Prepare for the Gestational Diabetes Screening Test

Gestational diabetes can develop in some women when they are pregnant. Similar to all other types of diabetes, gestational diabetes is related to how your body is able to process sugar. Unfortunately, gestational diabetes can have a negative impact on both the mother and the baby, and can cause complications during childbirth. The main method used to control diabetic symptoms and reduce negative outcomes is to introduce a healthy diet, regular exercise and, in some cases, medication.

Steps

Preparing for Your Test

1. Consider your risk factors before and immediately after you’re pregnant. There is no way to determine if a woman is going to get gestational diabetes before she is pregnant. But there are certain risk factors that may indicate a higher probability in some women. If you’re planning to get pregnant, or you are pregnant, review these risk factors and speak to your doctor about possible testing when the time is right.
   • Age. Women who are 25 years of age or older are at a higher risk or developing gestational diabetes.
   • Medical history. You are also at a higher risk if you have a personal history of diabetes, PCOS, insulin resistance, or history of diabetes in your immediate family. In these cases, you should be screened for gestational diabetes at the beginning of your pregnancy.
   • Previous pregnancies. Get screened for gestational diabetes at the beginning of your pregnancy if you have had gestational diabetes before or if you delivered a macrosomic (larger than average) baby, then you are at a higher risk of developing gestational diabetes.
   • Weight. Obese women with a body mass index (pre-pregnancy) of 30 or higher are at a higher risk of developing gestational diabetes and should be screened for gestational diabetes at the beginning of any pregnancy.
   • Ethnicity. Black, Hispanic, Indigenous peoples, and Asians have a higher risk factor for gestational diabetes.
2. Monitor and record your symptoms. Throughout your pregnancy, record any medical symptoms you may experience, especially those your doctor has asked you to track. This information may be useful to your doctor in diagnosing gestational diabetes at a later date. Some symptoms (and other items) to keep track of include:
   • Excessive thirst and urination.
   • Birth weights of previous children.
   • Details on when you’ve lost or gained significant weight in the past.
3. List all your current medications. Before any doctor’s appointment it’s always useful to write down any and all medications (prescription and over-the-counter) you current take. Having a written list will help ensure you don’t forget anything, and will allow you to easily remember the exact dosage of each medication that you take.
   • Remember to include medications you take on a regular basis (i.e. daily) and medications you take as needed (e.g. when you have specific symptoms).
4. Confirm any pre-appointment restrictions. Depending on the type of screening test that is going to be performed, there may be specific restrictions you have to follow in the 24 hours leading up to the appointment. Make sure you are fully aware of what these restrictions are — and that you following them as instructed — to ensure your test is not delayed.
   • For example, some blood glucose tests must be performed after the patient has fasted for 12 hours. However, most blood glucose tests that are performed during pregnancy are non-fasting.
5. Write down any and all questions you have for your doctor. It is highly likely that you have been reading pregnancy books or websites and have a lot of questions floating around in your head. To be sure you remember them all, write them down before your doctor’s appointment. Some example questions related to gestational diabetes are as follows:
   • What websites do you recommend I view in order to get reputable and relevant information pertaining to my condition?
   • If I have to change my diet, is there someone that can help me (e.g. dietician, nurse, etc)?
   • How will we know when and if I need to take medication? What type of medication might I need to take?
   • Will I need to check my blood sugar level regularly?
   • Will I continue to have diabetes after the baby is born? Will I need to do additional screening tests?
   • What potential complications might exist during my pregnancy, and what can we do to lower those risks as much as possible?
6. Prepare to keep yourself occupied. If your doctor sends you for the second gestational diabetes test, called the glucose tolerance test, you will be required to remain at the clinic or office for at least 3 hours. During this time you will not be permitted to eat or drink anything (except maybe water) and you will likely not be allowed to leave the premises.
   • You may want to bring something to keep you occupied during this time, as it will likely be rather boring.

