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 >>
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 Tolerance Test (gtt)
What is a glucose tolerance test? A glucose tolerance test (GTT) diagnoses diabetes in pregnancy by checking how well your body regulates your blood sugar levels. Gestational diabetes, or GD, is a common pregnancy complication. It's thought to affect one pregnant woman in six. Although GD is common, testing for it is not routine. Your midwife will offer you the test only if she thinks there's a chance you could develop GD. Usually, you'll have the test when you’re between 24 weeks and 28 weeks pregnant. You could have the test earlier than this, usually at 16 weeks, depending on your medical history and where you live in the UK. For example, your midwife will offer the GTT sooner if you’ve had GD before. Why do I need a GTT? GD doesn’t often cause obvious symptoms, which is why testing is important. If GD isn’t recognised and treated it may put your health and your baby's health at risk. GD happens when your body fails to make enough insulin. Insulin is a hormone that keeps your blood sugar levels stable. It also helps your body to store sugar for when you need it later. During pregnancy, your body has to produce extra insulin to meet your baby’s needs, especially when he's growing rapidly. If your body can't make enough insulin, you may end up with too much sugar in your blood, resulting in GD. Having too much sugar in your blood may mean that your baby grows large. This increases your chances of having an induced labour, and a caesarean birth. GD, especially if it's not controlled, even raises the risk of a baby being stillborn. That's why it's so important to follow the advice of your midwife or doctor if you're diagnosed with GD. Am I at risk of developing GD? You’re more likely to develop GD if: Your body mass index (BMI) is 30 or above. You have previo Continue reading >>
Glucose Testing (twins)
Who Gets the Test? All women should get glucose testing during pregnancy. It's especially important if you're having twins, since your risk of developing diabetes is higher. What the Test Does Glucose testing is a way of checking for a type of diabetes that can start when you're pregnant. Gestational diabetes is common and treatable. It usually goes away after birth. Without treatment, it can cause problems during pregnancy. There are a few basic tests. The glucose challenge screening tests how your body is processing blood sugar. If the results are unusual, you will get a follow-up test. It's called a glucose tolerance test. If that's positive, you'll get treatment to get your glucose under control and keep your babies healthy. Some women get a blood test to check glucose called the A1C. How the Test Is Done Glucose tests are harmless to you and your babies. During the glucose challenge screening, you'll drink a small amount of glucose. After an hour, a nurse or phlebotomist will take a blood sample. The follow-up glucose tolerance test is a little more complex. You'll have to adjust your diet for a few days. Then you'll fast for 8-14 hours before the test. A nurse will test your blood and then give you glucose. After that, the nurse or phlebotomist will take 3 more blood samples over the next few hours. The A1C test is a simple blood test to check long-term glucose levels. What to Know About Test Results If you do have a positive result, try not to worry too much. Diabetes during pregnancy is common, especially in women pregnant with twins. If you do have high glucose, your doctor may recommend extra testing to check on your babies. You will need to keep your blood sugar under control with diet, exercise, and sometimes medicine. Women who have gestational diabetes hav 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 >>
Crazy Baby After Glucose Test
So I did the 1 hour glucose test today and holy cow is the baby ever active and I had the test done almost 12 hours ago. Its been wiggling and squirming all day actually starting to cause some what feels like are braxton hicks...anyone else experience this after their glucose test..yikes! @Mommytobe0305 I have my glucose test tomorrow. So I guess I'll find out if he gets a sugar rush, too. Keep you posted. @supervallie good luck with the glucose test it really was not bad at all!! I was actually pretty thirsty when they gave me the drink so I actually kind of enjoyed it - tasted like orange crush! and another girl was doing it at the exact same time and they had us in a comfy room with comfy chairs so the time flew by!! @Mommytobe0305 I totally know what you mean! I had my 1 hour test on Dec 12. At 9:30 am I drank the drink and at 10:30 they took my blood and the whole time she was going CRAZY!!! I had a hodded sweatshirt on (which was still a little big) and I could see her moving through the sweatshirt! lol. Then I got home and tried to lay down cuz I was tired and my belly was twitching like crazy and bulging out all over the place from her moving and dancing... lol It was pretty funny! @LiLysMoMmY2010 I know I was completely entertained yesterday watching the baby dance around.But nearing the 10 hour mark it started to get uncomfortable so I got up and walked around..set up the xmas tree with my husband just trying to soothe the baby..it worked until I went to lay down at bed time and the baby thought it was play time haha. Today she is still a bit active but has settled down..tired from all the activity yesterday! @Mommytobe0305 My little girl was bouncing around for what seemed like forever after that test. I think it did take 12-15 hours for her to calm down. @M Continue reading >>
Glucola Pregnancy Glucose Test: What I Do
In my post about the pregnancy and prenatal care options I chose, I mention that I don’t take the pregnancy glucose test that requires drinking glucola (that syrupy orange or grape drink) and that I use an alternate method of testing. I’ve gotten so many questions about this that I decided it deserved its own post, especially while I am still pregnant and the topic is fresh on my mind. IMPORTANT: Please note that I am only writing about my own personal experience with this and the decisions I made after consulting with my OB or midwife (depending on which pregnancy it was). The information in this post (or any post I write) is not medical advice in any way… I’m just sharing my experience. Always consult with your own medical providers before making health decisions, especially during pregnancy, and make sure that you find providers who are willing to work with you to make the best decision for your pregnancy. All that being said, here’s what I do when it comes to the pregnancy glucose test. What is the Pregnancy Glucose Test? This was one of the sections I found in all of the many pregnancy books I read when pregnant with my first child. Current guidelines call for a glucose challenge test somewhere between 24-28 weeks of pregnancy to test for gestational diabetes. This test typically involves drinking a sweetened drink called Glucola that contains 50, 75, or 100 grams of sugar in different forms. In most cases, the first part of this test is an Oral Glucose Challenge Test (OGCT) that involves drinking the 50 gram solution and having a blood test exactly one hour later to measure blood sugar. If a woman passes this test, she typically won’t be given further testing for gestational diabetes. If a woman does not pass the test, a longer test involving a higher Continue reading >>
Guess How Many Times This Pregnant Mama Has Consumed That Orange Glucose Test Drink?
