diabetestalk.net

Early Glucose Test During Pregnancy

Are We Testing For Gestational Diabetes Too Late?

Are We Testing For Gestational Diabetes Too Late?

A new study shows that babies are already showing the effects of gestational diabetes by the time expectant moms are tested for it. So are we testing too late? No one likes the glucose tolerance test—having to chug down that nasty orange drink, and hoping there are no side effects. Unfortunately, screening for high blood sugar is a necessity in pregnancy, as gestational diabetes mellitus (GDM) can cause problems ranging from stillbirth to childhood obesity. But a new study published in journal Diabetes Care suggests that unborn babies are showing the effects of GDM before expectant mothers are even tested for it, throwing the screening's relevance into question. Should pregnant women be tested even earlier? Diagnosis after baby is already affected Researchers looked at data from over 4,000 pregnant women to measure baby's growth, as large size is an indicator of gestational diabetes, and compared that info to the 171 moms who actually developed GDM later on. They also looked at which women were obese, another risk factor for GDM. "Gestational diabetes and obesity were both associated with accelerated growth of the [baby's] abdomen between 20 and 28 weeks," study author Gordon Smith, M.D., Ph.D., the head of the department of obstetrics and gynecology at the University of Cambridge in the UK, tells Fit Pregnancy. "In relation to gestational diabetes, measurements were normal at 20 weeks, but were large by 28 weeks. Women who were both obese and had a diagnosis of gestational diabetes were almost five times more likely to have a baby with a large abdominal measurement at 28 weeks." Because GDM wasn't actually diagnosed in the women until 28 weeks, "the effects of gestational diabetes [are] already present at the time we normally make the diagnosis," Dr. Smith says. Alth Continue reading >>

Anyone Else Have To Do An Early Glucose Test?

Anyone Else Have To Do An Early Glucose Test?

I had to with my last pregnancy. I have PCOS and my OB thought that with some mild insulin resistance, I should take it early. I begged her not to make me because I always fail the one hour and pass the three hour. Sure enough, that's what happened with the early test. But then I had to do it again later in the pregnancy, which meant 2 one hour tests and 2 three hour tests. Some people dread epidurals or stretch marks...I dread the glucose tests. Hate them! I'm sure you will do fine, though, especially if you are down some weight. Good luck! Is this the test to look for gestational diabetes? I wanted my OB to test me early since I have PCOS but she won't because I'm not overweight. Not sure if I should push for it or not. Based on all of your responses it sounds pretty nasty so maybe it's a good thing that I don't have to do it early!? NTNP since 11/12, actively trying since 8/14 12/17/15: Got to see the heartbeat (105bpm)! Yep, also due to my weight I had to do an early test. I was kind of close to the minimum level of concern, so then I did a second 1-hour test and I was borderline, so my doc had me do the 3-hour test - fasting, with a baseline blood draw before drinking, and then a blood draw every hour. My blood sugar was perfectly fine, and actually my level at the 3rd hour was really low, even lower than my baseline. Which explains why I feel like crud when I eat too much sugar, and why I left the lab that day feeling woozy and headachey. The thing is, I wish they would do the 1-hour test as a fasting test and take a baseline blood draw before you drink the drink. I feel like that would give more accurate results from the very beginning, and then maybe people in our situation wouldn't potentially have to do 3 tests. I have some backup on this from my husband who Continue reading >>

