In order to determine whether you’ve developed gestational diabetes during pregnancy, doctors may test your blood sugar level. The most common procedure is a glucose screening.

Most women are tested between the 24th and 28th weeks of pregnancy, the time when the body is likely to begin having greater difficulty processing glucose. If you are at high risk, your doctor will likely test you much earlier. Pregnancy hormones disrupt your body's ability to make or use insulin (a hormone produced by the pancreas) that helps turn sugar from food into energy. When these hormones are disrupted, dangerously high amounts of sugar (glucose) can show up in the blood.

During the screening, you'll be asked to drink 50 grams of a sugary drink. After an hour, your blood will be drawn and tested for sugar levels. A normal reading should be less than 140 milligrams per deciliter, meaning you probably don't have gestational diabetes. If your glucose level is equal to or more than 140 mg/dl on this screening test, your doctor will usually ask you to take another test called a glucose tolerance test (GTT).

In this test, once your doctor has taken note of your fasting blood sugar, you will be asked to drink about 100 grams of a sugary drink. Then your doctor will take three blood samples over a three-hour period. If two or more of the four blood samples have high values, a diagnosis of gestational diabetes is confirmed.

The 2009 guidelines issued by the American Diabetes Association (ADA) recommend that all pregnant women have a risk assessment for gestational diabetes at their first prenatal visit. Women who are known to be at high risk of getting the condition should be screened as soon as possible after their pregnancy is confirmed. According to the ADA, a woman is considered to be high risk if she has any of the following risk factors:

•Is severely obese

•Has a strong family history of Type 2 diabetes

•Has glucose in her urine

•Has Polycystic Ovary Syndrome, or PCOS (a condition that affects a woman's menstrual cycle, hormone levels, heart, and blood vessels)

•Had gestational diabetes in a previous pregnancy

•Delivered a very large baby in a previous pregnancy

Like many screening procedures, initial glucose screenings have a high false-positive rate. You may simply be one of the 17.9 percent of women who test positive for the condition who aren't diagnosed with the disorder on follow-up testing. However, if your screening glucose test results show a reading of 200 mg/dl or more you'll automatically receive a probable diagnosis of gestational diabetes. In general, your blood glucose will need to be retested on a different day to confirm the diagnosis.

Below is a chart of the criteria for diagnosing gestational diabetes according to the American Diabetes Association standards (based on the standard glucose tolerance test plasma glucose results). To be diagnosed with gestational diabetes, you must test positive for at least two of these values:

Simply making some changes to your diet and adding exercise to your day can help keep your blood sugar levels from spiking after you eat. Your doctor or midwife may also refer you to a registered dietitian for nutritional counseling. Together you can work out a diet that provides enough calories and nutrients to keep you from going hungry while controlling your blood sugar level.

Depending on your diet, your counselor may suggest you increase the amount of fiber-rich foods you eat, as well as fruits, vegetables, and whole-grain cereals. You may also be advised to eat smaller meals more often, and to count the number of carbohydrates you eat during the day.

If diet and exercise don’t do the trick, your doctor may also prescribe insulin and recommend monitoring your blood sugar levels daily.

Either way, your health practitioner will closely monitor you and your developing baby to make sure you both stay healthy. Your practitioner may also suggest fetal monitoring to assess the size and well-being of your baby. These tests may include ultrasound exams and nonstress tests (noninvasive, painless procedures) that monitor your baby's heart rate.

After your baby is born, gestational diabetes usually goes away. But a small number of women continue having higher than normal blood sugar. Your practitioner will want to retest you, usually six to twelve weeks after your baby is born, to make sure you're free of the disorder.

-- Sarah Henry is a freelance writer whose health and parenting stories have appeared in The Washington Post, Los Angeles Times Magazine, Health, Hippocrates, Parenting and other publications.

References

Last updated May 26, 2009
Copyright © 2005 Consumer Health Interactive

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