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When Should A Woman Be Tested For Gestational Diabetes?

Gestational Diabetes

Gestational Diabetes

Between three and eight per cent of women will get gestational diabetes between the 24th and the 28th week of pregnancy, sometimes earlier. It usually goes away after the baby is born. Women who are more likely to get gestational diabetes are: older mothers women who have a family history of type 2 diabetes women who are overweight women who are from certain ethnic backgrounds, including South Asian, Vietnamese, Chinese, Middle Eastern and Polynesian/Melanesian. Other women at risk include those who have had gestational diabetes, polycystic ovarian syndrome, large babies or birth complications in the past What is gestational diabetes? The hormone insulin moves glucose or sugar from your blood and into your body’s cells, where it is used for energy. When you have diabetes, this process is blocked and your cells become 'insulin resistant'. This causes you to have too much glucose in your blood. In pregnancy, the hormones from the placenta, which help your baby to grow, can cause your cells to become insulin resistant. Usually in pregnancy the body produces more insulin to counter this. In some women, however, this doesn’t happen and they develop gestational diabetes. There are many health issues associated with gestational diabetes, including that both the mother and baby will have an increased risk of developing type 2 diabetes later in life. During the pregnancy, gestational diabetes can lead to excessive sugars and fats crossing the placenta, which can have an effect on the baby’s growth, usually making them bigger. Giving birth to larger babies can also lead to problems with the birth. Sometimes, even though it might not seem to make sense, some babies (particularly larger babies) are born with blood sugar levels that are too low – this is called hypoglycaemia Continue reading >>

Glucose Screening And Glucose Tolerance Tests

Glucose Screening And Glucose Tolerance Tests

Why do I need a glucose screening test during pregnancy? Most healthcare practitioners routinely recommend a glucose screening test (also called a glucose challenge test or GCT) between 24 and 28 weeks of pregnancy to check for gestational diabetes. Gestational diabetes is a high blood sugar condition that some women get during pregnancy. Between 2 and 5 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. Like any screening test, the GCT won't give you a diagnosis. Instead, it's designed to identify as many women as possible who may have a problem and 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 screen actually have the condition. If you test positive on the screening, you'll need to take the glucose tolerance test (GTT) – a longer, more definitive test that tells you for sure whether you have gestational diabetes. Your practitioner may want you to be screened earlier than 24 weeks if a routine urine test shows a lot of sugar in your urine or if you're considered high risk. If the results are normal, you'll be screened again at 24 to 28 weeks. Of course, if you were diagnosed with diabetes before pregnancy, you won't need to be screened. Instead, you'll continue to work with your practitioner to manage your condition during pregnancy. How is the glucose screening test done? When you arrive for the test, you're given a sugar solution that contains 50 grams of glucose. The stuff tastes like a very sweet soda pop (it comes in cola, orange, or lime flavor), and you have to Continue reading >>

Gestational Diabetes - Exams And Tests

Gestational Diabetes - Exams And Tests

The U.S. Preventive Services Task Force recommends that all women who are not already diagnosed with diabetes be tested for gestational diabetes after the 24th week of pregnancy.1 The American Diabetes Association (ADA) recommends that all pregnant women who are not already diagnosed with diabetes be tested for gestational diabetes between the 24th and 28th weeks of pregnancy. The method for testing may vary. Experts think that each method works as well as the other one.2 The first method can be done in two steps. You do not need to stop eating or drinking before the first step. In this step, you drink a liquid that contains 50 grams of sugar (glucose). Your blood sample is taken 1 hour later. If you don't have a lot of sugar in your blood, you do not have gestational diabetes. If you do have a lot of sugar in your blood, you will be asked to do the second step, the oral glucose tolerance test (OGTT). With the OGTT, you cannot eat or drink for at least 8 hours before the test. You will drink a liquid that contains 100 grams of sugar (glucose). Your blood sample is taken 3 hours later to see how much sugar is in your blood. If you don't have a lot of sugar in your blood, you don't have gestational diabetes. If you do have a lot of sugar in your blood, you do have gestational diabetes. Some experts do not use the two-step method. They just use another version of the OGTT step. You cannot eat or drink for at least 8 hours before the test. You will drink a liquid that contains 75 grams of sugar (glucose). Your blood sample is taken 1 and then 2 hours later to see how much sugar is in your blood. If you don't have a lot of sugar in your blood, you do not have gestational diabetes. If you do have a lot of sugar in your blood, you do have gestational diabetes. If you have gest Continue reading >>

