OB ABCs

Week 25

week_25Between 26 and 28 weeks, your healthcare provider will most likely order a glucose challenge, which is sometimes called a glucose tolerance test.

Designed to test for gestational diabetes, the glucose challenge results can have a tremendous effect on your pregnancy planning and prenatal nutrition.

Initially, a one-hour test is performed by having you drink 50 grams of a glucose solution. In one hour, your blood will be drawn to check your glucose level; normal levels should be less than 130mg/dL. If your results are abnormal, a three-hour glucose tolerance test will be recommended.

The three-hour glucose tolerance test requires that you not eat or drink anything for 8 to 12 hours prior to the test. Again, you will be asked to drink a sugary solution (ask your healthcare provider about substituting Brach’s jelly beans) followed by blood draws to check glucose levels at one hour, two hours and three hours (some healthcare providers request the initial test at 30 minutes). You will most likely feel shaky following this test, so take a carbohydrate/high-protein snack (i.e., peanut butter crackers) with you to eat at the conclusion of the test.

If diagnosed with gestational diabetes, your next steps are to work with your healthcare provider and dietitian to manage your blood glucose levels throughout your pregnancy, possibly with dietary modification and/or insulin. Maintaining a sound diet and exercising regularly are absolutely vital for those diagnosed with gestational diabetes. This condition, which occurs in an estimated 2 to 5 percent of mothers, can lead to a large baby and therefore, a more difficult birth, cesarean birth and/or breathing difficulties for the newborn.

The birth of the baby and the placenta will most likely reverse the diagnosis of diabetes, although you and the baby will be monitored closely following birth. Remember, gestational diabetes can be a forerunner of Type 2 diabetes, particularly if you have a family history of the disease. Therefore, good nutrition and exercise will be an important part of your future.

TIPS

  • Women who have not been diagnosed with high blood sugar levels are still at risk for developing gestational diabetes. About 4 percent of pregnant women are diagnosed with the condition, correlating to about 135,000 cases in the United States every year. Cases of gestational diabetes can often be controlled very well through diet, exercise and careful monitoring. However, these women may have an increased risk for developing Type 2 diabetes later in life.
  • The cause of gestational diabetes is unknown, but researchers feel it may be linked to the performance of the placenta during pregnancy. The placenta supplies hormones that help the baby develop while potentially blocking the effectiveness of insulin in the mother’s body. What results is known as insulin resistance and means the mother’s body does not use insulin efficiently.