arms each time your blood is drawn.
Some tips to make your test more comfortable:
- Have someone drive you to and from the test in case you feel lightheaded or are low on energy due to fasting.
- Bring something to distract you, because you have to stay nearby when your blood is not being drawn.
- Bring something to eat right after the final blood sample is taken, because you’ll probably be starving.
Results: After the test, if one of the readings is abnormal, you may have to take another test later in your pregnancy. Or your provider may ask you to make some changes in your diet and exercise routine. See “What is the treatment for gestational diabetes?” below.
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If You Get Low Blood Sugar
While you are waiting, tell a nurse if you have symptoms of low blood sugar , including weakness, sweating, anxiety, shakiness, pale skin, hunger, or irregular heartbeat.
Once all of the blood samples have been taken, you can go home. However, if you feel lightheaded or dizzy, you might be asked to wait a little longer before going home to make sure you’re OK.
You can go back to your normal routine and diet after the test.
Why The Test Is Performed
Glucose is the sugar the body uses for energy. People with untreated diabetes have high blood glucose levels.
Most often, the first tests used to diagnose diabetes in people who are not pregnant are:
- Fasting blood glucose level: diabetes is diagnosed if it is higher than 126 mg/dL on 2 different tests
- Hemoglobin A1c test: diabetes is diagnosed if the test result is 6.5% or higher
Glucose tolerance tests are also used to diagnose diabetes. The OGTT is used to screen for or diagnose diabetes in people with a fasting blood glucose level that is high, but is not high enough to meet the diagnosis for diabetes.
Abnormal glucose tolerance is an earlier sign of diabetes than an abnormal fasting glucose.
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How Is The Glucose Screening Test Done Do I Have To Fast
No, you don’t have to fast for the screening test. You can eat and drink that day as you normally would.
Here’s what to expect during and after the test:
- A sweet drink: When you arrive for the test, you’ll drink a sugar solution that contains 50 grams of glucose. The stuff tastes like a very sweet soda pop , and you have to get all of it down in five minutes. Some providers keep it chilled or let you pour it over ice and drink it cold.
- A blood draw: An hour later, a blood sample is taken to check your blood sugar level. The result indicates how efficiently your body processes sugar.
- Results: These should be available in a few days. If the reading is too high, which happens an estimated 15 to 23 percent of the time, you’ll be asked to return for a three-hour glucose tolerance test to see whether you have gestational diabetes. The good news is that most women whose screening test shows elevated blood sugar don’t turn out to have gestational diabetes.
Oral Glucose Tolerance Test: Uses And Results
The oral glucose tolerance test measures how well the body can break down and use sugar as well as clear it from the bloodstream. It’s also called a glucose tolerance test and is safe for adults and children.
For the test, you drink a syrupy solution after not eating for a while . A few blood samples are taken to see how your body is handling the sugar in the drink.
This article will go over why the oral glucose tolerance test is used, what to expect if you have to have it done, and what your results mean.
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What Is Lactose Intolerance
Lactose intolerance is a condition that is quite common among adults of Hispanic, African-American, American Indian and Asian descent. In some cases, infants usually have lactose intolerance due to an uncommon genetic fault or premature birth. The symptoms of lactose intolerance can be mild or severe and tends to occur 30 minutes or even up to 2 hours after eating dairy products. The treatment involves regulating or avoidance of foods that include lactose or using a lactase enzyme medication when dairy products are eaten. If you suspect that a family member is intolerant, it is best to consult a doctor for further testing and assessment.
Monitoring Blood Glucose Levels
Monitoring your blood glucose levels is essential. It gives you a guide as to whether the changes you have made to your lifestyle are effective or whether further treatment is required.
A diabetes nurse educator can teach you how and when to measure your blood glucose levels. They will discuss the recommended blood glucose levels to aim for.
Your doctor or diabetes educator can help you register with the National Diabetes Services Scheme for discounted blood glucose strips. Regular contact with your diabetes educator or doctor is recommended.
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How Do You Manage Gestational Diabetes
If you are diagnosed with gestational diabetes, it is important that you are supported and know what to do to manage it. Health professionals such as your doctor, a dietitian, a diabetes nurse educator, or sometimes, a diabetes specialist will help you understand what to do and will support you.
Family also can be a great support. It is important that your family understands gestational diabetes and how it is managed.
Management of gestational diabetes aims to keep blood glucose levels in the recommended range during pregnancy. This can prevent problems during birth and also helps reduce the babys risk of being overweight in childhood and developing type 2 diabetes later in life.
Management of gestational diabetes involves:
- monitoring blood glucose levels
- healthy eating. Referral to a dietitian is an important part of management. Often this will be organised for you via your health care team
- regular physical activity
Some women may need insulin injections to help manage their gestational diabetes.