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 >>
Glucose Tolerance Test
What is a glucose tolerance test? A glucose tolerance test measures how well your body’s cells are able to absorb glucose, or sugar, after you ingest a given amount of sugar. Doctors use fasting blood sugar levels and hemoglobin A1c values to diagnose type 1 and type 2 diabetes, and prediabetes. A glucose tolerance test can also be used. Doctors primarily use a glucose tolerance test to diagnose gestational diabetes. Doctors often diagnose type 1 diabetes quickly because it usually develops quickly and involves high blood sugar levels. Type 2 diabetes, on the other hand, often develops over years. Type 2 diabetes is the most common form of diabetes, and it usually develops during adulthood. Gestational diabetes occurs when a pregnant woman who doesn’t have diabetes before pregnancy has high blood sugar levels as a result of the pregnancy. The American Diabetes Association estimates that gestational diabetes occurs in 9.2 percent of pregnancies. Doctors should screen all women for gestational diabetes. Gestational diabetes can cause pregnancy complications, so early detection and prompt treatment are important. If you’re pregnant, your doctor will usually recommend this test between the 24th and 28th week of your pregnancy. Your doctor may also recommend that you have this test earlier if you’re having the symptoms of prediabetes or diabetes. Preparing for the glucose tolerance test involves the following: Continue to eat a normal diet in the days leading up to the test. Consult with your doctor about any medications you’re currently taking. Some medications, such as corticosteroids, beta-blockers, diuretics, and antidepressants, can interfere with the results. Abstain from food for at least eight hours before the scheduled test. You may drink water, but avoid Continue reading >>
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 >>
Reference Values During Pregnancy
perinatology.com Please enable JavaScript to view all features on this site. Activated partial thromboplastin time Alanine aminotransferase (ALT, SGPT)AlbuminAldosteroneAlkaline phosphataseAlpha-1-antitrypsin Alpha-fetoproteinAmylase Angiotensin converting enzyme Anion gapAntithrombin III, functionalApolipoprotein A-1Apolipoprotein BAspartate aminotransferase (AST, SGOT)Basophil countBicarbonateBile acidsBilirubin,conjugated (direct) Bilirubin,unconjugated (indirect) Bilirubin,totalCA -125Calcium,ionizedCalcium,totalCeruloplasminChlorideCholesterol,HDLCholesterol,LDLCholesterol,VLDLCholesterol,total Complement C3 Complement C4 CopperCortisol C-reactive protein CreatinineCreatine kinaseD-dimerDehydroepiandrosterone sulfateEosinophil countErythrocyte sedimentation rate (ESR)ErythropoietinEstradiolFactor VFactor VIIFactor VIIIFactor IXFactor XIFactor XIIFerritin Fibrinogen Folate,red cellFolate,serumGamma-glutamyl transferase (GGT)Glomerular filtration rate (GFR)Glucose,fasting HematocritHemoglobin Hemoglobin A1CHomocysteineImmunoglobulin A (IgA)Immunoglobulin G (IgG)Immunoglobulin M (IgM)IronLactate dehydrogenase (LDH)LipaseLymphocyte countMagnesiumMean corpuscular volume (MCV)Mean corpuscular hemoglobinMean corpuscular hemoglobin concentration Mean platelet volume (MPV)Monocyte count Neutrophil countOsmolalityParathyroid hormoneParathyroid hormone-related proteinPhosphatePlatelet countPotassiumPrealbuminProgesteroneProlactinProtein, totalProtein C activityProtein S activityProtein S freeProtein S totalProthrombin timeRed blood cell count (RBC)Red cell distribution width (RDW)SeleniumSex hormone binding globulinSodiumTestosteroneThyroxine-binding globulinThyroid-stimulating hormone(TSH)Thyroxine, freeThyroxine, totalTissue plasminogen activatorTissue plasminogen activator Continue reading >>
My Site - Chapter 36: Diabetes And Pregnancy
