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. 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 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.

Physicians usually recommend that all pregnant women be screened for gestational diabetes, and may even order an early test for women who are known to have a high risk of getting the condition. According to the National Institute of Child Health and Human Development, a woman is considered at high risk of getting gestational diabetes if she has at least two of the following risk factors:

•Is a member of a high-risk ethnic group (Hispanic, African American,Native American,South or East Asian,Pacific Islander, or Indigenous Australian)

•Is overweight or obese

•Is closely related to anyone who has diabetes now or had diabetes in their lifetime

•Is older than 25

•Had gestational diabetes in a previous pregnancy

•Delivered a very large baby (heavier than 9 pounds) in a previous pregnancy

•Had a stillbirth

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 glucose test results show a reading of 200 mg/dl or more you'll automatically receive a probable diagnosis of gestational diabetes without the need to take the glucose test.

Below is a chart of the criteria for diagnosing gestational diabetes according to the National Diabetes Information Clearinghouse standards (based on the standard glucose tolerance test plasma glucose results):

Simply making some changes to your diet and adding exercise to your day can 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.

Your doctor may also prescribe medication to keep your blood sugar under control, and recommend monitoring your levels daily. Talk to your doctor about your medication options.

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 at the first visit and about six 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

First published August 15, 2005
Last updated March 17, 2008
Copyright © 2005 Consumer Health Interactive

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