Glucose testing which checks for gestational diabetes is offered and/or done to all pregnant women at some point during their pregnancy. I say “offered” though because no one can force you to take the test, although most pregnant women and professionals will strongly recommend it.
According to the American Pregnancy Association, gestational diabetes is a temporary (in most cases) form of diabetes in which the body does not produce adequate amounts of insulin to regulate sugar during pregnancy. It may also be called glucose intolerance or carbohydrate intolerance.
Less than 10% percent of women actually develop gestational diabetes, however, the ones that have it and don’t treat it, the risks are: 1) Large birth weight; 2) Premature delivery; 3) Increased chance of cesarean delivery; and 4) Slight increased risk of fetal/neonatal death.
If a pregnant woman is diagnosed with gestational diabetes then she will have to test her blood sugar level via needle prick up to 5 times a day. If her sugar or glucose level is high then she would have to be injected an insulin shot when needed.
I personally know 3 women who had gestational diabetes who had to go through that process, but ultimately all of them had healthy, full-term babies. One can avoid the insulin injection though through a healthy, balanced diet.
Normally, the glucose test is performed between 24 and 28 weeks of pregnancy, UNLESS the woman has a higher risk of developing gestational diabetes. The following pregnant women have an increased chance of having gestational diabetes:
1) Over the age of 35;
3) Family history of diabetes;
4) Previously had gestational diabetes;
5) High blood pressure;
6) Smoking; and
7) Not getting enough physical activity
If you have 2 or more of the above risk factors then your doctor will likely suggest taking the test earlier in your pregnancy. And of course I had 3 of the above risk factors (over 35, overweight, and family history of diabetes), so my OB suggested that I take the glucose test at 16 weeks.
I agreed, without much hesitation, just to get it out of the way. They informed me that the first test would involve me drinking a sugary drink and then waiting for an hour. When the hour was up they would take a sample of my blood and I could go home. The doctor gave me the drink, which I refer to as “liquid sugar”. It basically tasted like water and sugar with an orange flavor to it. Once I drank the “liquid sugar” I waited an hour, and then they took a sample of my blood. The blood sample was then sent out for analysis and I went home. A few days later though, I received a call from my OB’s office stating that my glucose level was a little high.
Believe it or not, it is pretty common to fail the 1 hour glucose test and NOT actually have Gestational Diabetes! According to a study which looked at the results of glucose tests less than half of all pregnant women who fail the 1 hour glucose test subsequently are confirmed to have GD. It doesn’t quite make sense, but the general idea is that first test is there to determine if you are “in the range” of having Gestational Diabetes. If you aren’t even close, then you’re “in the clear” so to speak. But if you are close, then you need to do a more accurate test to see if you actually have Gestational Diabetes.
So because my glucose test came back high, they wanted me to come back in to take a 3 hour glucose test. This time, I was told not to eat after 12:00 am the morning before my 8:15 am appointment – not even water.
The process of the 3 hour glucose level was 4 draws of your blood. The first draw was before I took the “liquid sugar” and then I drank a larger amount of the glucose drink. Every hour after I drank the “liquid sugar” my blood was drawn – so another 3 times.
I never received a call after this test and asked my OB during my next visit if everything came back okay from the glucose test. The OB responded yes and that I didn’t have gestational diabetes.
Now, fast forward 2 months when I was 24 weeks pregnant, wherein the nurse practitioner stated that I need take the 1 hour glucose test again. This time I had some hesitation because I’m thinking, I would never consume this much “liquid sugar” at one time which in my mind is literally going straight to my blood stream since its liquid.
After contemplating it for a few days, I scheduled another hour long glucose test to check for gestational diabetes during my 26th week of pregnancy. The results came back indicating that my glucose level was a little too high – again. A nurse called me a couple days later when I happened to be in the middle of the grocery store, heading to a client meeting. She informed me that the ideal level was no more than the 130’s, however, mine was in the 180’s.
The nurse attempted to get me make an appointment at that moment. I was disappointed and advised the nurse that I would call back to make an appointment for the follow-up 3 hour long glucose test.
So I get off the phone and think, “So let’s get this straight – when I was 16 weeks pregnant, I took an hour long glucose test because of my increased risk of having gestational diabetes due to being pregnant over 40, my parents and brother having Type 2 diabetes, being overweight and classified as African American. Great….”
That first glucose test at 16 weeks came back a little high so then I took the 3 hour glucose test. Those results back normal and I would not need to take insulin at this time.
My third glucose test during 26 weeks came back high. Now they want me to take a 4th glucose test! Seriously!?!?!
I went home that evening and vented to my husband exclaiming that these people were trying to poison me and my baby by taking this test again, which includes drinking approximately 100 grams of liquid glucose (you drink approximately 50 grams of the liquid glucose for the 1 hour test.) Glucose, which contains several ingredients ending in “ose”, “ate” or “ide”, seems harmful in itself, as I would never consume that much sugar in one sitting anyway.
So I did what I normally do and went on an internet researching spree trying to find alternatives to taking this test for the 4th time. The worst case scenario was that I had gestational diabetes. With that being the case, if I ate a sensible diet, then I could regulate the condition without having to take insulin. After several searches, I found a decent Gestational Diabetes Diet, which keeps you full and eating throughout the day. I put myself on that meal plan and avoided calling my OB back to make another appointment for the 3 hour glucose test.
However, I wondered if I was doing the right thing. So, during my next visit to the Fetal Maternal Specialist at 29 weeks, I decided to ask that doctor for a second opinion. The specialist responded that if I didn’t take the 3 hour glucose test again, then she would have to treat me as if I had gestational diabetes and “require” me to prick myself with a needle 5 times a day to check my blood sugar level and if it happened to be high after a meal then I would have to give myself an insulin shot – whether I actually had gestational diabetes or not.
Hmmmm, what a predicament. Surely, I didn’t want to put the baby at risk by not taking the insulin in the event that I had gestational diabetes. I also didn’t want to prick myself with a needle 5 times a day either. I could take the 3 hour glucose test again to determine if I had gestational diabetes or not. After all, my previous 3 hour glucose test, which included having my blood drawn 4 times in 3 hours, came back normal. What to do, what to do?????
Well, eventually I gave in and made an appointment to take the 3 hour glucose test AGAIN a few weeks later when I was 31 weeks pregnant. The results – 3 out of the 4 blood test came back normal, however, 1 of the blood tests was borderline diabetic. Ultimately, the nurse confirmed that I did not have gestational diabetes, but did state that I needed to watch my carbs and sugars. I didn’t disagree with the nurse’s advice and was ecstatic that I didn’t have gestational diabetes and would not have to take insulin for the remainder of my pregnancy.
The moral of this story is that just because you “failed” your first glucose test doesn’t mean you definitely have Gestational Diabetes. Your subsequent test is quite likely to show that you don’t have GD. Now it’s personal choice as to whether you want to take the glucose test. If they come back negative for gestational diabetes, great! If the tests coming back positive or with a high glucose level, then it can be monitored through diet and insulin. All three of the women that had gestational diabetes advised that I take the test for the sake of the baby and I heeded and respected their advice.
However, I will say that if you eat a balanced and healthy diet with minimal carbohydrates and sugar, before and during your pregnancy, then that will significantly decrease your chance of developing gestational diabetes.