Need For Testing Glucose Tolerance In The Early Weeks Of Pregnancy

Need For Testing Glucose Tolerance In The Early Weeks Of Pregnancy

Need for testing glucose tolerance in the early weeks of pregnancy 1Diabetes in Pregnancy Study Group India, Bengaluru, Karnataka, India 2International Association of Diabetes and Pregnancy Study Group, Bengaluru, Karnataka, India 3Dr. Balaji Diabetes Care Centre and Dr. V. Seshiah Diabetes Research Institute, Bengaluru, Karnataka, India 4Expert Review Committee, Bengaluru, Karnataka, India 5Expert Group Committee on GDM, Bengaluru, Karnataka, India 6Ministry of Health Government of India and Indian Council of Medical Research, Bengaluru, Karnataka, India 7Federation of Obstetrics and Gynecology Society India, Bengaluru, Karnataka, India 8Divakar's Speciality Hospital, Bengaluru, Karnataka, India 1Diabetes in Pregnancy Study Group India, Bengaluru, Karnataka, India 1Diabetes in Pregnancy Study Group India, Bengaluru, Karnataka, India 2International Association of Diabetes and Pregnancy Study Group, Bengaluru, Karnataka, India 3Dr. Balaji Diabetes Care Centre and Dr. V. Seshiah Diabetes Research Institute, Bengaluru, Karnataka, India 5Expert Group Committee on GDM, Bengaluru, Karnataka, India 6Ministry of Health Government of India and Indian Council of Medical Research, Bengaluru, Karnataka, India 1Diabetes in Pregnancy Study Group India, Bengaluru, Karnataka, India 2International Association of Diabetes and Pregnancy Study Group, Bengaluru, Karnataka, India 3Dr. Balaji Diabetes Care Centre and Dr. V. Seshiah Diabetes Research Institute, Bengaluru, Karnataka, India 4Expert Review Committee, Bengaluru, Karnataka, India 5Expert Group Committee on GDM, Bengaluru, Karnataka, India 6Ministry of Health Government of India and Indian Council of Medical Research, Bengaluru, Karnataka, India 7Federation of Obstetrics and Gynecology Society India, Bengaluru, Karnataka, India 8Di Continue reading >>

All You Need To Know About The Glucose Tolerance Test

All You Need To Know About The Glucose Tolerance Test

Most of the food people eat is turned directly into glucose when digested, and the body uses it as energy. The pancreas is responsible for making the hormone insulin which helps to get glucose into the cells of the body. Diabetes is a long-term disease that occurs due to the pancreas not producing enough insulin or the body being unable to use the insulin it produces effectively. The body is unable to process food properly to use for energy. Glucose builds up in the blood, which can lead to severe health problems. There are two main types of diabetes. Type 1 diabetes is usually diagnosed in children and young adults and is also known as juvenile diabetes. With type 1 diabetes the body does not produce insulin. According to The American Diabetes Association, only 5 percent of people with diabetes have type 1. Type 2 diabetes is the most common form of diabetes. In people with type 2 diabetes, their body does not use insulin properly, which is known as insulin resistance. The pancreas responds by making more insulin to cover the deficiency but is not able to keep blood glucose at normal levels. As glucose builds up in the blood, the body's cells do not receive the energy they need. Over time, high blood glucose levels can damage the eyes, kidneys, nerves, and heart. Glucose tolerance test: Testing for diabetes A simple blood test can often detect diabetes. If the test produces borderline results, a glucose tolerance test may help with the final diagnosis. In a healthy person, glucose levels will rise after eating a meal and return to normal once the glucose is used or stored by the body. A glucose tolerance test can help to work out the difference between normal glucose levels and the levels seen in diabetes and prediabetes. The glucose tolerance test is used to measure t Continue reading >>

Glucose Screening And Glucose Tolerance Test

Glucose Screening And Glucose Tolerance Test

Nearly 1 in 10 women will develop gestational diabetes (GD or GDM) during pregnancy — which is why almost all practitioners screen for it in all their patients. Fortunately, gestational diabetes is also one of the most easily managed pregnancy complications. When blood sugar is closely controlled through diet, exercise and, if necessary, medication, women with gestational diabetes are likely to have perfectly normal pregnancies and healthy babies. When a glucose screening is done The glucose screen is usually done between week 24 of pregnancy and week 28 of pregnancy. Some practitioners may test earlier if you're at higher risk for the disorder, including if you're obese, 35 or older, have a family history of diabetes or had gestational diabetes in a previous pregnancy. How a glucose screening is done The glucose screening is simple, especially if you have a sweet tooth. First, you'll drink a very sweet glucose (aka sugar) drink, which usually tastes like flat orange soda. Then you'll wait for one hour before having some blood drawn and tested for glucose. Most women chug the stuff with no problem and no side effects; a few, especially those who don't have a taste for sweet liquids, feel a little queasy afterwards. How a glucose tolerance test is done If the results of your glucose screening show elevated levels of glucose in your blood, it's possible that you might not be producing enough insulin to process the extra glucose in your system. Your doctor may then order a glucose tolerance test. For this diagnostic test, you'll be asked to fast overnight. Your blood will be drawn in the morning, and then you'll drink a higher-concentration glucose mixture. Your blood will be drawn three more times, at one, two, and three hours later. If a glucose tolerance test diagnose Continue reading >>

Glucose Tolerance Test - 1st Tri??

