Tuesday I was faced with the lovely task of chugging a bottle of orange-flavored sugar water {50 grams of dextrose aka sugar!} for the mandatory pregnancy glucose screening test. I had visions of nausea and light-headedness and general feelings of crappiness, but in reality, it wasn’t so bad. However, if I don’t pass…I’m not so sure I can handle the double strength version of the test. Around 26-28 weeks, every pregnant woman has to go through the not so pleasant task of downing a super sugary artificially flavored drink and then sitting around waiting for an hour to have blood drawn.
Most of the time you don’t get any hint that you have gestational diabetes- most women do not experience any symptoms, other some experience increased thirst or urination, fatigue, blurred vision, or frequent infections. Gestational diabetes puts you at risk for possible birth complications, the most apparent being macrosomia- a fancy term for a big baby. They made me sit in a closet (where they weigh you) and drink it while the CNA stared me down. Anyway, my doctor said I would go to the lab, drink the stuff, come up for my appointment, and then go back to the lab for the blood work to be drawn. I had my appointment in between- I think it was mostly luck that the midwife was ready then though!
I think super sugary flat orange soda is the perfect description- and it being cold would be so much better! You must have JavaScript enabled in your browser to utilize the functionality of this website.
OGTT is advised to individuals at high risk of developing diabetes or those with impaired sugar levels.
If one is diagnosed to have pre-diabetes, it is important to have OGTT repeated at 12 months initially; then as indicated by the results. Gestational Diabetes Mellitus is defined as glucose intolerance diagnosed during pregnancy.
It is recommended that pregnant women with any risk factors be screened at the first prenatal visit.
For women at high risk not found to have GDM at the first visit, repeat testing is indicated between 24 and 28 weeks.
If 2 or more values are abnormal then the patient has a positive diagnosis of gestational diabetes.
It has been found that women diagnosed with gestational diabetes already have insulin resistance at baseline with a higher level of plasma insulin levels.
Women diagnosed with GDM need training about daily self monitoring of glucose 6-7 times a day with a minimum of 4 times. All women diagnosed with GDM require nutritional counseling for the appropriate amount of weight gain during pregnancy as well as dietary control. It is a critical point in time for changing the lifestyles of these women since they are at a high risk for development of type 2 diabetes. The use of oral medications is considered when diet and exercise do not adequately control blood sugars. Some studies have recently evaluated the safety and efficacy of Glyburide [sulphonylurea] after the first trimester for treatment of GDM.
There is inadequate data in regards to the safety and efficacy of other oral antidiabetic medications such as Metformin, thiazolidinediones and Acarbose. The diagnosis and treatment of gestational diabetes is critical because elevated blood sugars adversely affect both the mother and the baby.


Approximately 50% women will develop type 2 diabetes within 5 years of development of gestational diabetes. I was dreading it- I do not like super sugary things, and I do not like drinking things fast. If you fail, you’re subjected to an even more wonderful three hour version of the test, where you drink a double strength or double volume drink and then have your blood taken each hour for 3 hours.
Gestational diabetes is a form of diabetes that can occur during pregnancy, regardless of whether or not you had diabetes before hand. Some people can keep it under control through diet and exercise, just like type 2 diabetes. It’s not uncommon for additional blood tests to be run with the same blood draw from your glucose test, specifically iron.
I had to have the ultrasound first though so the sugar didn’t make the baby go crazy. OGTT is used as a confirmatory test to diagnose diabetes & can indicate presence of pre-diabetes (insulin resistance).
The test is done after at least 3 days of unrestricted diet & normal physical activity.
The test is never done during any illness because blood sugar levels may fluctuate due to the underlying infection, medicines or illness.
The person is instructed to fast for 10-16 hours during which drinking plain water is permitted. 75 grams glucose is dissolved in 250 – 300 ml of water & it should be drunk by the person over the course of about 5 minutes. She has done her post graduation from Pune University and she is currently pursuing her PhD in area of Diabetes Prevention.
This could either be newly diagnosed type 1 or type 2 Diabetes Mellitus or this could be a new onset of hyperglycemia secondary to metabolic changes related to pregnancy. One can either take a two step approach, starting with the 50 gm glucose challenge test, followed by an oral glucose tolerance test if the results of the former test are abnormal. During the early part of pregnancy there is increase in insulin secretion and beta cell hyperplasia. It is recommended that pregnant women exercise for about 20-30 minutes everyday or at least most days of the week. The older sulphonylureas were not recommended for use in pregnancy because they crossed the placenta. The fetus is at increased risk of macrosomia, hypoglycemia, hypocalcemia, hypomagnesaemia, jaundice, polycythemia, respiratory complications, congenital malformations and fetal loss including abortion, still births and neonatal deaths. The greatest risk factor for early-onset type 2 diabetes after pregnancy was early gestational age at the time of diagnosis and elevated fasting glucose.
Everybody is tested because it doesn’t really matter what your risk factors are- you can still get it. A baby born to a mother with gestational diabetes also faces the risk of hypoglycemia- low blood sugar- right after birth, because the baby immediately loses the large supply of glucose from the  mother.  While gestational diabetes goes away after giving birth, having gestational diabetes also means you’re at a greater risk of developing type 2 diabetes down the road, so consider it a flashing warning sign. Pregnancy literally robs your body of iron- and it’s super important to keep those levels up. The worst part was having that much liquid in my stomach (for normal people it’s no big deal- maybe 8 or 10 oz?).
All flavors are available in the standard 50, 75, and 100 grams of Glucose per 10 ounce bottle.


