Thirteen hours of foodless torture and six blood samples later, I had established I didn’t have gestational diabetes. What ever that is. Wait, what is that? It suddenly occurred to me I had been submitted to this three hour glucose test, after failing a glucose challenge for a pregnancy condition I knew nothing about. Well, now I do, and I’m going to share with you.
What is gestational diabetes?
Gestational diabetes is one of the most common complications of pregnancy occurring in 2-7% of women. It is a type of diabetes that develops during pregnancy, and usually goes away after the baby is born. Gestational diabetes is very similar to type 1 and 2 regular diabetes in the sense that it causes glucose to stay in the body rather than being properly processed. Glucose, a type of sugar derived during digestion, enters the bloodstream with the help of insulin. Insulin however has a more difficult job to do while pregnant because of certain hormones, and if your pancreas is unable to pump out the increased amount needed to deal with all that glucose (about 3 times the norm), the result is gestational diabetes. [1]
What are the risks of gestational diabetes?
Depending on the time during pregnancy that gestational diabetes is developed effects the risks. Gestational diabetes developed in early pregnancy can cause birth defects and premature births. However, the majority of cases occur later in pregnancy during the second or third trimester. These cases result in abnormal baby growth. Basically, it makes for a really big baby, which can make for an unpleasant labor and delivery, and likely c-section. This doesn’t mean the baby can’t be born perfectly healthy, but it does create complications. [2] Having gestational diabetes once does however increase the risk of both getting it again in a future pregnancy, and of type 2 diabetes later in life.
Is there anything in particular that puts me at risk?
Yes, though many women that develop gestational diabetes do so with none of the risk factors, there are some characteristics that throw up red flags such as; being overweight prior to being pregnant, a family history of diabetes, being of an at risk ethnicity (African American, American Indian or Asian), previously having had gestational diabetes, a over 9 lbs baby, or a still birth, and/or having too much amniotic fluid (polyhydramnios).
There is no conclusive evidence to suggest anything can be done to prevent gestational diabetes, though proper nutrition is suggested to help. [3]
Ok, so what are these tests you mentioned?
Initially all women are given a quick and dirty type gestational diabetes test called the oral gestational diabetes test, often refereed to as the glucose challenge, that consists of refraining from sugary foods for about 12 hours, then drinking a glucola, a sugary beverage containing 50g of glucose, and having your blood drawn one hour later. Now if you fail this test so to speak, you will be given a three hour glucose test. This test is also often automatically given to women over 35.
The three hour glucose test is very similar to the glucose challenge except you must fast, as in no food, for12-14 hours before the test, and the glocola contains 100g of glucose rather than 50. Your blood will be taken once before you begin, and then once every hour for 3 hours. [4]
What if I do have gestational diabetes?
Gestational diabetes is normally treated through simple diet and exercise changes, but can also be medicated with a daily pill called Glyburide, or insulin shots. Home glucose monitoring and additional tests to monitor your baby will also be necessary.
If you feel your at an increased risk for gestational diabetes you may want to discuss it with your health care provider ahead of time, changes in diet and exercise now may save you a 12 hour fast and a whole lot of poking. Take my word for it. Also, if your very concerned about failing you could consider fasting before the glucose challenge. Many women fail this test simply by eating a dinner they didn’t know had so much sugar in it.
Citation:
1. Baby Center on Gestational Diabetes (http://www.babycenter.com/0_gestational-diabetes_2058.bc)
2. WebMD Gestational Diabetes risks (http://diabetes.webmd.com/guide/gestational_diabetes)
3. Plus Sized Pregnancy on Gestational Diabetes prevention (http://www.plus-size-pregnancy.org/gd/gd_prevention.htm)
4. About.com Gestational Diabetes tests (http://diabetes.about.com/od/preventreversetypeii/a/gestdmtests.htm) and personal experience.