Gestational diabetes in a previous pregnancy Given birth to a baby that weighed more than 4 kg A parent, brother or sister with type 2 diabetes Polycystic ovary syndrome or acanthosis nigricans (darkened patches of skin). All pregnant women without known pre-existing diabetes should be screened for gestational diabetes between 24 to 28 weeks of pregnancy If you were diagnosed with gestational diabetes during your pregnancy, it is important to: Breastfeed immediately after birth and for a minimum of 4 months in order to prevent hypoglycemia in your newborn, obesity in childhood, and diabetes for both you and your child Reduce your weight, targeting a normal body mass index in order to reduce your risk of gestational diabetes in the next pregnancy and developing type 2 diabetes Be screened for type 2 diabetes after your pregnancy: within 6 weeks to 6 months of giving birth . As a result, meticulous glycemic control throughout pregnancy is required for optimal maternal and fetal outcomes. An important first step in achieving optimal glycemic control is to set target BG levels . However, optimal targets for fasting, preprandial and postprandial BG levels in women with pre-existing diabetes have not been examined in randomized controlled trials; and a variety of BG targets are used in clinical practice. Older studies confirm that the lower the mean BG, the better the outcome, with some suggesting a target mean BG <6.7 mmol/L and, others, a mean <6.9 mmol/L. A fasting BG (FBG) target <5.9 mmol/L is still associated with a 29% macrosomia rate . Recent retrospective data demonstrated that a mean A1C 6.0% in pregnant women with type 2 diabetes was associated with increased risk of neonatal complications (preterm birth, neonatal intensive care unit [NICU] admission, neonatal hyp Continue reading >>
Gestational Diabetes And The Glucola Test
June 14, 2012 by Rebecca Dekker, PhD, RN, APRN © Copyright Evidence Based Birth®. Please see disclaimer and terms of use. In the comment sections of one of my first posts, I received this question from a reader named Lela: “I would like to know more about what routine tests are actually necessary. The one that particularly caught my interest is the gestational diabetes test. The American Diabetes Association presents a list of low risk women who should not need the glucose test , even though I fit all those categories, my physician’s office still insists I take it. Is the glucose test truly the only way to catch gestational diabetes? Am I really risking both the health of me and my baby if I declined?” **This post was written before the 2013 NIH Consensus conference on “Diagnosing Gestational Diabetes.” Since then there has been new evidence published on this topic. To read updated, in-depth information about the glucola test and screening for gestational diabetes, you can read these blog articles about the conference: Day 1 and Day 2.** This article has taken me quite a bit of time to write for several reasons. First, gestational diabetes is a very complex and controversial topic. Second, there is a ton of research that has happened in the last 10 years, and it took me a long time to read the literature. Third, my readership has really taken off in the past few weeks, and I want to make sure that my posts are of the highest quality. Fourth, my kids have had a bad virus and I was very sleep-deprived this week. It was hard for my brain to function well and critically think about this issue on so little sleep, until now. With that being said, here is my best shot at an evidence-based article on gestational diabetes and the glucola test. I tried to remain as un Continue reading >>
A 50-g Glucose Challenge Test: Is There Any Diagnostic Cut-off?
J Med Assoc Thai Vol. 91 No. 9 2008 1309 Correspondence to: Chaithongwongwatthana S, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand. Phone: 0-2256-4241, Fax: 0-2254-9292. E-mail: [email protected] A 50-G Glucose Challenge Test: Is There Any Surasith Chaithongwongwatthana MD, MSc**, Boonchai Uerpairojkit MD** * Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration (BMA) Medical ** Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok Objective: To evaluate the diagnostic performance of 50-g glucose challenge test for diagnosis of gestational Material and Method: A retrospective study was conducted by reviewing the medical records of pregnant women who had a 50-g glucose challenge test of 140 mg/dL or higher and followed by a 100-g glucose tolerance test. Results were categorized in 10 mg/dL increments. Gestational diabetes was diagnosed using Results: The present study included 2,226 cases from universal screening of 11,084 pregnant women. The incidence of gestational diabetes was 3.2% (351/11,084). Only 1.6% (6/374) of patients with positive screening results of less than 145 mg/dL had gestational diabetes. All of the 6 women undiagnosed by this threshold were gestational diabetes class A1 and had at least one risk factor. Of 1,875 women, seven cases (0.4%) would be over diagnosed as gestational diabetes if 100-g glucose tolerance test was not performed after a result of 50- g glucose challenge test of > 250 mg/dL (99.6% specificity, 85.8% negative predictive value, 12.3% sensitivity Conclusion: A 50-g glucose challenge test may be used as a diagnostic test when the value is > 250 mg/dL. The present data suggested that the value of gluc Continue reading >>