Last week when I shared 5 Prenatal Standards That I Refuse, the conversation, if I can call it that, got a little heated on social media and I hadn’t even mentioned the orange glucose drink yet. Some folks were up in arms that I would say no to my doctor about anything, apparently, or they didn’t read the post and assumed I said NO to everything. Others echoed my sentiments, and still more were on the far end of the spectrum and had no medical care at all – no ultrasounds, no doctors, no tests of any kind. I see my own choices as slightly to one side of the middle, personally – a little closer to the “no medical intervention” side than the “do everything your doctor says without question” side. Clearly others didn’t agree! Out of all that mess, which is both intriguing and exhausting to keep up with and participate in, I did realize that I forgot one important prenatal test that deserved mention: the glucose drink and blood test for gestational diabetes. It’s at this point that I need to remind you that I’m just a mom telling my story. I don’t have any medical knowledge of any kind. You definitely should not listen to me or take any of this as medical advice. We’re just chatting about our own experiences, m’kay? This is the second in a five-part series. Catch up here: I would never tell anyone that the test isn’t important, because gestational diabetes is a BIG deal and for sure something that needs to be known and addressed via a healthy, low-carb diet. Perhaps all pregnant women should eat more that way, my hunch says. All human beings, perhaps, but that’s another post entirely… (top photo modified from lisasolonynko via MorgueFile) Take heart – I have a list of my Top 10 Baby Steps to take as you move towards real food living. Whet Continue reading >>
Gestational Diabetes: Please Don’t Drink The “glucola” Without Reading The Label
I’m a midwife and MD who specializes in the health and wellness of pregnant mommas. While I’m one of the original crunchy mamas, I got the science thing down tight in my medical training at Yale, so I can keep you informed on what’s safe, what’s not, and what are the best alternatives. This article, in which I take on the toxic ingredients in oral glucose test drinks, is the first in a 3-part series on gestational diabetes. If you’re pregnant, planning to be pregnant, or working with pregnant mommas – this series is for you! Is Gestational Diabetes Really an Issue? In the past decade obesity has become rampant in our country. With it the rates of diabetes in the general population, and gestational diabetes (GDM) – which is an excessive increase in glucose intolerance in pregnancy (some increase in glucose intolerance is actually normal and allows more sugar to get to the baby for growth) – have risen dramatically. Current estimates are that 5%-7% of pregnant women in the U.S. develop GDM. Gestational diabetes increases the risk of a host of serious medical problems for mom and baby. However, at levels even lower than those that would qualify a woman for a GDM diagnosis, chronically elevated blood sugar also puts mom and baby at much higher risk of pregnancy and birth complications. Elevated blood sugar creates a condition in the body called “oxidative stress” and in pregnancy, which is already a state of somewhat increased oxidative stress, this can lead to high blood pressure, preeclampsia, and preterm birth. Also, babies born to overweight or diabetic moms have a much higher lifetime likelihood of developing chronic health problems associated with obesity and diabetes. Women who develop GDM also have at least a 50% change of becoming diabetic later Continue reading >>
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 >>
Glucose Tolerance Test. What They Don't Warn You About!