Testing For Gestational Diabetes

Testing For Gestational Diabetes

Your ‘booking appointment’ is your first appointment with your midwife or GP to talk about your pregnancy. This usually happens around 8–12 weeks of pregnancy. During that appointment, the midwife or GP will carry out some routine tests (tests offered to every woman) and ask lots of questions. Some of the questions will help find out if you are at risk of developing gestational diabetes (they will be looking to see if you have any of the risk factors). If you are considered at high risk, you will be offered a test. Agreeing to these tests is important because if you have gestational diabetes, there is a small increased risk of serious birth complications. Finding out if you have it and treating the condition can reduce those risks. The key things you need to know are: If you are at risk of gestational diabetes but don’t take the test, it can’t be found and treated. This may increase the risk to you and your baby. If you are diagnosed with gestational diabetes, you will have more check-ups and extra care during your pregnancy and labour. In some women, gestational diabetes responds to changes in diet and exercise, while others will need to take medication, which may be in the form of tablets or insulin injections. "I wasn’t obviously skinny, but I wasn’t massively obese either… I had no symptoms whatsoever. I had no expectation that the Lucozade test would be anything other than a formality." What if I had gestational diabetes in an earlier pregnancy? If you have had gestational diabetes in a previous pregnancy, you need to take action before you become pregnant again. You need to be scanned for diabetes when you are planning your pregnancy to make sure that your blood glucose levels are safe. You also need to be tested as soon as possible after your book Continue reading >>

Is The Glucose Test During Pregnancy Optional?

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. It’s an appointment on the calendar most pregnant women dread: the glucose test (or oral glucose screening), usually scheduled around week 26 to week 28 of pregnancy. You’ve no doubt seen many Instagram or Facebook pics posted by women tasked with drinking the super-sweet, typically orange liquid to gauge their body’s 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. (Ask your doctor, midwife or blood lab if you should fast beforehand or not—it can vary by clinic.) 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. When I was expecting my second baby, the nurse at my bloodwork clinic told me there are two kinds of women when it comes to the glucose test: chuggers and sippers. I was totally a chugger. I downed that syrupy drink in just a few mouthfuls, to get the test over with as soon as possible. But a couple of days later, the doctor’s office called me back. There had been an error at the lab. I had to do the test again. I chugged the second time, too, eager to get back to work. That time my results were borderline, just a hair above acceptable levels, a Continue reading >>

Screening For Gestational Diabetes

Screening For Gestational Diabetes

Understanding Task Force Recommendations The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement on Screening for Gestational Diabetes. This final recommendation statement applies to pregnant women who have not already been diagnosed with diabetes. The recommendation statement summarizes what the Task Force learned about the potential benefits and harms of screening for gestational diabetes: (1) All women should be screened after 24 weeks of pregnancy. (2) There is not enough evidence to judge the benefits and harms of screening women before 24 weeks of pregnancy. This fact sheet explains these recommendations and what they might mean for you. What is gestational diabetes? This condition is diabetes that begins during pregnancy. Diabetes is a disease in which the body does not make enough insulin (a hormone) or use it correctly. When this happens, the body can’t turn starches or sugars from foods and beverages into the energy it needs to function. As a result, blood sugar levels become too high and this can cause many health problems. Facts About Gestational Diabetes About 240,000 of the 4 million women who give birth every year in the United States develop diabetes during their pregnancy. This condition has become more common over the past 20 years because a growing number of pregnant women have risks factors for it, such as being overweight or obese or having a family history of diabetes. Gestational diabetes usually goes away after the baby is born, but it can put the pregnant woman and her baby at risk for serious health problems: • Pregnant women have a greater chance of complications during pregnancy, labor, and delivery, including a higher risk for preeclampsia. Preeclampsia is a condition defined by high bloo Continue reading >>

Diagnosis

Diagnosis

Print Medical experts haven't agreed on a single set of screening guidelines for gestational diabetes. Some question whether gestational diabetes screening is needed if you're younger than 25 and have no risk factors. Others say that screening all pregnant women is the best way to identify all cases of gestational diabetes. When to screen Your doctor will likely evaluate your risk factors for gestational diabetes early in your pregnancy. If you're at high risk of gestational diabetes — for example, your body mass index (BMI) before pregnancy was 30 or higher or you have a mother, father, sibling or child with diabetes — your doctor may test for diabetes at your first prenatal visit. If you're at average risk of gestational diabetes, you'll likely have a screening test during your second trimester — between 24 and 28 weeks of pregnancy. Routine screening for gestational diabetes Initial glucose challenge test. You'll drink a syrupy glucose solution. One hour later, you'll have a blood test to measure your blood sugar level. A blood sugar level below 130 to 140 milligrams per deciliter (mg/dL), or 7.2 to 7.8 millimoles per liter (mmol/L), is usually considered normal on a glucose challenge test, although this may vary by clinic or lab. If your blood sugar level is higher than normal, it only means you have a higher risk of gestational diabetes. You'll need a glucose tolerance test to determine if you have the condition. Follow-up glucose tolerance testing. You'll fast overnight, then have your blood sugar level measured. Then you'll drink another sweet solution — this one containing a higher concentration of glucose — and your blood sugar level will be checked every hour for three hours. If at least two of the blood sugar readings are higher than normal, you'll Continue reading >>

