Gestational Diabetes and Screening in Pregnancy

When it comes to the 40 weeks spent carrying baby, the body goes through dramatic changes. Some of these changes are perfectly in sync with carrying and developing the fetus, other changes are harmful the baby and to mom’s body. One such change is the development of gestational diabetes.

Gestational diabetes carries the same symptoms and problems as other forms of diabetes not associated with pregnancy. The body loses the ability to handle food sugars and insulin development when pregnant. The onset of gestational diabetes can lead to hyperglycemia, hypoglycemia and complications with fetal growth and birth.

Glucose Screening and Mom
At your first visit your doctor will find out if you are at risk for diabetes. If, for example, there is a family history then you will usually get tested foir diabetes right away. Without risks, then diabetes screening will often occur during the 26^th to 28^th week of gestation.

This preliminary glucose screening, called the glucose challenge screening test, will involve mom drinking a special liquid full of glucose. After 1 hour, mom will have blood drawn and the levels of glucose in the blood will be recorded. Blood glucose levels will most often be the highest 1 hour after consuming a high sugar meal or drink.

• A level below 140 mg/dL is usually considered normal
• A level above 140 mg/dL is usually considered elevated
• Some doctors consider levels above 130-135 mg/dL elevated 

About 15-25% of pregnant women will have an elevated glucose level on the 1 hour glucose test.

If this preliminary test is passed, the pregnant mom will be cleared of having any likelihood of gestational diabetes unless urine testing shows some sign of glucose in the urine farther into the pregnancy.

If this preliminary test is failed, mom will have to undergo a 3-Hour Glucose Tolerance Test in order to verify if there is a problem with gestational diabetes.

The 3-Hour Glucose Tolerance Test
Unlike the preliminary 1-hour glucose test, the glucose tolerance test requires 14 hours of fasting before the test can take place. After those 14 hours, a baseline sample of blood will be taken. This baseline will tell the doctor what the fasting glucose level is for mom. After the initial blood is drawn, mom will drink a highly concentrated glucose solution and more blood will be taken every hour for the next 3 hours.

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

What Will Happen if I am Diagnosed with Gestational Diabetes?
Gestational diabetes in pregnancy is treated in much the same manner as diabetes is treated in those not with child. In order for the official diagnosis of gestational diabetes to come back, two of the three vials of blood drawn will have to measure outside of the normal blood glucose range.

If mom only fails one of the tests, she will often undergo dietary changes for the duration of the pregnancy and undergo the glucose tolerance test later in the gestational stage of the pregnancy to completely rule out gestational diabetes.

If the official gestational diabetes diagnosis is made a combination of dietary changes, insulin usage and increased exercise will be used in most cases to control the blood glucose levels. Mom will have to test her blood sugar levels throughout the day and try to maintain healthy levels for both her health and the health of the baby. After the baby is born, most mothers find the gestational diabetes will end with the finalization of the pregnancy.