She works with Diabetes Unit, KEM Hospital (Pune), Just for Hearts (Pune), Moraya Multispeciality Hospital & Healing Hands Clinic (Chinchwad) etc. This leads to an increase in insulin sensitivity with low fasting blood sugar levels, increased glucose uptake by peripheral tissue and glycogen storage as well as decreased hepatic gluconeogenesis.
The pancreas however, is unable to cope with this additional stress of elevated level of insulin resistance. Testing for the presence of ketones in a fasting urine sample is a valuable tool to assess the adequacy of caloric intake in these patients. These patients should restrict fat intake and substitute simple or refined sugars in their diet to more complex carbohydrates. Either way, you’ll probably be monitoring your blood sugar with finger pricks to keep an eye on things.
I was really, really not looking forward to it because I hate sweet things too- the idea of a regular soda makes me gag. All Glucose Drink varieties are non-carbonated, packaged in a 10 oz plastic bottle, and have an easy to read volume indicator. This process is crucial for the build-up of maternal adipose tissue, to be used in the later part of pregnancy.
Positive urine for ketones indicates a state of starvation and the patients should be advised to increase their daily caloric consumption. There isn’t enough data regarding the safety of the long acting insulin glargine in pregnancy. It has been shown that it is as effective as insulin, more cost effective than insulin and safe for use in pregnancy. Women with normal pregravid glucose tolerance who develop gestational diabetes in late gestation have no increased risk of fetal congenital anomalies beyond the population risk for women with normal glucose metabolism. During the late phase, there is an increase in hormones such as cortisol, prolactin, progesterone and human placental lactogen which leads to a state of relative insulin resistance, possibly via a post receptor defect in the cells. Both American Diabetic Association [ADA] and American college of Obstetricians and Gynecologists [ACOG] await more research related to the effect of glyburide on maternal and perinatal outcomes before approving its use. The children of women diagnosed with GDM are at increased risk of obesity and abnormal glucose metabolism during childhood, adolescence and adulthood.
While being obese and unhealthy certainly increase your chances, it’s not unheard of for a perfectly fit and healthy woman to become diabetic during pregnancy.
Luckily the doctors office called me the next day and told me my levels were completely normal… NO three hour test for me! Women diagnosed with gestational diabetes are at increased risk of gestational hypertension including preecclempsia, caesarian section and assisted deliveries.
One of the mechanisms thought to be contributing to the long term complications in these babies is ‘early onset hyperinsulinimia’.
The hormones produced by the placenta cause insulin resistance, meaning it can’t work as well.




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Comments

  1. 20.10.2014 at 20:15:54


    Felt pain still hard to avoid those very uncomfortable and morning or after.

    Author: Scorpion
  2. 20.10.2014 at 12:51:58


    Are ketones present in your amount of carbohydrate that you eat each.

    Author: A_L_I_8_K_M
  3. 20.10.2014 at 12:59:40


    Check your levels when you bloodstream and into our body's people with undiagnosed.

    Author: MAHSUM
  4. 20.10.2014 at 11:44:12


    Performed in the morning after a person has not eaten.

    Author: ANAR_666