What Is Gestational Diabetes and Should I Be Screened for It?
By Jody Mullen
As a mom, I’ve spent a good amount of time in social media groups for pregnant women and mothers of young kids. One question I see from expecting mothers is, “What is gestational diabetes, and should I take the diabetes screening test?” To be honest, I always cringe when I see that. I’m always concerned that an anxious first-time mom is about to receive some really bad advice that’s not grounded in evidence-based medicine.
Many new moms are worried that the syrupy-sweet drink you consume as part of the one-hour glucose challenge test is “toxic” or “too much sugar for the baby.” When you’re pregnant, of course, you worry about anything you put into your body, since you’re “eating for two.” But it’s important to know that the gestational diabetes screening test won’t hurt your baby. Gestational diabetes, on the other hand, can be dangerous for both you and your little one. I’ll explain here a little more about what it is, how doctors screen for it, and how you can manage it.
What Is Gestational Diabetes?
Gestational diabetes (GD) is diabetes that develops in pregnant women who were not diabetic prior to pregnancy. The CDC estimates that two to ten percent of pregnancies are affected by GD. Having GD means your pancreas isn’t producing enough insulin to maintain a normal blood sugar level. Anyone can develop GD, but you may be predisposed to it if you had it during a previous pregnancy, are overweight, or have polycystic ovarian syndrome. You can learn more about the risk factors for GD here.
The older you are when you get pregnant, the greater your risk of developing GD. I can personally attest to this one; with my first two babies, I failed the one-hour oral glucose tolerance test but passed the three-hour test. With my third, I was fully diabetic due to my advanced maternal age. It doesn’t mean that you can’t have a happy and healthy baby if you’re over 35 or 40, but it does mean you could require some extra medical care during your pregnancy and postpartum period.
What Does Gestational Diabetes Screening Involve?
Gestational diabetes usually doesn’t have any symptoms, so it’s diagnosed via a specialized test. Your OB/GYN will schedule you for an oral glucose tolerance test at around 24 to 28 weeks pregnant.
You may be required to fast beforehand, which means you’ll want to schedule your appointment as early in the morning as possible. The test itself is pretty simple: You guzzle a syrupy drink and sit and wait for an hour.
When 60 minutes have passed, you’ll have a quick blood draw to see how your body has handled the sugary drink. If the test shows a normal blood sugar level, you’re in the clear. When it’s elevated, your doctor will bring you back on another day for a three-hour glucose challenge, which is like an extended version of the one you just finished. If your blood sugar levels are above normal during the three-hour test, your doctor will diagnose you with gestational diabetes.
I’ve taken the one-hour test three times and the three-hour test four times. I’m not going to lie to you: They’re not the funniest part of pregnancy. The sugary drink is pretty gross — I recommend orange or lemon-lime, as fruit punch is vile! — and you may feel queasy chugging it on an empty stomach. And sitting in the waiting room for three hours during the longer glucose challenge is pretty boring, so bring a good book. That said, the diabetes test is extremely low-risk, whereas the potential complications of diabetes during pregnancy are very serious. The drink is very sugary by necessity, but the test will not hurt your developing baby.
Does Gestational Diabetes Mean I Have a High-Risk Pregnancy?
If you are diagnosed with gestational diabetes, your OB/GYN may refer you to a high-risk specialist in maternal-fetal medicine to help you manage it. I know it’s difficult not to panic at this point, but your doctor can help to ease your anxiety. Expectant mothers with GD can go on to deliver healthy babies, but they do require extra monitoring and care.
Your doctor will ask you to perform regular blood sugar checks, usually when you first wake up and one hour after you finish each of your meals. You’ll need a lancet for finger pricks, a glucose meter, and test strips, all of which may be covered by your medical insurance plan. You can write down each result in a notebook, but I found that using an app on my phone was easier.
Some women with GD are able to keep their numbers within normal limits through dietary choices alone. Your care provider can give you some sample meal plans to help you get started or refer you to a dietician. You’ll want to load up your plate with lean protein, fruits and veggies, and a small serving of whole grains.
For some expectant mothers, it’s not possible to keep your numbers where they should be through diet alone. Your doctor may prescribe an oral medication, like metformin to help lower your blood sugar. That one didn’t work very well for me, as my numbers were all over the place and the side effects were intolerable. My OB put me on insulin injections, which worked much better for me. Each patient is unique, so what works for one mom may not be of much use to the next.
If you have gestational diabetes, your doctor likely will want to monitor you carefully for elevated blood pressure. They’ll also keep a close eye on the baby via regular ultrasounds to make sure he or she isn’t gaining weight too quickly. Having gestational diabetes can mean you need to have a planned C-section to deliver safely. You’ll also need follow-up care after your baby is born to be sure your blood sugar levels have returned to normal. Women who develop GD are at an increased risk of developing type 2 diabetes later in life, so you’ll want to ask your general practitioner about diabetes prevention strategies that are appropriate for you.
I know it’s no fun to deal with an issue like gestational diabetes when all you want to do is to get ready for your new little bundle. Hang in there, follow your doctor’s recommendations, and know that you and baby are going to get through this. If you have a question or concern, leave it for me in the comments section below. I’ve been where you are!
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