What To Expect From Gestational Diabetes Testing
What to Expect From Gestational Diabetes Testing What to Expect From Gestational Diabetes Testing Two tests are available to screen for gestational diabetes. Most women will get the oral glucose tolerance test, only following up withgetting the three-hour glucose test if their results are concerning. If you are pregnant, your obstetrician has probably told you that you will need gestational diabetes testing. Don't worrygestational diabetes testing is an important part of routine prenatal care. Most women are tested during weeks 24 through 28 of pregnancy. If you have any risk factors for diabetes, your doctor may consider testing your blood sugar as early as your first prenatal visit. Certain hormones increase during pregnancy, transferring valuable nutrients from the mother to the baby so that the fetus develops and grows. Other hormones block the action of insulin , ensuring that the mother herself does not develop low blood sugar. To compensate, the mothers insulin levels rise. If her insulin levels cannot increase sufficiently, rising blood sugar levels will eventually result in gestational diabetes. Untreated, gestational diabetes can lead to complications for both the mother and the baby. These complications may include: Multiple gestation (twins, triplets or more) Gestational diabetes in a previous pregnancy Being American Indian or Alaska native, African American, Asian, Hispanic or Pacific Islander Two tests are available to screen for gestational diabetes. Most women will get the oral glucose tolerance test, only following up withgetting the three-hour glucose test if their results are concerning. Why it's Done: The oral glucose tolerance test (also known as the glucose challenge screening) is routine for all pregnant women. It is far from definitive, so don' Continue reading >>
The 50g Glucose Challenge Test Does Not Diagnose Gestational Diabetes
This systematic review found that the 50g test is not accurate enough to diagnose gestational diabetes on its own. Clinical question In pregnant women <32 weeks gestation, what is the sensitivity and specificity of the 50g glucose challenge test? The conventional test for diabetes is the oral glucose tolerance test (OGTT), in which a woman has to fast for several hours before being given an oral glucose solution. Her blood is then sampled at intervals to see how well her body metabolises the additional sugar. The 50g glucose challenge test is a simpler test in which the woman does not have to fast and only has one blood sample taken, one hour after drinking 50g of glucose in solution. The review set out to work out how well the 50g test performs in clinical practice at detecting gestational diabetes. Sensitivity is the proportion of people with the disorder who test positive. A test with a high sensitivity has a low rate of false negatives. Specificity is the proportion of people without the disorder who test negative. A test with a high specificity rarely gives false positives. The evidence Twenty-six studies were found, comprising 13,564 women. In better quality studies (those with consecutive recruitment): sensitivity was 0.74 (95% CI 0.62-0.87) specificity was 0.85 (95% CI 0.80-0.91). Neither value is high enough to consider the 50g test definitive for gestational diabetes. Appraisal hints Users of this research should consider: Did the reviewers perform blind, independent evaluation of the individual studies? Consider the quality of the individual studies. Consider the population of the individual studies, and whether appropriate subgroup analysis revealed patterns in the performance of the test. Although the review abstract claims that the 50g test may have a role Continue reading >>
The 50-g Glucose Challenge Test And Pregnancy Outcome In A Multiethnic Asian Population At High Risk For Gestational Diabetes - Sciencedirect
