It seems that the glucose screening visit is the least favorite visit for most of my pregnant patients. Women often start their prenatal care dreading the glucose screening appointment. Some have heard stories from their girlfriends about how the drink tastes awful, others have a friend who had a bad “reaction” to the sugar and others are worried about “flunking” the test and getting a diagnosis of gestational diabetes.
So here is a little insight into what to expect for your glucose screening visit and why it is very important. And the drink really is not that bad!
The test: The glucose screening test is recommended between 24 and 28 weeks of pregnancy and is done in two steps. First the pregnant woman drinks 10 ounces of a sugary solution. The taste is described as a very sweet juice drink. One hour later, blood is drawn to measure the blood sugar level. The results of the glucose challenge test indicate whether you might have gestational diabetes. If the results of the glucose screening test are above normal, you’ll need to have further diagnostic testing, which is done with a three-hour glucose tolerance test.
Gestational diabetes (the reason for the screening test): Gestational diabetes develops during pregnancy and affects how your cells use sugar (glucose.) It is estimated to affect as many as 9% of pregnant women and causes high blood sugar levels that can affect both the pregnant woman and the baby.
Any woman can develop gestational diabetes, but some women are at greater risk. Risk factors for gestational diabetes include:
- Age greater than 35. Women older than age 35 are more likely to develop gestational diabetes.
- Family or personal health history. The risk of developing gestational diabetes increases in women who have history of slightly elevated blood sugar that may be a precursor to type-2 diabetes. There is also a higher incidence of gestational diabetes in women who had it in a previous pregnancy.
- Excess weight. Being significantly overweight with a body mass index (BMI) of 30 or higher increases the risk of developing gestational diabetes.
- Nonwhite race. Women who are African American, Hispanic, American Indian or Asian are more likely to develop gestational diabetes.
For women diagnosed with gestational diabetes, the baby may be at increased risk of:
- Excessive birth weight. Extra glucose in your bloodstream crosses the placenta, which triggers your baby’s pancreas to make extra insulin. This can cause a baby to grow too large. This can increase the risk of complications during delivery or require a c-section.
- Early (preterm) birth and respiratory distress syndrome. A mother’s high blood sugar may increase her risk of early labor and delivering her baby before its due date.
- Low blood sugar (hypoglycemia.) Sometimes babies of mothers with gestational diabetes develop low blood sugar shortly after birth because their own insulin production is high. Severe episodes of hypoglycemia may provoke seizures in the baby.
- Type 2 diabetes and obesity later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
- The most serious complication of untreated gestational diabetes is death of the baby either before or shortly after birth.
Gestational diabetes may also increase the mother’s risk of:
- High blood pressure and preeclampsia. Gestational diabetes increases the risk of high blood pressure, as well as, preeclampsia — a serious complication of pregnancy that causes high blood pressure and other symptoms that can threaten the lives of both mother and baby.
- Future diabetes. Women with gestational diabetes are more likely to develop it again during a future pregnancy. There is also a higher lifetime risk of type 2 diabetes.
There are no guarantees when it comes to preventing gestational diabetes, but adopting healthy lifestyle habits before pregnancy can minimize the risk. This includes eating a healthy diet that is high in fiber and focused on vegetables, fruits and whole grains. Exercising regularly before and during pregnancy also lowers the risk of developing gestational diabetes. And finally losing excess weight before pregnancy can decrease risk of gestational diabetes as well as other pregnancy complications.
-Nicole