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.
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.
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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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.
Testing For Gestational Diabetes
HomePregnancyHubPregnancy complicationsGestational diabetes Testing for gestational diabetes
There are some risk factors that increase your chance of developing gestational diabetes. Your midwife will ask you about these at your booking appointment, which happens around 8-12 weeks of pregnancy. If you have any of the risk factors, youll be offered a test for gestational diabetes when youre between 24 and 28 weeks pregnant.
Gestational diabetes does not usually cause any symptoms, but some women may have some if their blood glucose levels get too high. Speak to your midwife if you have any concerns. Talk to your midwife if you think you are at risk of developing gestational diabetes, but you havent been offered a screening test.
You dont have to take the test if its offered, but there are a few things to keep in mind:
- if you have gestational diabetes, you will be offered more care during both pregnancy and labour, to help reduce the risk of problems
- for some women, gestational diabetes can be improved by changes in diet and doing more exercise
- if changes in diet and doing more exercise dont improve gestational diabetes, youll be offered medication or insulin.
I wasnt obviously skinny, but I wasnt massively obese either I had no symptoms whatsoever. I had no expectation that the test would be anything other than a formality.
Beth, mum of two
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What Is A Glucose Test During Pregnancy
Having a glucose test in pregnancy helps to diagnose gestational diabetes mellitus .
There are several ways to test glucose levels and your bodys ability to break down sugar. Depending on where you live, the process of assessing risk factors and diagnosing GDM might differ.
Usually in the first trimester, your antenatal blood tests might include one called HbA1C.
If the result of HbA1C comes back as high, it indicates youre at risk of developing GDM or another type of diabetes during pregnancy.
HbA1c cant diagnose GDM, so youll also need glucose tolerance testing for further screening and diagnosis.
These screens are usually done in two steps:
- Glucose challenge test , sometimes called the 1 hour glucose test.
- Glucose tolerance test , also known as the 3 hour glucose test.
The GCT is becoming a standard antenatal test for all pregnancies. If its positive, youll be asked to follow up with a GTT to diagnose GDM.
What Do The Results Of The Glucose Tests Mean
As the normal range for blood sugar levels detected in the glucose challenge test and the glucose tolerance test may vary depending on the lab or clinic, your provider will be your best resource for information and advice on your specific results and recommended next steps in your pregnancy. However, these general guidelines may apply:
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Risk Of Neonatal Hypoglycemia Is Related To Maternal Bg Levels
Maternal hyperglycemia during labour, even when produced for a few hours by intravenous fluids in mothers without diabetes, can cause neonatal hypoglycemia . Studies have generally been performed in mothers with pregestational diabetes or insulin- treated GDM. These have been observational with no randomized trials deliberately targeting different levels of maternal glycemia during labour. Most have found that there is a continuous relationship between mean maternal BG levels during labour and the risk of neonatal hypoglycemia with no obvious threshold. Authors have often chosen 2 levels within the range and shown that there is more hypoglycemia with the higher value, but the studies do not arrive at a common value and vary from < 4.6 mmol/L to < 8.0 mmol/L . By consensus, we suggest aiming for < 7.0 mmol/L during labour and delivery.
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.
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Who Is At Risk
Risk factors for gestational diabetes include:
- having had gestational diabetes in an earlier pregnancy
- a family history of diabetes
- having obesity or other diabetes-related conditions
- being physically inactive
- older age
If a person gains more weight than is usual during pregnancy, this may be a sign of gestational diabetes, according to the
- attending more frequent screening and seeking medical help if glucose levels go up
- insulin use, in some cases
The healthcare provider will advise on each persons needs and treatment plan, as diabetes affects everyone differently.
Is The Glucose Test During Pregnancy Optional
Doctors recommend having a glucose test for gestational diabetes, but it’s not mandatory. Here’s what you need to know to make an informed choice.
Its an appointment on the calendar most pregnant women dread: the glucose test , usually scheduled around week 26 to week 28 of pregnancy. Youve no doubt seen many Instagram or Facebook pics posted by women tasked with drinking the super-sweet, typically orange liquid to gauge their bodys ability to handle glucose.
This test is one of the ways to screen for gestational diabetes, a temporary form of diabetes that occurs only in pregnancy and typically resolves after delivery.
The mama-to-be drinks the juice, hangs out for an hour in the waiting room, and then has blood taken to measure her glucose levels. Your care provider may also specify a time constraint, like drinking the whole bottle in three to five minutes.
A reading higher than 7.7 millimoles/L on the gestational diabetes chart calls for further follow-up testing, often called the glucose tolerance test. A reading higher than 11.1 millimoles/L likely means a gestational diabetes diagnosis.
The night before my third visit to the lab, my husband asked me what would happen if I just skipped the test. I didnt knowI assumed it was mandatory.
