6% : the percentage of pregnant women that will be diagnosed with gestational diabetes (commonly called GDM, and AKA diabetes of pregnancy). Pregnancy itself puts women in an insulin resistant state, which subsequently increases the risk of developing diabetes (temporarily).
10%: percentage of women in the US are considered “low risk” for developing GDM given baseline health status. That means 90% of us have some risk factor that makes it possible, and sometimes even likely, that we will develop GDM. Even low risk women may develop some potential risk factors during pregnancy – hello significant weight gain. That means universal screening is recommended – that means screening for every.single.one.of.you (and me during both of my pregnancies).
24-28 weeks of pregnancy: normal screening window. If you have significant risk factors, such as a history of GDM or very large baby in a previous pregnancy, first degree relative with diabetes, obesity, and/or insulin resistance before pregnancy, I recommend screening early in pregnancy and again during the normal window.
To screen for gestational diabetes, nearly every OBGYN office uses a pre-formulated glucose load in the form of a Fanta-esque drink, sin gas. Most women tolerate it, some women fear it, others refuse it.
The “2 hour” screening test – a fasting blood test, a 75g glucose load (more about this in the next post!), a second blood test 2 hours later. If you pass, you’re done. If you fail, you are diagnosed with GDM.
The “2 step” screening test. First step: a 50g glucose load followed by a blood test 1 hour later. If you pass, you’re done. If you fail, you need the 3 hour test – a fasting blood test, a 100g glucose load, then blood tests at 1 hour, 2 hours, and 3 hours. This is the kind of testing I do – it’s onerous for women who have to do the additional 3 hour for confirmation, but the 1hr test is relatively painless if you don’t mind the and tolerated well.
Of course you can. I don’t suggest it unless there is a medical indication (such as history of gastric bypass surgery). This is because the glucose load is the most accurate way to diagnose GDM, and GDM can have severe effects on the pregnancy and baby. Knowing whether or not you have GDM is extremely important for the health of you and your baby (which is why we screen everyone).
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Dec 29, 2020
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