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Gestational Diabetes

Headline: Gestational Diabetes

Gestational Diabetes is a condition of elevated blood glucose which is first recognized during pregnancy. It affects 3–5% of all pregnancies. It is caused by rising levels of pregnancy-related hormones which interfere with the body’s ability to control blood glucose levels.

Screening for Gestational Diabetes

Mothers are screened at around 28 weeks with a one-hour glucose test. You will need to fast two hours before your appointment (water is OK), and we recommend avoiding foods high in carbohydrates and sugar that day. You will be asked to drink a 50g glucose solution (Glucola) and your blood will be drawn one hour later. Approximately 15% of patients will have a positive test and will be asked to take the three-hour glucose tolerance test (GTT).

Three-Hour Glucose Tolerance Test (GTT)

If your one-hour screening glucose test is elevated (135 or higher), you will be asked to take the three-hour diagnostic test. You will need to fast, starting at 10:00 p.m. the night before your test. When you get to our office in the morning, we will draw blood to check your fasting glucose and then have you drink a 100g glucose solution. After this, we will draw your blood in one, two, and three hours.

To increase how fast your insulin works and prevent false positive results (in other words, to maximize your chance of passing the three-hour GTT), you will need to prepare by including at least 120g of carbohydrates in your diet per day for three days prior to your test (see table of foods containing carbohydrates). Eat your normal meals and snacks, and then every day for three days add eight items from our list.

List of Carbohydrates

Each item on this list contains approximately 15g of carbohydrates:

1/2 cup cereal

1 baked potato

1 slice pound cake

1/3 cup rice

1/2 cup mashed potato

1 apple

1/2 cup pasta

1/2 bagel

9-inch banana

1/4 cup baked beans

1 slice bread of any type

3/4 cup of blueberries

1/2 cup corn

3 graham crackers

1 and 1/4 cup strawberries

1/2 cup peas

6 saltine crackers

1 and 1/4 cup cubed watermelon

12 cherries

15 grapes

1 orange

1 pear

1/2 cup most fruit juices

1 and 1/4 cup milk (skim or whole)

Approximately 15% of patients who take the three-hour GTT will test positive for gestational diabetes.

Gestational Diabetes Diagnosis and Treatment

If you are diagnosed with gestational diabetes, we will have you start meeting with an endocrinologist (gestational diabetes specialist) and nutritionist to learn how to test your blood sugars and adjust your diet. Careful calorie counting, avoidance of certain foods, and incorporating safe activity are emphasized. Usually that is all that is needed to control your blood glucose. A small percentage of patients will need additional insulin therapy to control their blood glucose.

We will order a few more ultrasounds to follow your baby’s growth. If you do require insulin, we will monitor your baby with nonstress-tests in the third trimester.

Babies born to mothers who develop diabetes during pregnancy are not at increased risk for birth defects. Your baby is at increased risk for conditions such as macrosomia (being large at birth), hypoglycemia (low blood glucose), hyperbilirubinemia (jaundice), and delivery complications.

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