If you selected a midwife as your care provider instead of an OB/GYN, whether or not youre going to take the glucose test to begin with may be presented as a question, instead of as an assumption or recommendation.
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Risks If You Have Diabetes In Pregnancy
If you have diabetes when you are pregnant and dont get treatment:
- your baby can grow too big, and this can cause problems for you and your baby during the birth
- you can develop high blood pressure and pre-eclampsia
- your baby may have problems with their own blood sugar when they are born, and they will have more risk of getting diabetes later in life.
What Can I Do To Manage The Risks Of Diabetes In Pregnancy
Its really overwhelming to get a diagnosis of gestational diabetes. You might do everything right to keep yourself well in pregnancy and still receive a diagnosis of GDM.
Gestational diabetes isnt necessarily a reflection on your health or weight, or the health of your baby. Theres still plenty you can control to support your health. Many pregnant people use diet to manage their diabetes and dont need medication.
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Extra Tests You May Be Offered
A Glucose tolerance test is a way of examining how your body handles glucose. If a GTT is deemed necessary it is routinely performed at 26-28 weeks of pregnancy .
If the result is not as expected you will be referred to Southmead Hospital Antenatal Clinic Diabetes Obstetric Team if you are booked to birth there. If you are booked at RUH or UHB, then a referral will be made to their endocrine service.
What Is The Oral Glucose Tolerance Test
Gestational diabetes is tested with the oral glucose tolerance test . The test is simple and will not harm you or your baby. It may be carried out at your usual clinic or at a special diabetes clinic.
Step 1 You will usually be asked not to eat anything and drink only water the night before and on the morning of the test.
Step 2 A nurse takes a blood sample from you to measure your blood glucose level.
Step 3 You drink a glucose drink.
Step 4 After 2 hours, the nurse takes another blood sample and measures your blood glucose level, to see how your body processed the sugars in the glucose drink.
You shouldnt eat anything before or during the glucose tolerance test. But if you dont live near the clinic its a good idea to bring a snack with you, as you will probably be hungry afterwards.
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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|
What Happens During The Oral Glucose Tolerance Test
The oral glucose tolerance test involves quickly drinking a sweetened liquid , which contains 50g of glucose. The body absorbs this glucose rapidly, causing blood glucose levels to rise within 30 to 60 minutes. A blood sample will be taken from a vein in your arm about 60 minutes after drinking the solution. The blood test measures how the glucose solution was metabolized .
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Symptoms Of Gestational Diabetes
Gestational diabetes does not usually cause any symptoms.
Most cases are only discovered when your blood sugar levels are tested during screening for gestational diabetes.
Some women may develop symptoms if their blood sugar levels gets too high , such as:
- needing to pee more often than usual
- a dry mouth
But some of these symptoms are common during pregnancy and are not necessarily a sign of gestational diabetes. Speak to your midwife or doctor if you’re worried about any symptoms you’re experiencing.
Why Might My Healthcare Provider Recommend These Tests
Some doctors recommend all pregnant women â even those with a low risk of gestational diabetes â take a glucose screening test between weeks 24 and 28 of pregnancy. Some doctors, though, may not automatically offer it to pregnant women under age 25 who have a low risk of gestational diabetes. If you have one or more of the risk factors for gestational diabetes, your healthcare provider will likely offer you the screening or the glucose tolerance test at one of your first prenatal visits instead of waiting until the second trimester screening. Risk factors for gestational diabetes include:
Having had gestational diabetes in an earlier pregnancy
A family history of diabetes
Having conditions such as metabolic syndrome or polycystic ovary syndrome .
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How To Prepare 1 Hour Test
Foods To Eat Before A Pregnancy Glucose Test
In order to pass the glucose test, you should plan to eat a healthy diet as soon as you become pregnant and throughout your pregnancy.
Changing what you eat a day or a week before your glucose test wont make much of a difference .
When planning your meals, focus on complex carbohydrates, fiber, lean proteins, and nutrient-dense fruits and vegetables.
Here are some healthy foods to incorporate into your diet to help maintain optimal blood sugar levels:
- Whole grains
- Non-starchy vegetables
- Fresh fruits
- Healthy proteins
- Nuts/nut butters and seeds
- Dairy .
On the day of your glucose test, be sure to eat a healthy breakfast or lunch that is low in carbs and high in protein.
Examples of foods to eat for breakfast would be eggs, cheese, a protein shake, bacon, or sausage.
Examples of foods for lunch would be a salad with a low-sugar dressing. Or any kind of meat with a side of vegetables.
And if you can, take a quick 10 minute walk after you eat. This can help to regulate your glucose levels further.
Dont be tempted to skip out on breakfast, because it can actually throw your glucose levels out of whack!
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