What Is Gestational Diabetes? Gestational diabetes sometimes develops when a woman is pregnant. It’s when the blood glucose level (blood sugar level) of the mother goes too high during pregnancy. Having an elevated blood glucose level during pregnancy can cause problems for your baby—if it’s left untreated. Fortunately, doctors are vigilant about checking for gestational diabetes so that it can be identified and effectively managed. A pro-active treatment plan helps you have a good pregnancy and protects the health of your baby. Gestational Diabetes Symptoms Gestational diabetes doesn’t often cause noticeable symptoms for the mother. Other types of diabetes (eg, type 1 diabetes or type 2 diabetes) do cause symptoms such as increased thirst, but that is hardly ever noticed in gestational diabetes. Because there aren’t often symptoms, it’s very important to be tested for a high blood glucose level when you’re pregnant. (Your doctor will most likely test you for gestational diabetes sometime between the 24th and 28th week. You can learn more about the diagnostic process here.) Then your doctor will know if you need to be treated for gestational diabetes. Gestational Diabetes Causes and Risk Factors Gestational diabetes develops when your body isn’t able to produce enough of the hormone insulin during pregnancy. Insulin is necessary to transport glucose—what your body uses for energy—into the cells. Without enough insulin, you can build up too much glucose in your blood, leading to a higher-than-normal blood glucose level and perhaps gestational diabetes. The elevated blood glucose level in gestational diabetes is caused by hormones released by the placenta during pregnancy. The placenta produces a hormone called the human placental lactogen (HPL), also Continue reading >>
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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 >>
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 >>
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 >>
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 >>
Foods To Avoid Before A Glucose Tolerance Test During Pregnancy
Between 26 and 28 weeks of pregnancy, you will have a glucose screening test to check your blood sugar levels. If the screening test results are high, your doctor will perform a glucose tolerance test in order to diagnose gestational diabetes. Gestational diabetes puts you and your baby at risk for immediate and long-term health consequences. It is important to follow your doctor’s instructions before the test to ensure an accurate test result and to follow a diet and exercise routine if you are diagnosed with this condition. Video of the Day For your glucose tolerance test, your practitioner will take a fasting blood draw to determine your blood sugar levels. You will then drink a glucose solution, and your blood will be tested once an hour for three hours. You will stay at the doctor’s office the entire time, so bring something to entertain yourself, arrange for child care for older children and have a snack on hand to eat after the blood draws are complete. If two or more of your blood readings are abnormal, you will be diagnosed with gestational diabetes. Eating the Day of the Test According to the National Diabetes Information Clearinghouse, you need to abstain from eating anything for at least eight hours prior to your glucose tolerance test. Eat a healthy meal the night before the test. From then on, you are only allowed sips of water. Typically, this test is scheduled for first thing in the morning, so most of the time you are fasting you are asleep. Consider having someone drive you to and from the test if you’re concerned about low energy levels from fasting. According to MedlinePlus, you can eat your standard diet leading up to the test. You may be advised that you need to eat at least 150 grams of carbohydrates per day for three days leading up to the Continue reading >>
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 >>
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 >>
10 Things I Wish I'd Known About The Pregnancy Glucose Test, Before I Actually Experienced It
10 Things I Wish I'd Known About the Pregnancy Glucose Test, Before I Actually Experienced It The pregnancy glucose test, otherwise known as the disgusting orange drink of doom, is something literally no expectant mom looks forward to. It's unavoidable, but as you enter your third trimester it will very much become part of your pregnant reality. Fortunately, it's not an experience that needs to be shrouded in mystery, unless you want to remain blissfully unaware. So if you're feeling a little nervous about your test, I offer you the things I wish I'd known about the pregnancy glucose test , before I actually experienced it. I've been pregnant three times , but I've only reached the 28-week mark with two of them, so I've had two glucose tests. Having been through it before made the second time a lot easier, but honestly, what surprised me most was how much things changed over the three years between them. With my daughter, I remember that I couldn't eat or drink anything and had to show up at the clinic first thing in the morning. It seemed like it took forever. This go around was quicker, and there was literally zero required of me in terms of preparation. If I've learned anything, it's that the pregnancy glucose test itself is nothing to be scared of. So before you plant yourself in that waiting room, it may be helpful to know the following: Yes, dear reader, and there are two tests you should be familiar with. Most likely, you will initially be given the glucose challenge screening test . You will be asked to drink a sweet liquid, and you'll have your blood drawn in an hour. Your results will tell your provider how effectively your body processes sugar . If your challenge test comes back positive, you will likely have to do the glucose tolerance test . This test does Continue reading >>
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 Testing In Pregnancy: Should It Be Routine?