Volume 105, Issue 1 , April 2009, Pages 50-55 The 50-g glucose challenge test and pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes Author links open overlay panel Peng ChiongTan To evaluate the 50-g glucose challenge test (GCT) on pregnancy outcome in a multiethnic Asian population at high risk for gestational diabetes (GDM). GCT was positive if the 1-hour plasma glucose level was 7.2mmol/L. GDM was diagnosed by a 75-g glucose tolerance test using WHO (1999) criteria. Of the 1368 women enrolled in the study, 892 were GCT negative, 308 were GCT false-positive, and 168 had GDM. Pregnancy outcomes were extracted from hospital records. Multivariable logistic regression analysis was performed with GCT negative women as the reference group. GCT false-positive status was associated with preterm birth (adjusted odds ratio [AOR] 2.1; 95% CI, 1.23.7) and postpartum hemorrhage (AOR 1.7; 95% CI, 1.02.7). GDM was associated with labor induction (AOR 5.0; 95% CI, 3.37.5), cesarean delivery (AOR 2.2; 95% CI, 1.63.2), postpartum hemorrhage (AOR 2.1; 95% CI, 1.23.7), and neonatal macrosomia (AOR 2.5; 95% CI, 1.06.0). GCT false-positive women had an increased likelihood of an adverse pregnancy outcome. The role and threshold of the GCT needs re-evaluation. Continue reading >>
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The Association Between Low 50g Glucose Challenge Test Result And Fetal Growth Restriction
The association between low 50 g glucose challenge test result and fetal growth restriction Accepted author version posted online: 28 Jan 2013 Get access/doi/full/10.3109/14767058.2013.770460?needAccess=true Objective: To determine whether a low-GCT result is predictive of low birthweight and to identify the lower GCT threshold for prediction of fetal growth restriction. Methods: A retrospective cohort study of 12 899 women who underwent a GCT (2428 weeks). Women with a low-GCT result (<10th percentile (70 mg/dL) were compared to women with normal-GCT result (70140 mg/dL). ROC analysis was used to determine the optimal lower GCT threshold for the prediction of growth restriction. Results: Women in the low GCT had significant lower rates of cesarean delivery (18.7% versus 22.5%), shoulder dystocia (0.0% versus 0.3%), mean birthweight (3096 576 versus 3163 545) and birthweight percentile (49.1 27.0 versus 53.1 26.7) and significant higher rates of birthweight <2500 g (11.3% versus 8.5%), below the 10th percentile (8.3% versus 6.5%) and 3rd percentile (2.3% versus 1.4%). Low GCT was independently associated with an increased risk for birthweight <2500 g (OR = 1.6, 1.22.0), birthweight <10th percentile (OR = 1.3, 1.11.6), birthweight <3rd percentile (OR = 1.7, 1.22.5) and neonatal hypoglycemia (OR = 1.4, 1.022.0). The optimal GCT threshold for the prediction of birthweight <10th percentile was 88.5 mg/dL (sensitivity 48.5%, specificity 58.1%). Conclusion: Low-GCT result is independently associated with low birthweight and can be used in combination with additional factors for the prediction of fetal growth restriction. Continue reading >>
Glucose Challenge And Glucose Tolerance Test - Gct And Gtt
Before and during pregnancy there is usually a two-step approach to diagnosing diabetes: The initial screening test is called GCT, or Glucose Challenge Test, and it's often done between 24 and 28 weeks of pregnancy. The GCT does not necessarily diagnose diabetes but it screens women who may be at risk and who may need a 3-hour glucose tolerance test or GTT. The GCT consists of measuring the serum glucose concentration 1 hour after the woman has drunk a 50 g (some use 75 g) oral glucose load. Values below 130 dg/mL are usually considered normal, values above 140 mg/dL are usually considered abnormal, and values between 130 and 140 mg/dL are "in between." A glucose threshold value >140 mg/dL identifies approximately 80% of women with pregnancy diabetes (GDM), and the yield is further increased to 90% by using a cutoff of >130 mg/dL. Women whose serum glucose is above the threshold value on the GCT (130-140 mg/dL) have a diagnostic 3-hour GTT done to find out if they have diabetes. The 3-hour GTT consists of a woman drinking 100 g of glucose and having four blood samples drawn: fasting, and then 1, 2, and 3 hours after the drink. Cutoff values for the 3-hour GTT are as follows (Sullivan criteria): Fasting: 95 mg/dL 1-hour: 180 mg/dL 2-hours: 155 mg/dL 3-hours: 140 mg/dL Pregnant women with two or more elevated values are considered to have gestational diabetes mellitus (GDM), though even one elevated value increases certain risks. Continue reading >>
A 50-g Glucose Challenge Test: Is There Any Diagnostic Cut-off?