Glucose Tolerance Test - 1st Tri??

Hi LizzieJane, firstly try not to worry. The exact same thing has happened with me. Basically at my 10&3 scan they took blood, rang me a week later to say my blood sugar was too high to go in for a GTT (Glucose Tolerance Test). The test lasts 3 hours. Once you go in they will take 4 testtubes of blood. Afterwards you drink a really sugary glucose drink which isn't the most pleasant. One hour later they take another 2 testtubes of blood. Another hour later then take another two then they fed me with food and i was able to go. The worst part for me was the throwing up before the test as i had M/S and was sick if i didn't eat first thing. You need to fast from the evening before until after the test. Test was for 8.30am so didn't get eating to 12. They rang me that afternoon to say that all 3 readings were too high - fasting, one hr later and two hours later. I am now with the Metabloic Clinic and i have to go every 2 weeks. The upside is i now receive scans every 4 weeks as they want to check the size of the baby. The problem is the stomach can get bigger than the head and there is an increased chance of stillborn therefore they won't let me get to full term. Ideally they would induce at 39 or if have too at 37-38 but baby wld be on steriods for lungs to build up. 50% get a Caescaran. Firstly you will try to control with diet. This is my 3rd day of it and it's ok, just no sweets/cakes/buns etc. I have to prick myself 7 times a day and record readings. will discuss when go back to hospital. Worse case scenario is that insulin will need to be injected but hoping with diet/exercise it won't get this far. Apprantely after 20 weeks it will get gradually worse. I am now 13&1. Sorry this is so long but wanted to try and help you out as i know how scared it was. If you need any Continue reading >>

Diabetes Mellitus In Pregnancy: Screening And Diagnosis

Diabetes Mellitus In Pregnancy: Screening And Diagnosis

INTRODUCTION Pregnancy is accompanied by insulin resistance, mediated primarily by placental secretion of diabetogenic hormones including growth hormone, corticotropin-releasing hormone, placental lactogen, and progesterone. These and other metabolic changes ensure that the fetus has an ample supply of nutrients. (See "Maternal adaptations to pregnancy: Endocrine and metabolic changes".) Gestational diabetes develops during pregnancy in women whose pancreatic function is insufficient to overcome the insulin resistance associated with the pregnant state. Among the main consequences are increased risks of preeclampsia, macrosomia, and cesarean delivery, and their associated morbidities. The approach to screening for and diagnosis of diabetes in pregnant women will be reviewed here. Management and prognosis are discussed separately: Continue reading >>

Early-pregnancy Glucose Screening For Gestational Diabetes Mellitus

Early-pregnancy Glucose Screening For Gestational Diabetes Mellitus

From the Departments of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina; University of Hawaii School of Medicine, Honolulu, Hawaii; and California State University, Stanislaus, Turlock. Dr. Nahum is Associate Clinical Professor, Residency Program Coordinator and Director of Medical Student Education, Department of Obstetrics and Gynecology, Duke University School of Medicine. Dr. Wilson is in private practice in Honolulu, Department of Obstetrics and Gynecology, University of Hawaii Medical Center. Dr. Stanislaw is Professor and Chair, Department of Psychology, California State University, Stanislaus. Address reprint requests to: Gerard G. Nahum, M.D., Department of Obstetrics and Gynecology, Duke University Medical Center 3241, Durham, NC 27710 ([email protected]). Financial Disclosure: The authors have no connection to any companies or products mentioned in this article. 0024-7758/02/4708-0656/$15.00/0 Journal of Reproductive Medicine OBJECTIVE: To determine the accuracy of the 50-g, one-hour glucose screening test administered at 16 weeks patients without diagnoses of gestational diabetes during the second trimester of pregnancy underwent standard RESULTS: Gestational diabetes mellitus was diagnosed in 25 patients. Glucose screening tests administered at 16 weeks of pregnancy identied 96% (24) of these pa- tients. Patients with 16-week glucose screening test re- sults 135 mg/dL had a 55% risk of developing diabetes during pregnancy, while the risk was 0.6% for patients with 16-week test results 110 mg/dL. Patients with 16- week glucose screening test results in the intermediate range, 111134 mg/dL, had a 4.8% risk of developing di- This latter nding is superior to the 8.622% found dur- ing the third-trimester. (J Reprod Med 2 Continue reading >>