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 >>

Gestational Diabetes

Gestational Diabetes

Gestational diabetes is high blood sugar that develops during pregnancy and usually disappears after giving birth. It can occur at any stage of pregnancy, but is more common in the second half. It occurs if your body cannot produce enough insulin – a hormone that helps control blood sugar levels – to meet the extra needs in pregnancy. Gestational diabetes can cause problems for you and your baby during and after birth. But the risk of these problems happening can be reduced if it's detected and well managed. Who's at risk of gestational diabetes Any woman can develop gestational diabetes during pregnancy, but you're at an increased risk if: your body mass index (BMI) is above 30 – use the healthy weight calculator to work out your BMI you previously had a baby who weighed 4.5kg (10lbs) or more at birth you had gestational diabetes in a previous pregnancy one of your parents or siblings has diabetes your family origins are south Asian, Chinese, African-Caribbean or Middle Eastern If any of these apply to you, you should be offered screening for gestational diabetes during your pregnancy. Symptoms of gestational diabetes Gestational diabetes doesn't usually cause any symptoms. Most cases are only picked up when your blood sugar level is tested during screening for gestational diabetes. Some women may develop symptoms if their blood sugar level gets too high (hyperglycaemia), such as: But some of these symptoms are common during pregnancy anyway and aren't necessarily a sign of a problem. Speak to your midwife or doctor if you're worried about any symptoms you're experiencing. How gestational diabetes can affect your pregnancy Most women with gestational diabetes have otherwise normal pregnancies with healthy babies. However, gestational diabetes can cause problems s 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 >>

Gestational Diabetes And Your Health After Your Baby Is Born

Gestational Diabetes And Your Health After Your Baby Is Born

Your healthcare provider will check your blood sugar level after you deliver. For most women, blood sugar levels go back to normal quickly after having their babies. Six to twelve weeks after your baby is born, you should have a blood test to find out whether your blood sugar level is back to normal. Based on the results of the test, you will fall into one of three categories. After Pregnancy Test Categories If your category is… You should… Normal Get checked for diabetes every three years Impaired Glucose Tolerance or Pre-iabetes Get checked for diabetes every year Talk to your healthcare provider about ways to lower your risk level for diabetes Diabetes Work with your healthcare provider to set up a treatment plan for your diabetes The test also checks your risk for getting diabetes in the future. Women who have had gestational diabetes have a 40 percent higher chance than women who have not had gestational diabetes of developing type 2 diabetes later in life. Getting checked for diabetes is important because type 2 diabetes shows few symptoms. The only way to know for sure that you have type 2 diabetes is to have a blood test that reveals a higher-than-normal blood sugar level. You should also tell your healthcare provider right away if you notice any of these things: Increased thirsty Urinating often Feeling constantly or overly tired Losing weight quickly and/or without reason Having one or more of these symptoms does not mean you have diabetes, but your healthcare provider might want to test you to make sure. Finding type 2 diabetes early can help you avoid problems, like early heart disease and damage to your eyes, kidneys, or nerves. If you choose to use birth control methods in the future, talk with your health care provider about a method that won’t incr Continue reading >>

Pregnancy And Gestational Diabetes Screening

Pregnancy And Gestational Diabetes Screening

All pregnant women should be screened for gestational diabetes during their pregnancy. Screening may be done by taking the woman's medical history and examining certain risk factors, but an oral glucose tolerance test is also recommended. The oral glucose tolerance test is used to screen for gestational diabetes. Gestational diabetes is a specific type of diabetes that can develop in some women late in pregnancy (usually after the 24th week). Women who develop this complication do not have diabetes before becoming pregnant. The test is generally given between the 24th and 28th week of pregnancy. If you have had gestational diabetes before, or if your health care provider is concerned about your risk of developing gestational diabetes, the test may be performed before the 13th week of pregnancy. The oral glucose tolerance test involves quickly drinking a sweetened liquid (called Glucola), 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 (processed by the body). A blood glucose level of 140mg/dL or higher will identify 80% of women with gestational diabetes. When that cutoff is lowered to 130mg/dL, the identification increases to 90%. If your blood glucose level was greater than 130 mg/dL, your provider will likely recommend you take another diabetes screening test that requires you to fast (not eat anything) before the test. During this second test, called the 100-gram oral glucose tolerance test, your blood glucose level will be tested four times during a three-hour period after drinking the sweetened (many flavors are availabl Continue reading >>