“Gestational diabetes is one of those conditions where we just can’t seem to decide how to define it and how we should screen for it.” ~ Michelle Williams, Chair of the Department of Epidemiology, Harvard School of Public Health, August 2013 Tests should be done on the basis of individual risk. It’s rare that a test needs to be universally done – meaning that everyone gets it, pretty much no matter what. And healthy women should not be bullied into getting tests, as many pregnant women report happens when the 24 week mark rolls around signaling their doctor or midwife that it’s time for glucose testing. But should all women get glucose testing in pregnancy? This article explores just that… Pregnancy is Natural; Diabetes is Rampant…So What Should a Pregnant Mom Do? My strong belief in our ability to grow and birth healthy babies usually leads me to say less is more when it comes to pregnancy testing. In fact, if you’d asked me ten years ago, i, I’d have said, nope, routine glucose testing in pregnancy is just another example of the medicalization of a natural life process. While I still don’t recommend universal routine testing, here’s an interesting twist on the subject that has caused me to revisit my opinion on the potential value of glucose testing: The high rates of obesity, insulin resistance, and diabetes in our country, and our growing knowledge of the risks posed to the developing baby from chronic exposure to mom’s elevated blood sugar suggest that many pregnant women – and their babies – might actually benefit from knowing their blood sugar status and adjusting their diets if their sugar is found to be chronically high. That said, there is uncertainty about whether glucose testing makes a difference in pregnancy outcomes, which gl Continue reading >>
Do I Need An Oral Glucose Tolerance Test?
Your blood sugar level can give your doctor important clues about your health, and an oral glucose tolerance test (OGTT) shows how well your body handles sugar from foods. It can tell whether you are at risk for diabetes or if you already have it. A shorter version of an OGTT checks for diabetes during pregnancy. Normally when you eat, your blood sugar rises. Your pancreas, a long gland deep in the belly, releases a hormone called insulin. It helps move sugar from your blood into your cells for energy and storage. Then your blood sugar goes back down to normal. If you have type 2 diabetes, your body uses insulin poorly. Glucose builds up in your blood. This excess sugar can damage blood vessels around your body. Diabetes can lead to heart disease, nerve damage, eye disease, and kidney damage. You might need an oral glucose tolerance test if you: Have a close family member with diabetes Have high triglycerides (a type of fat in your blood) Have polycystic ovarian syndrome (which causes menstrual problems) Delivered a baby who weighed more than 9 pounds A shorter version of this test is done between the 24th and 28th week of pregnancy to see whether you have gestational diabetes. It's called the oral glucose challenge test. To get an accurate result on the OGTT, eat about 150 grams of carbohydrates each day for 3 days before the test. Don't eat or drink anything except water after about 10 o’clock the night before. You don't need to do any special prep before the pregnancy glucose challenge test. You can eat in the morning. Just avoid foods with a lot of sugar, such as doughnuts or orange juice. You'll get the OGTT at your doctor's office, a clinic, hospital, or lab. Here’s what happens: A nurse or doctor will take a blood sample from a vein in your arm to test your s 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 >>
Glucose Screening And Glucose Tolerance Testing
Learn what these painless tests are, and why it's important to have them done during your second trimester. When is the test taken? Glucose screening is usually done between 24 and 28 weeks of pregnancy. If the test, which screens for gestational diabetes, reveals elevated levels of blood glucose (sugar), a glucose tolerance test is then given to confirm the gestational diabetes diagnosis. Who needs to take the test, and why? You should have a glucose screening during pregnancy if you are over 30, have a family history of diabetes, had a troubled earlier pregnancy or are obese. But even if you don't fit any of these criteria, your practitioner may still advise taking this safe and simple test, because about half of the women who develop gestational diabetes have no known risk factors. About 15 to 20 percent of women who take this screening will show abnormal levels of glucose and will be given the more involved (and more precise) glucose tolerance test. About 15 percent of the women given the second test will be diagnosed with gestational diabetes. Gestational diabetes can be controlled by diet, exercise or insulin. But if the elevated glucose levels remain undetected, the excess sugar in the mother's blood raises the odds of the baby being macrosomic, or overly large—generally 9 pounds, 14 ounces or more. Macrosomic babies may have difficulty fitting through the birth canal and are at risk for health problems such as jaundice, low blood calcium levels, or hypoglycemia. Luckily, glucose screening and glucose tolerance testing can help you detect gestational diabetes early, and give you a chance to minimize the risks of this condition. What's involved? For glucose screening, you will be given a syrupy (and a little unpleasant) glucose solution to drink. An hour after y 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 >>