Conducting the Screening Tests

1. Drink the glucose solution as instructed. The initial screening test requires that you drink a glucose solution about 1 hour before your blood test. The doctor may provide you with the solution to take home, so you’ll need to remember to drink it on time before you go to your appointment.
   • You do not need to change your eating habits in any other way, other than to drink this solution.
2. Measure blood sugar levels. When you come into the lab you will have your blood drawn and the glucose levels will be measured. This initial test looks at your risk level for gestational diabetes. However, if your blood glucose is abnormal enough, such as 200mg/dl or higher, then this may be sufficient for a diagnosis of gestational diabetes.
   • Blood sugar levels of 135 to 140 mg/dL or 7.2 to 7.8 mmol/L are considered normal levels for this type of test. If the test results show your blood sugar as being higher, you are at a high risk of developing gestational diabetes.
   • This is a routine test that is performed on most pregnant women, especially those that have at least one of the higher risk factors. It is normally performed between weeks 24 and 28 of pregnancy, but will be performed earlier if your doctor thinks you have a higher risk of gestational diabetes.
   • If this blood test shows you are at high risk, your doctor will most likely request you go for a second test — the glucose tolerance test.
3. Determine your glucose tolerance. The second type of test that the doctor may request can determine if you do in fact have gestational diabetes. This test will require that you fast the night before the test (usually 12 hours). When you arrive at the clinic your blood will be drawn and your blood sugar levels will be checked. After the initial check, you’ll be asked to consume a glucose solution. After you’ve consumed the solution your blood sugar levels will be tested every hour for 3 hours. If 2 or more (out of four) of the blood sugar tests show higher than normal readings, you will most likely be diagnosed with gestational diabetes.
   • This test will require that you remain at the clinic or doctor’s office for at least 3 hours. During this time you will not be allowed to eat or drink anything while you wait (except maybe small amounts of water).
   • Abnormal values for each test are:
     • Test 1 - Fasting: greater than 95 mg/dL
     • Test 2 - First hour: greater than 180 mg/dL
     • Test 3 - Second hour: greater than 155 mg/dL
     • Test 4 - Third hour: greater than 140 mg/dL
4. Get re-tested. If only one of the four blood sugar tests from the glucose tolerance test were abnormal, your doctor may request a slight change in your diet and then ask you to be re-tested. The re-test will determine if the one abnormal result was easily fixed, or if there is still a problem.
5. Attend regular check-ups. If you are diagnosed with gestational diabetes you will most likely have more frequent checkups throughout your pregnancy, specifically in the last trimester. Your doctor will test your blood sugar levels at each of these checkups, but most of the time you will need to perform tests to monitor your blood sugar at home.
6. Check your blood sugar levels after pregnancy. If you’ve been diagnosed with gestational diabetes, your doctor will test your blood sugar levels the day after you give birth. Your doctor will then test your blood sugar levels sometime between the 6th and 12th week after delivery.
   • In most cases, a woman’s blood sugar level returns to normal after she has given birth. However, even if it is normal your doctor will most likely ask you to get re-tested every three years to be sure it doesn’t develop into something more serious.