Glucose Test During Pregnancy For Gestational Diabetes

Glucose Test During Pregnancy For Gestational Diabetes

Congratulations! A baby is on the way. Your nine months will be filled with preparations, from decorating the nursery to stocking up on bibs and booties to going for regular checkups to ensure that you and your baby are as healthy as possible. One of the tests that you’ll have during this time is to check for gestational diabetes. A few weeks ago, we looked at Type 1 and Type 2 diabetes. Gestational diabetes, which is growing more common among pregnant women, will be our focus this week. What is gestational diabetes? Gestational diabetes, or GDM for short, is diabetes that occurs during pregnancy. In fact, it only occurs during pregnancy. (Gestational diabetes is not the same as diabetes in women who have existing diabetes and become pregnant). Diabetes, as most of you know, is a condition in which blood glucose levels go too high. High blood glucose levels can be harmful to you and, in the case of pregnancy, to your unborn child. Fortunately, blood glucose, or sugar, levels can be controlled during pregnancy, and in most instances, high blood sugar levels return to normal after the baby is delivered. According to the National Institutes of Health, up to 10% of pregnant women in the United States have gestational diabetes. What causes gestational diabetes? A lot of changes occur in the body during pregnancy, many of them occurring due to widely fluctuating hormone levels. The placenta, which is what connects the baby to the mother’s uterine lining, makes various hormones, and while this is a good thing, these hormones can sometimes make it hard for the body’s insulin to work properly (a condition called insulin resistance). As a result, blood sugar levels can start to climb in women who cannot produce enough insulin to deal with the insulin resistance. How do you Continue reading >>

Fasting Glucose Testing In First Trimester Allows Early Risk Detection

Fasting Glucose Testing In First Trimester Allows Early Risk Detection

High-normal fasting glucose levels in the first trimester increase the risk of adverse pregnancy outcomes, including gestational diabetes mellitus, clinicians from Israel report. Dr. Shlomit Riskin-Mashiah, from The Lady Davis Carmel Medical Center in Haifa noted that, “The findings highlight the potential benefits of using first trimester fasting glucose screening to detect women at a high risk of developing gestational diabetes mellitus.” “Screening in the third trimester provides only scant time to treat the condition,” she added. “By contrast, diet and exercise interventions initiated in at-risk women during the second trimester might improve maternal and neonatal outcomes.” In the previously reported Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study, at 24 to 32 weeks gestation, maternal blood glucose levels above normal but below those diagnostic of overt diabetes were associated with adverse pregnancy outcomes, including macrosomia, cesarean delivery and birth injury. In the current study, Dr. Riskin-Mashiah and colleagues evaluated links between first trimester fasting plasma glucose levels and adverse pregnancy outcomes. Their retrospective analysis centered on 6,129 women with singleton pregnancies who had a first trimester fasting glucose level recorded. Women with pregestational diabetes, fasting glucose greater than 105 mg/dL, or delivery at less than 24 weeks were excluded. As in the HAPO study, fasting glucose levels were analyzed in seven categories: less than 75, 75-79, 80-84, 85-89, 90-94, 95-99, and 100-105 mg/dL. At a median of 9.5 weeks gestation, the median fasting glucose level was 79 mg/dL. According to the investigators, “With increasing fasting maternal glucose levels, the frequency of gestational diabetes mellitus developm Continue reading >>