Gestational Diabetes Test: What To Expect

Gestational Diabetes Test: What To Expect

Gestational diabetes occurs only during pregnancy, and it usually goes away once you’ve delivered your baby. Pregnant women with gestational diabetes have higher than normal blood sugar. This is because their bodies aren’t producing enough insulin. Insulin is a hormone that regulates blood sugar. Gestational diabetes can happen at almost any time during pregnancy, but it typically occurs between 24 to 28 weeks. This is also when testing typically takes place. Getting tested for gestational diabetes is an important part of prenatal care. Doctors test all pregnant women at least once during pregnancy. Your doctor will consider your risk factors when determining when you should have this test and how often you should have it. Learn what to expect during this test and how to prepare. Many women who have gestational diabetes have no symptoms. If symptoms do appear, it’s possible you may overlook them because they’re similar to typical pregnancy symptoms. These symptoms may include: frequent urination extreme thirst fatigue snoring You should call your doctor if you’re experiencing these symptoms to a greater degree than is normal for you. The exact cause of gestational diabetes is unknown, but it may be due to hormones your placenta produces. These hormones help your baby grow, but they can also stop insulin from doing its job. If your body can’t make enough insulin, the sugar in your bloodstream stays put. The sugar is then unable to convert into energy in the cell. This is called insulin resistance. If it’s left untreated, gestational diabetes can have significant consequences for both you and your baby. Once your doctor knows you have this condition, they’ll work with you on a treatment plan to ensure your and your baby’s health. Any pregnant woman can g Continue reading >>

Is Routine Testing For Gestational Diabetes Necessary?

Is Routine Testing For Gestational Diabetes Necessary?

High blood sugar during pregnancy, known as gestational diabetes mellitus (GDM), used to be a rare condition, occurring in about 3% of pregnancies. In recent years, the rate has doubled – up to 8% of pregnant women are diagnosed with GDM. With new recommendations lowering the cutoff point for diagnosis, a dramatic increase in GDM rates is expected; experts predict it could be up to 15%. Not all medical professionals agree with routine testing to diagnose GDM, however, and question whether GDM is a pathological problem in such high numbers, or simply part of pregnancy. Is Routine Testing For Gestational Diabetes Necessary? Dr. Sarah Buckley, author of Gentle Birth, Gentle Mothering recommends most women avoid the routine test. Dr. Michel Odent, world-renowned obstetrician and birth specialist, and Henci Goer, expert on evidence-based maternity care, both believe diagnosis of GDM increases risk and stress unnecessarily. Most pregnant women will have to decide whether or not to take the gestational diabetes screening test. Women who are offered the test might not know anything about GDM, the risk factors, the accuracy of the screening tests, or what failing the test could mean. For many women, negotiating their way through GDM screening is a challenge, especially for those who decide to forgo having the test, or want to know what their options are. Unfortunately, there aren’t many doctors or midwives who support alternative testing for GDM. What Is Routine GDM Screening? The test for GDM has traditionally been two-tiered and occurs around 24-28 weeks gestation. Glucose challenge test (GCT): This requires you to drink 50g of sugar solution, one hour prior to having a blood test. You don’t need to fast for this test. If your blood sugar levels are above normal, you wil Continue reading >>

Tests & Diagnosis For Gestational Diabetes

Tests & Diagnosis For Gestational Diabetes

When will I be tested for gestational diabetes? Testing for gestational diabetes usually occurs between 24 and 28 weeks of pregnancy. If you have an increased chance of developing gestational diabetes, your doctor may test for diabetes during the first visit after you become pregnant. How do doctors diagnose gestational diabetes? Doctors use blood tests to diagnose gestational diabetes. You may have the glucose challenge test, the oral glucose tolerance test, or both. These tests show how well your body uses glucose. Glucose Challenge Test You may have the glucose challenge test first. Another name for this blood test is the glucose screening test. In this test, a health care professional will draw your blood 1 hour after you drink a sweet liquid containing glucose. You do not need to fast for this test. Fasting means having nothing to eat or drink except water. If your blood glucose is too high—140 or more—you may need to return for an oral glucose tolerance test while fasting. If your blood glucose is 200 or more, you may have type 2 diabetes. Oral Glucose Tolerance Test (OGTT) The OGTT measures blood glucose after you fast for at least 8 hours. First, a health care professional will draw your blood. Then you will drink the liquid containing glucose. You will need your blood drawn every hour for 2 to 3 hours for a doctor to diagnose gestational diabetes. High blood glucose levels at any two or more blood test times—fasting, 1 hour, 2 hours, or 3 hours—mean you have gestational diabetes. Your health care team will explain what your OGTT results mean. Your health care professional may recommend an OGTT without first having the glucose challenge test. Continue reading >>

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