Changing Your Activities If You Are Diagnosed

1. Get plenty of exercise. As long as you are otherwise healthy, and your doctor doesn’t have any objections, you should exercise regularly while you’re pregnant. Women should try to perform at least 150 minutes of moderate-level activities every week.
   • One of the best types of exercises to perform while pregnant is walking. Try to schedule yourself for a brisk walk for 30 minutes every day if possible.
   • If you performed activities such as running or other intensive physical activities before you were pregnant, you can continue to do these activities while you’re pregnant. Throughout your pregnancy you should consult with your doctor as to when and how to reduce such activity if required.
   • 150 minutes is equal to 2 hours and 30 minutes. At 30 minutes per day, you would only need to perform activities for 5 out of the 7 days of the week. You can even perform activities for as little as 10 minutes at a time if that works for you.
2. Maintain a healthy diet. If you’ve been diagnosed with gestational diabetes, one of the best things you can do is change your diet to be as healthy as possible. If possible, enlist the help of a dietician to help you plan your meals and select the types of foods you should eat regularly (and which ones to avoid). The following foods should be part of a balanced diet while you’re pregnant:
   • Whole grains. Breads, cereals, pastas and brown rice.
   • Fruits. Any type of fresh, frozen or canned fruits are great. If you choose canned fruits, look for ones without any added sugar.
   • Vegetables. Any type of fresh, frozen or canned vegetables in a variety of colors are best. If you choose canned vegetables, look for ones without any added salt. It is also a good idea to avoid raw sprouts.
   • Lean protein. Meats, poultry, fish, eggs, beans and peas, peanut butter, soy products and nuts. You should avoid eating tilefish, shark, swordfish and king mackerel. You should limit the amount of tuna you eat to 6 ounces per week. It is recommended that you reheat deli meats or hot dogs before you eat them.
   • Low-fat or fat-free dairy. Milk, cheese and yogurt. Unpasteurized milk, and any dairy products made from unpasteurized milk, should not be consumed.
   • Healthy fats. Vegetable oils such as canola, corn, peanut and olive.
   • Less sugar and processed foods. Eliminate or reduce the amount of processed items you consume, and anything that is high in fat or sugar. Try to reduce or eliminate your consumption of regular sodas, sweets and fried foods.
3. Add supplements to your diet. Many doctors will recommend prenatal vitamins specifically designed for pregnant women. However, the following supplements will also provide you with the valuable health benefits for both you and your baby. If these are not included in your other vitamins and supplements, ask your doctor how you might add them (either as supplements or as part of your diet).
   • Folic Acid. Reduces birth defect complications associated with the spinal cord. While pregnant you should consume at least 400 mg of folic acid every day. Foods that contain folic acid include: cereals, pastas, breaks, legumes, green leafy vegetables and citrus fruits.
   • Iron. Most pregnant women will suffer from some level of iron deficiency, taking iron supplements will ensure the iron in your body stays at proper levels. While pregnant you should consume at least 27 mg of iron a day. Foods that contain high amounts of iron include: red meat, chicken, fish, fortified cereals, spinach, some leafy greens and beans.
   • Calcium. Required for the development of your baby’s bones, teeth, nerves and muscles. While pregnant you should consume at least 1,300 mg per day. This amount is equivalent to 3 servings of calcium-rosh foods such as: milk, yogurt, cheese, fortified cereals, or fortified juices.
4. Eliminate your use of cigarettes and alcohol. In addition to the positive benefits associated with gestational diabetes, eliminating smoking and alcohol while you’re pregnant will have a lot of other positive impacts on you and your baby. Alcohol, in general, can have high sugar contents, which may make it harder to control your blood sugar levels if consumed.
5. Take medications or insulin. If you are unable to maintain healthy blood sugar levels with diet and exercise alone, your doctor may request that you take an oral medication or insulin. Medications and insulin can help you to control your blood sugar levels so that they are equivalent to the levels of a pregnant woman who does not have gestational diabetes.
   • There are many different oral blood sugar control medications available, but some doctors have concerns about the safety of these drugs for pregnant women. Talk to your doctor about oral blood sugar control medication options and ask about the potential side effects of these drugs.
   • If your doctor prescribes insulin, the amount of insulin you take, and how often you have to take it, will depend on your specific situation.
6. Talk with your doctor about the potential need for a c-section. One potential issue with having gestational diabetes is the fact that your baby will most likely be larger than average. This can cause discomfort during the last trimester of your pregnancy, but it can also cause complications during delivery. Your doctor may prefer to schedule you for a c-section in order to ensure your baby is delivered without any additional stress or nerve damage.
   • While c-sections are a fairly common occurrence, it is an invasive surgery that will require more recovery time for the mother. Knowing in advance you will be having a c-section will help you plan accordingly.
   • When the estimated fetal weight is suspected to be greater than 4500 grams (9.9 pounds), you may need a cesarean to prevent complications such as dystocia, which is when the baby's shoulder gets stuck behind the pelvic bone.
7. Watch for symptoms of high blood pressure. Women who have gestational diabetes are more likely to also experience high blood pressure — or preeclampsia — during pregnancy. Possible symptoms of preeclampsia are fingers and toes that swell, but never go back to normal. If you notice these symptoms while pregnant, notify your doctor immediately.

Tips

• If you are not yet pregnant, but think you may be at high risk for gestational diabetes, there are things you can do. Changing to a healthy diet, increasing your activity levels and losing weight can help prevent the development of gestational diabetes while you’re pregnant.

Warnings

• If you have already been diagnosed with type 1 or type 2 diabetes, you should consider getting pre-conception counselling. This counselling will help determine the best method to manage your diet and ensure good nutrition, which in turn will help you have the best possible outcome with your pregnancy. This counselling will also inform you of possible complications due to having diabetes. Your doctors will also likely request that you start taking folic acid supplements 3 months in advance of getting pregnant in order to increase your chances of a positive outcome.
• In general, the methods for testing for gestational diabetes are slightly controversial in that not all doctors agree with which methods are most effective. Please ensure you conduct your own research, including an in-depth discussion with your doctor, to determine what methods are right for you.
• While losing weight before you’re pregnant is recommended in order to help prevent gestational diabetes, it is not recommended that you attempt to lose weight when you’re pregnant.

Related Articles

• Prepare for a Glucose Screening Test
• Avoid Gestational Diabetes

Sources and Citations

See also

• Tell if You Have Diabetes
• Control Diabetes
• Check Feet for Complications of Diabetes
• Prepare for a Glucose Screening Test
• Know if You Have Diabetes
• Use a Glucometer
• Live a Healthy Life As a Diabetic
• Stabilize Blood Sugar
• Avoid Type 2 Diabetes
• Change an Accu Chek Spirit or Combo Insulin Pump Cartridge

Read more ...

What links here

• Alleviate Back Pain During Pregnancy