Glucose Tolerance Test. What they don't warn you about! I had my GTT yesterday morning. The glucose stuff was yukky and NOT Lucozade like some ladies get. Anyway baby was bouncing around like a gymnast for quite a while yesterday and was active into the evening. Normally she's been waking me up around 5am jumping around. But this morning nothing. I rolled over into positions she really doesn't like me being in and normally goes crazy trying to get me to move. By this time I was really worried, so I got up and ready for work and had some cereal and a cup of tea. Still no movement. So I rang the hosptial and they asked me to come in. The midwife found her heartbeat straight away but still no movement. After a while baby woke up a bit and I felt a few small kicks. It turns out that some babies move around so much after all that glucose, that they tire themselves out and have a "down" day afterwards. It scared the living crap out of me. But always remember if you're worried, get it checked out. It's horrible stuff, but then I don't even like Lucazade. It must have been a worry with the baby not moving, I seem to remember something similar. We've just realised my partner can't get the morning off while I have my test so I need to rearrange it (I think chasing a toddler round the waiting room may affect the result). Am vaguely tempted to cancel as this is my 3rd pregnancy and I've never had any problems with blood sugar in pregnancy (my Mum is diabetic, hence the test) but I can't find any info on whether you should have it done every time. Does anyone know? i dont want mine done they say gotta have it done as lots of family history but having a section anyway wud it really matter I had to have it as my DS was 10.5lb when he was born and I have a high bmi. i think its best t Continue reading >>
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 >>
Think Before You Drink: A Closer Look At Glucola
. . . and don’t forget those vegetables. Healthy fats are essential, of course, and don’t skip meals! You dutifully nod your head, and then look down at the bottle of glucola that’s just been handed to you. All of a sudden you’re in a “choose your own adventure” story. Which path will you take? What are the risks and benefits of this test? Today I’m going to share my personal process in deciding whether or to take the oral glucose challenge test (OGCT). Please keep in mind that as I wrote in my posts on the vitamin K shot and Group B Strep, “Best Boo-Boo Kisser South Of Puckett’s Gas Station” is about as official as things get for me professionally. I am not a doctor, this is not medical advice, and your decision is completely up to you. If you need some convincing on this, read my full disclaimer where I say it over and over again. Okay, let’s jump in! What is gestational diabetes? Most doctors say we don’t really know why gestational diabetes happens, but there is a theory out there that makes a lot of sense to me personally, and it’s this: Before modern conveniences like grocery stores, people ate what grew in their backyard. Our ancestors’ staples were sometimes starch heavy (like the maca root consumed by Peruvians), and other times they were more fat and protein-based (like the Inuit). Our bodies do an amazing job adapting to whatever’s available, but there are certain things we all need to thrive. Glucose is a particularly essential nutrient for babies, but in some regions it can be scarce. According to this theory, our bodies adapted to the risk of scarcity by giving our babies preferential access to it during pregnancy. How does that work? As Chris Kresser has observed, “Pregnant women are naturally insulin resistant.” In other Continue reading >>
Pregnancy If You Have Diabetes
If you have diabetes and plan to have a baby, you should try to get your blood glucose levels close to your target range before you get pregnant. Staying in your target range during pregnancy, which may be different than when you aren’t pregnant, is also important. High blood glucose, also called blood sugar, can harm your baby during the first weeks of pregnancy, even before you know you are pregnant. If you have diabetes and are already pregnant, see your doctor as soon as possible to make a plan to manage your diabetes. Working with your health care team and following your diabetes management plan can help you have a healthy pregnancy and a healthy baby. If you develop diabetes for the first time while you are pregnant, you have gestational diabetes. How can diabetes affect my baby? A baby’s organs, such as the brain, heart, kidneys, and lungs, start forming during the first 8 weeks of pregnancy. High blood glucose levels can be harmful during this early stage and can increase the chance that your baby will have birth defects, such as heart defects or defects of the brain or spine. High blood glucose levels during pregnancy can also increase the chance that your baby will be born too early, weigh too much, or have breathing problems or low blood glucose right after birth. High blood glucose also can increase the chance that you will have a miscarriage or a stillborn baby.1 Stillborn means the baby dies in the womb during the second half of pregnancy. How can my diabetes affect me during pregnancy? Hormonal and other changes in your body during pregnancy affect your blood glucose levels, so you might need to change how you manage your diabetes. Even if you’ve had diabetes for years, you may need to change your meal plan, physical activity routine, and medicines. Continue reading >>
Pregnancy If You Have Diabetes
If you have diabetes and plan to have a baby, you should try to get your blood glucose levels close to your target range before you get pregnant. Staying in your target range during pregnancy, which may be different than when you aren’t pregnant, is also important. High blood glucose, also called blood sugar, can harm your baby during the first weeks of pregnancy, even before you know you are pregnant. If you have diabetes and are already pregnant, see your doctor as soon as possible to make a plan to manage your diabetes. Working with your health care team and following your diabetes management plan can help you have a healthy pregnancy and a healthy baby. If you develop diabetes for the first time while you are pregnant, you have gestational diabetes. How can diabetes affect my baby? A baby’s organs, such as the brain, heart, kidneys, and lungs, start forming during the first 8 weeks of pregnancy. High blood glucose levels can be harmful during this early stage and can increase the chance that your baby will have birth defects, such as heart defects or defects of the brain or spine. High blood glucose levels during pregnancy can also increase the chance that your baby will be born too early, weigh too much, or have breathing problems or low blood glucose right after birth. High blood glucose also can increase the chance that you will have a miscarriage or a stillborn baby.1 Stillborn means the baby dies in the womb during the second half of pregnancy. How can my diabetes affect me during pregnancy? Hormonal and other changes in your body during pregnancy affect your blood glucose levels, so you might need to change how you manage your diabetes. Even if you’ve had diabetes for years, you may need to change your meal plan, physical activity routine, and medicines. Continue reading >>
