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Glucose Tolerance Test

Gestational diabetes usually begins in the fifth or sixth month of pregnancy (between the 24th and 28th weeks), and it often has no symptoms, so most women are routinely tested between the 24th and 28th weeks of pregnancy. However, if you are considered high-risk for gestational diabetes, you will be screened before the 24th week of pregnancy.

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The gestational diabetes screening test, also called the one hour glucose test, consists of drinking a sweet liquid called Glucola, and then having your blood analyzed about one hour later. A blood sugar level below 140 milligrams per deciliter (mg/dL) is usually considered normal. If your blood sugar level is higher than this, you do not necessarily have gestational diabetes, it simply means you need more extensive testing, called the glucose tolerance test (GTT), to diagnose or rule out gestational diabetes. This test requires you to fast for 8 hours (or overnight), have a baseline blood test and then drink another sweet liquid (with a higher glucose content) and have your blood re-tested every hour for three hours. If at least two of the blood sugar readings are higher than normal, you are considered to have gestational diabetes. If only one of the tests shows an elevated blood sugar level, you may be asked to repeat the GTT in two to four weeks.

Women who are considered high risk for gestational diabetes include those who had preexisting diabetes, were diagnosed and treated for gestational diabetes during a previous pregnancy, or those who may have had large babies with previous pregnancies. Other women who are considered high-risk include those who:

  • Are obese
  • Who have had other problems in pregnancy such as previous miscarriages or preeclampsia
  • Are older (the tendency to develop diabetes increases with age)
  • Who were large babies when they were born (nine pounds or more)
  • Who have a history of diabetes in their family
  • Who have recurrent or persistent bladder infections or vaginal yeast infections

Most women who develop gestational diabetes are able to manage it with a modified diet and regular exercise (always check with your doctor before beginning any exercise regimen). The most effective way to manage your diet is to have your doctor or midwife refer you to a registered dietician who can create a diet plan for you. He or she will determine how many calories you and your baby need on a daily basis; as well as the correct balance of protein, fats, and carbohydrates; and teach you how to distribute them throughout the day to maintain your energy and blood glucose levels. Depending on how serious your condition is, you may have to test your blood several times a day to monitor your blood sugar levels as well. If you are not able to control your blood sugar by diet and exercise, you will have to give yourself daily insulin shots.

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