Early Screening Of Women At High Risk For Gestational Diabetes Recommended

Early Screening Of Women At High Risk For Gestational Diabetes Recommended

Early Screening of Women at High Risk for Gestational Diabetes Recommended May 13, 2008 (New Orleans) The outcome of gestational diabetes appears similar whether a woman is screened early (during the first trimester of pregnancy) or later (during the second trimester). Furthermore, more women can be managed with oral agents rather than with insulin if risk is managed early. Two teams of investigators announced these results here during presentations at the American College of Obstetricians and Gynecologists 56th Annual Clinical Meeting. In the first study, Patricia L. Maran, MD, of Lehigh Valley Hospital, in Allentown, Pennsylvania, and colleagues took a retrospective look at 152 patients with gestational diabetes presenting for prenatal care from December 1, 2004, to June 30, 2006. The patients were matched 2:1 for age, race, and parity with nondiabetic controls. Their objective was to determine whether early screening, using a 50-g glucose challenge, improves pregnancy outcomes. Women were screened either at their first prenatal visit or between 24 and 28 weeks' gestation, at the discretion of the physician. Women with a negative early screen underwent repeat screening at 24 to 28 weeks, using a 3-hour glucose-tolerance test. Of the 252 women screened, Dr. Maran's team identified 84 patients with gestational diabetes. Those screened early were more likely to be Hispanic (76% vs 55% of other ethnic origin; P=.02), to have a family history of diabetes mellitus (41% vs 27% with no family history; P=.02), or to have a history of gestational diabetes (21% vs 5% with no history; P=.001). Women with a higher body-mass index (BMI) (average, 31.9kg/m2) had a higher risk for gestational diabetes than those with a BMI less than 28.4kg/m2 (P=.002). Overall, 51% of those with a B Continue reading >>

Early Gestational Glucose Screening And Gestational Diabetes.

Early Gestational Glucose Screening And Gestational Diabetes.

Early gestational glucose screening and gestational diabetes. Department of Obstetrics and Gynecology, University of Illinois at Chicago 60612-7313, USA. The purpose of this study was to determine the benefit of early glucose screening prior to 24 weeks' gestation in detecting gestational diabetes. A retrospective analysis of 329 patients who received both early and complete prenatal care at the University of Illinois was performed. A 50-g, 1-hour glucose screen was performed at the first prenatal visit. An abnormal glucose screen, defined as blood sugar > 135 mg/dL, was followed by a 100-g, 3-hour glucose tolerance test. Gestational diabetes was defined as the presence of two or more abnormal values on the three-hour test. This protocol was repeated again at 28 weeks in all patients except those diagnosed as diabetic by having abnormal early three-hour tests. Data collected included maternal age, race, gravidity, presence of risk factors, pregnancy weight gain at glucose testing and delivery, neonatal birth weight and trauma. Data were analyzed using analysis of variance and chi 2 testing, with P < .05 considered significant. Gestational diabetes was diagnosed in 20 (6.1%) of the study patients. Eight (40%) of the gestational diabetics in the study population were detected with the early screening protocol. Factors associated with early detection of glucose intolerance included maternal age > 30 years (P < .001), black race (P < .001) and the presence of risk factors (P < .0001). Poor pregnancy weight gain was associated with the late development of glucose intolerance (P < .001). Gestational diabetes was subsequently diagnosed in 16% (6/38) of those patients who had, on early testing, an elevated one-hour glucose screen and negative three-hour glucose tolerance test Continue reading >>

Screening Of Gestational Diabetes Mellitus In Early Pregnancy By Oral Glucose Tolerance Test And Glycosylated Fibronectin: Study Protocol For An International, Prospective, Multicentre Cohort Trial

Screening Of Gestational Diabetes Mellitus In Early Pregnancy By Oral Glucose Tolerance Test And Glycosylated Fibronectin: Study Protocol For An International, Prospective, Multicentre Cohort Trial

