Testing for Diabetes in Pregnancy

First things first: congrats to all mothers-to-be! This is a very exciting time for you and your families. We all know that mothers play an important role in their children’s development as they grow. however, it starts even from this very early stage. Gestational diabetes can have long reaching consequences, so being proactive about this is paramount.{{more}} If you were diagnosed with diabetes BEFORE pregnancy, you will not need the testing described below.

The standard test period for diabetes in pregnancy (called gestational diabetes) is usually done during weeks 24-28 of pregnancy in women of average risk. If you are higher risk for developing gestational diabetes the test will be done earlier. You are thought to be at higher risk for developing gestational diabetes if you:

— Are over age 25 years.

— Are overweight even before becoming pregnant

— Have been told that you had pre-diabetes or glucose in your urine before becoming pregnant

—Are of Black, Hispanic, Asian or Pacific Islander racial background

—Have a family member with diabetes, especially a brother, sister or parent

—Had polycystic ovarian syndrome

—Have previously given birth to a child weighing more than 9 pounds

—Had gestational diabetes with a prior pregnancy. Your chances of having it again are higher if you had it before. History does tend to repeat itself, I am afraid…

You are at highest risk if you had gestational diabetes before, have family members with diabetes or are overweight before becoming pregnant.

So what’s the testing? Blood tests, of course! These are versions of the glucose tolerance test I described in the past but use special “normal” levels for pregnant women. Now there is some fussin-and-fighting going on regarding these glucose levels and the testing overall, so there may be some changes in recommendations in the very near future. But right now these are the guidelines your doctor will likely use. There is also a third test using a different glucose load, but it is less well accepted than these below:

Standard screening test: You will fast for at least 8 hours, then come into the lab, have your blood drawn, and then drink your glucose load (a super-sweet drink). They will then check your blood sugar after 1 hour. A test showing high glucose levels will have

a) Fasting greater than 95 mg/DL (5.28 mMol/L). Fasting glucose over 126 mg/dL (7 mMol/L) is a diagnosis of diabetes in itself.

And/or

b) 1-hour glucose level of over 140mg/dl (7.7 mMol/L)

If your first test is mildly positive or borderline, your doctor may want to do another longer test. The 3-hour glucose challenge is similar to the first screening one but involves a higher dose of glucose drink (100 grams) and 3 hours of testing. Positive test (showing gestational diabetes) is any 2 of these:

Fasting higher than 95mg/dL (5.28 mMol/L)

1-hour level of higher than 180mg/dL (10mMol/L)

2-hour level of higher than 155mg/dL (8.6 mMol/L)

3-hour level of higher than 140mg/dL (7.7 mMol/L)

Be sure to have this testing discussed with your doctor and do it on time. This is part of good prenatal care! Start doing the best for your baby from the very beginning.

Until next week, stay healthy Vincies!

Anita Ramsetty, MD
endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227