Routine Glucose Screening in Pregnancy

March 18, 2010

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Routine Glucose Screening in Pregnancy

by Marjorie Greenfield, M.D.
reviewed by Laura Jana, M.D., F.A.A.P.

Pregnancy can cause a woman who has perfectly normal blood sugars to turn (temporarily) diabetic, otherwise known as having gestational diabetes. This is because hormones from the placenta sometimes interfere with the action of insulin, the hormone responsible for the regulation of blood sugar.

Gestational diabetes can have no symptoms, yet can complicate the pregnancy. Identifying who has developed diabetes of pregnancy helps the physician protect the fetus from the bad effects of high maternal blood sugars.

Since you cannot tell who may become diabetic in pregnancy, most practitioners test all pregnant women for gestational diabetes. The test isn't done until the early third trimester, because many women who will develop gestational diabetes don't get it until late in the pregnancy.

Two stages of glucose tolerance testing

One-hour glucose testing
This is a screening test done around 24-28 weeks gestation. Different practitioners use slightly different protocols, but the concept is that the woman drinks a solution of sugar (glucose) and then, at a specified time interval (often one hour) later, gets her blood drawn to check the glucose level. This tests how her body has handled the sugar solution. If the blood sugar level is over a certain value, more definitive testing is usually needed.

Oral glucose tolerance test
There is some overlap in blood sugar results between women with gestational diabetes and women who are not diabetic. The one-hour glucose test really just identifies the group of mothers who need to proceed to the more complicated (and more definitive) oral glucose tolerance test. This test usually requires a three-day special diet, followed by drinking a glucose solution. The blood is drawn four times: once before drinking the glucose (when she is fasting) then at one, two and three hours after the glucose solution is consumed. If two values are above a certain threshold, gestational diabetes is diagnosed.


RELATED INFORMATION

			Methods of Prepared Childbirth
			Third Trimester Experiences
			Moms-to-Be Testing
			Diabetes and Pregnancy

Created September 22, 2000
Reviewed September 29, 2000

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