What is
gestational diabetes?
The hormone
insulin moves glucose or sugar from your blood and into your body’s cells,
where it is used for energy. When you have diabetes, this process is blocked
and your cells become “insulin resistant”. This causes you to
have too much glucose in your blood. In pregnancy, the hormones from the
placenta, which help your baby to grow, can cause your cells to become insulin
resistant. Usually in pregnancy the body produces more insulin to counter this
but in some mothers this doesn’t happen and they develop gestational diabetes.
Who are more likely to get gestational diabetes (GDM)?
- older mothers
- women who have a family history of type 2 diabetes
- women who are overweight
- women who are from certain ethnic backgrounds; including, South Asian, Vietnamese, Chinese, Middle Eastern and Polynesian/Melanesian.
- Other women at risk include those who have had gestational diabetes, polycystic ovarian syndrome, large babies or birth complications in the past
Testing for gestational diabetes
During pregnancy, women are generally offered a test to screen for
glucose (called a Glucose Challenge Test).
The screening test can identify women who may have elevated blood sugars. If
you have elevated blood sugar levels you will be offered a Glucose Tolerance Test (GTT).
The GTT assesses how your body responds to a 'glucose load' or how efficiently
the glucose is moved from your blood to your body’s cells. You are required to
fast for 8 to 12 hours and then you have a blood test. After the blood test you
have a drink that contains glucose. One or two hours after you have the drink
another blood test is done. Gestational diabetes will be diagnosed if your
blood sugar levels are above what they should be.
This test is used to
screen for Gestational Diabetes and is usually performed at about 26 -28 weeks.
- The test
requires you to have a very sweet glucose drink and then return for a
blood test exactly one hour later.
- You are not required
to fast but you can have a light breakfast or meal prior to the test. Do
not over indulge in sweet foods and drinks prior to the test.
- If you are
having the test at Suite 6 go there on your way before your scheduled
appointment time here.
- Come to the
rooms for your appointment then return to Suite 6 for your blood to be
taken one hour after having your glucose drink. At the same time you
may have blood taken to check for anemia or blood group antibodies.
- If you haven’t
seen your doctor before having your blood taken please let our reception staff
knows prior to going back to Suite 6.
- There
is no need to ring for the results as we will contact you if they are
abnormal. If you GCT is abnormal this means you need a definitive test i.e.;
a Glucose Tolerance Test. (Some women in the higher risk category
may go directly to a GTT).
Difference
between GCT and GTT Test
A Glucose Challenge
Test (GCT) is a non-fasting screening test which measures the level of blood
sugar after the patient has had a drink which contains a specific amount of
glucose. An hour later a blood test is taken to check the blood sugar
level. (The idea of this is to see how efficiently your body processes
sugar). If the level is too high, then you will be required to have a
Glucose Tolerance Test (GTT).
A high test result
does not necessarily mean that you have Gestational Diabetes.
A Glucose Tolerance
Test is a more definitive examination. This a fasting test performed over
two hours (fasting means no food or drinks- apart from water- from 10pm the
night before). When you attend for your pathology visit a fasting blood sample
is taken. You will then be given a small bottle of gluscose drink. A second
blood test will be collected 1 hour later and again 1 hour after that.
During this time you are not allowed to drink, eat or smoke. The results of
these blood tests are very specific and if elevated will indicate that you have
gestational diabetes. Not every one having a Glucose Tolerance Test will
be diagnosed has having gestational diabetes.
What
happens if I am diagnosed with gestational diabetes?
You will work with
your Obstetrician, a diabetes specialist and a diabetes educator or dietician
to come up with a plan to manage your condition. Your condition should
only last as long as your pregnancy.
Your Obstetrician may
recommend further ultrasounds later in your pregnancy, and you may have
additional monitoring of the baby. You will learn to measure your blood
glucose levels regularly. Most are managed with diet modifications;
however a few women may need to have insulin to bring their sugar levels down
during pregnancy.
Managing gestational diabetes
Gestational diabetes can be managed with healthy eating, physical
activity, monitoring your blood glucose levels and sometimes medication.
Diet
A good diet can keep your blood sugar levels within target. With
diabetes you are encouraged to eat regular meals, eat small amounts but eat
often, include some carbohydrate in every meal or snack.
Foods should be enjoyable and varied, low in saturated fats and high in fiber.
Avoid carbohydrates that have little nutritional value like cakes and biscuits
or juices and soft drinks. Give preferences to more complex carbohydrates such
as multigrain breads and breakfast cereals, pasta and noodles (preferable Doongara
or Basmati rice because they have a lower glycemic index). Legumes such as baked
beans, red kidney beans and lentils, fruit, Milk and yoghurts.
Monitoring
If you have gestational diabetes, you will need to learn how to measure
your blood sugar levels. Fifty per cent of women who develop gestational
diabetes ultimately develop Type 2 diabetes, so if you have had a gestational
diabetes diagnosis, it is very important that you have regular follow-up tests
for diabetes after the pregnancy or before becoming pregnant again.
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