Strengths and limitations of this study This is an international, prospective, multicentre cohort trial recruiting at six centres in Switzerland, Austria and Germany. It is the first study to assess an ‘early’ oral glucose tolerance test 75 g and novel biomarkers like glycosylated fibronectin for screening of gestational diabetes mellitus in early pregnancy. The recruitment of 748 pregnant women is planned. We have designed the study to be sufficiently powered to compare the different early screening approaches with the detection of gestational diabetes mellitus at 24–28 weeks of gestation. This study may be underpowered for the evaluation of neonatal outcomes like large for gestational age infants, neonatal hypoglycaemia, shoulder dystocia or birth trauma (secondary outcomes). Gestational diabetes mellitus (GDM) is defined as diabetes diagnosed during pregnancy that is not clearly overt diabetes.1 The increasing number of women with undiagnosed type 2 diabetes mellitus (T2DM) in pregnancy has led to the recommendation of screening women with risk factors for pre-existing diabetes at the first antenatal visit. GDM is still diagnosed in the late second or early third trimester, because accurate diagnostic approaches for GDM assessment in first trimester are still lacking.2 GDM is associated with adverse maternal and perinatal outcomes, such as fetal overgrowth, shoulder dystocia, operative delivery, birth injury, pre-eclampsia, haemorrhage and preterm delivery,3–5 but also a sevenfold higher risk of the mother developing T2DM after pregnancy.6 In addition, the maternal metabolic milieu was also identified as a key determinant for the susceptibility to obesity, metabolic syndrome and T2DM in the offspring,7 a phenomenon often described as ‘fetal programming’. Continue reading >>

Early Glucose Test - January 2018 Babies | Forums | What To Expect

Early Glucose Test - January 2018 Babies | Forums | What To Expect

Has anyone else been asked to take an early glucose test? I have a doc appointment today, and I'm 11 weeks. I have to take the glucose test today that is typical between 24-28 weeks. They said it is because my BMI is in the "overweight" category. However, I think this is RIDICULOUS. I am 5'9" tall and a size 10. Yes, I could lose 15 pounds or so ... but someone a size 10 should not be taking an early glucose test in my opinion. However, they are insistent. I have no history of GD (this is my third pregnancy), and I was actually significant heavier with my second son but not asked to do this (different doc, different state). I am just so upset!!! I have awful morning sickness - and because the doc is a longer drive from my home - I'm going to have to drink the glucola while driving (following a GPS into a major city) with my little kids in the car. If I vomit, I have to redo the test. I am just beyond upset. I feel like the doc is only looking at the "number" of my BMI and not the whole picture (my stature, body composition). It has given me so much mental stress too - and makes me feel terrible about myself and my pregnancy. I am considering expressing my feelings this morning during the appointment. Thoughts? Anyone else in the same boat? you can deny it. they can't make you. saying that though I will be taking the glucose test at 16 weeks. I did though have GD in my 2 previous pregnancies and am over weight. plus the 2 diabetes runs in my family. I've already told the Dr that I will do the 1 hr test but if I fail I won't do the 3 hr. Definitely tell them your thoughts! They can't make you do the test. I personally would have declined but that's just me. I am a nurse, so I tend to disagree with doctors often lol. Omg that is horrible! I'm also 5'9 and a size 10-12. I Continue reading >>

Glucose Screening Tests During Pregnancy

Glucose Screening Tests During Pregnancy

TWO-STEP TESTING During the first step, you will have a glucose screening test: You DO NOT need to prepare or change your diet in any way. You will be asked to drink a liquid that contains glucose. Your blood will be drawn 1 hour after you drink the glucose solution to check your blood glucose level. If your blood glucose from the first step is too high, you will need to come back for a 3-hour glucose tolerance test. For this test: DO NOT eat or drink anything (other than sips of water) for 8 to 14 hours before your test. (You also cannot eat during the test.) You will be asked to drink a liquid that contains glucose, 100 grams (g) . You will have blood drawn before you drink the liquid, and again 3 more times every 60 minutes after you drink it. Each time, your blood glucose level will be checked. Allow at least 3 hours for this test. ONE-STEP TESTING You need to go to the lab one time for a 2-hour glucose tolerance test. For this test: DO NOT eat or drink anything (other than sips of water) for 8 to 14 hours before your test. (You also cannot eat during the test.) You will be asked to drink a liquid that contains glucose (75 g). You will have blood drawn before you drink the liquid, and again 2 more times every 60 minutes after you drink it. Each time, your blood glucose level will be checked. Allow at least 2 hours for this test. Continue reading >>

More in blood sugar