Why screening for gestational diabetes is important

By Teresa Pitman on February 19, 2013
Chrysta Tsafkopoulos of Burlington, Ont., was shocked to learn that she’d failed the routine test for gestational diabetes, with blood sugar levels so high that her doctor wasn’t even going to send her back for the second test.

“I wasn’t overweight and I didn’t think I was at risk for this,” says Chrysta. “But the nurse at the program I was referred to explained that some women just don’t process glucose the same way during pregnancy.”

Women with gestational diabetes (GD) have higher than normal levels of sugar in their blood during pregnancy. Dr. Douglas Black, President of the Society of Obstetricians and Gynecologists of Canada, explains that this is a problem because “this excess sugar acts like a growth hormone.” Babies of mothers with GD tend to grow larger than usual (10–25 percent will weigh more than 4,000 grams, or 8 lbs, 13 oz), which can make the birth more diffi cult and potentially dangerous. The baby may also be at risk of hypoglycemia (low blood sugar) after birth.

Approximately 6.5 percent of pregnant women in Canada develop GD. Symptoms are similar to those of other types of diabetes: excessive thirst, frequent urination, blurred vision and fatigue. Risk factors include being overweight, smoking, belonging to certain ethnic groups (African-Canadian, Aboriginal, Hispanic), and being over 35, but many women with GD have no known risk factors and no symptoms. Testing is normally done between 24 and 28 weeks and usually in two parts.

Your doctor may refer you to a specialist, to a diabetes program and other community resources for treatment advice. “We begin with dietary changes. Most women can control this by changing their diets,” says Dr. Black. “They will do fi ngerpricks to test their blood several times a day. If the diet isn’t working, they may need to be given insulin, but that is less common.”

“I followed my diet to a T,” says Chrysta. “They also did frequent ultrasounds to make sure my baby wasn’t growing too fast. I wasn’t taking any chances.”

The test

At your lab appointment, you will drink a sugary beverage, similar to orange pop. The entire glass must be drained within five minutes. If you’re being screened first thing in the morning or after fasting, the sweet concoction can sometimes cause an upset tummy.

An hour later, you will have blood taken to evaluate your blood sugar level. Yes, it takes an hour. You cannot leave during this time, so bring something to keep you busy.

Results are available in a few days. Nearly 20 percent of patients will have high blood sugar levels and be asked to return for another test, this time with blood being taken once an hour for three hours. Because of this high “false positive” rate, speak with your healthcare provider about skipping the first test and jumping right to the second. It could save some valuable time.

Originally published in ParentsCanada magazine, February/March 2013.

By Teresa Pitman| February 19, 2013

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