Abstract OBJECTIVE: To evaluate the diagnostic performance of 50-g glucose challenge test for diagnosis of gestational diabetes. MATERIAL AND METHOD: A retrospective study was conducted by reviewing the medical records of pregnant women who had a 50-g glucose challenge test of 140 mg/dL or higher and followed by a 100-g glucose tolerance test. Results were categorized in 10 mg/dL increments. Gestational diabetes was diagnosed using National Diabetes Data Group criteria. RESULTS: The present study included 2,226 cases from universal screening of 11,084 pregnant women. The incidence of gestational diabetes was 3.2% (351/11,084). Only 1.6% (6/374) of patients with positive screening results of less than 145 mg/dL had gestational diabetes. All of the 6 women undiagnosed by this threshold were gestational diabetes class A1 and had at least one risk factor Of 1,875 women, seven cases (0.4%) would be over diagnosed as gestational diabetes if 100-g glucose tolerance test was not performed after a result of 50-g glucose challenge test of > or = 250 mg/dL (99.6% specificity, 85.8% negative predictive value, 12.3% sensitivity and 86.0% positive predictive value). CONCLUSION: A 50-g glucose challenge test may be used as a diagnostic test when the value is > or = 250 mg/dL. The present data suggested that the value of glucose screening of > or = 145 mg/dL can be used as a threshold for a positive test in the low risk women. Continue reading >>
Glucose Tolerance Test
The glucose tolerance test is a medical test in which glucose is given and blood samples taken afterward to determine how quickly it is cleared from the blood.[1] The test is usually used to test for diabetes, insulin resistance, impaired beta cell function,[2] and sometimes reactive hypoglycemia and acromegaly, or rarer disorders of carbohydrate metabolism. In the most commonly performed version of the test, an oral glucose tolerance test (OGTT), a standard dose of glucose is ingested by mouth and blood levels are checked two hours later.[3] Many variations of the GTT have been devised over the years for various purposes, with different standard doses of glucose, different routes of administration, different intervals and durations of sampling, and various substances measured in addition to blood glucose. History[edit] The glucose tolerance test was first described in 1923 by Jerome W. Conn.[4] The test was based on the previous work in 1913 by A. T. B. Jacobson in determining that carbohydrate ingestion results in blood glucose fluctuations,[5] and the premise (named the Staub-Traugott Phenomenon after its first observers H. Staub in 1921 and K. Traugott in 1922) that a normal patient fed glucose will rapidly return to normal levels of blood glucose after an initial spike, and will see improved reaction to subsequent glucose feedings.[6][7] Testing[edit] Since the 1970s, the World Health Organization and other organizations interested in diabetes agreed on a standard dose and duration. Preparation[edit] The patient is instructed not to restrict carbohydrate intake in the days or weeks before the test.[citation needed] The test should not be done during an illness, as results may not reflect the patient's glucose metabolism when healthy. A full adult dose should not be Continue reading >>
Comparative Effectiveness Of 50g Glucose Challenge Test And Risk Factor Based Screening In Detection Of Gestational Diabetes Mellitus In Ibadan, Nigeria. | Bello | Tropical Journal Of Obstetrics And Gynaecology
Tropical Journal of Obstetrics and Gynaecology Log in or Register to get access to full text downloads. Comparative effectiveness of 50g glucose challenge test and risk factor based screening in detection of gestational diabetes mellitus in Ibadan, Nigeria. Oluwasomidoyin O Bello, Timothy A Oluwasola, Jokotade O Adeleye, Kayode S Adedapo, Opemipo Maxwell, Akin-Tunde A Odukogbe Context: Gestational diabeles mellitus (GDM) complicates 3- 5% of pregnancies. Prompt diagnosis helpsto prevent its subsequent complications and one-step effective screening method is desirable for ourenvironment. Objective: To compare the effectiveness of 50g glucose challenge test (GCT) with risk factors alone inscreening for GDM. Study Design: Prospective study of booked, consenting pregnant women with no previous history ofdiabetes mellitus.Fasting sample ofvenous blood was obtained for plasma glucose, followed byadministration of 50g oral glucose and collection of blood sample an hour later. The process wasrepeatedafter a week using 75g oral glucose; each patient serving as her own control. Threshold bloodglucose of 140mg/dl was used for both post-ingestion tests. Statistical analysis was done using SPSSversion 17. Results: All the seventy-nine study participants completed the 2 arms.Mean maternal and gestational agesat recruitment were 30.8+1.2 years and 24.2+1.6 weeks respectively.Among the respondent,35( 44.3%)were nulliparous while24(30.3%) had positiverisk factors for GDM. The 50g GCT was abnormalin 10 patients (12.7%) while GDM was confirmed in 2 patients giving an incidence rate of 2.5%. The 50gGCT was normal in 89.6% of women with normal 75g OGTT and it was more predictive ofGDM (PositivePredictive Value, PPV - 20%) compared to risk factors only (PPV- 11.1%). Conclusion: Using 50g GC Continue reading >>
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