When and how is glucose screening done in pregnancy? Screening versus diagnosis, what a high result means, gestational diabetes and follow-up after birth.
Glucose screening in pregnancy is a test in which blood sugar is measured before and after a glucose drink, generally in the second half of pregnancy, to detect high blood sugar (gestational diabetes) that can appear for the first time during pregnancy. If the result is high, the doctor determines how the assessment will continue. In people who have risk factors, the assessment can be done earlier. Practice may vary by country and healthcare institution; in Turkey the doctor who follows you decides which test will be used.
What does gestational diabetes mean?
Gestational diabetes is a high blood sugar level that appears during pregnancy. Diabetes known before pregnancy, on the other hand, is a different condition and requires separate monitoring.
Is glucose screening done even if you have no complaints?
The aim of screening is to detect high blood sugar early and make it possible to start monitoring and treatment, and thus to reduce the risk of complications for the mother and baby. Screening can be planned even if you have no complaints.
When is glucose screening planned?
Screening is generally planned in the second half of pregnancy. In Turkey, the doctor who follows you decides which approach and which timing will be applied.
In which situations can an earlier assessment be made?
For people who have risk factors, a blood test and/or a glucose tolerance test is recommended in early pregnancy. The risk factors listed include a high body mass index, having given birth to a very large baby in an earlier pregnancy, gestational diabetes in an earlier pregnancy, diabetes in a first-degree relative, some ethnic origins and glucose being found in the urine. Some of these factors are outside the person's control; developing gestational diabetes should not be interpreted as the person's fault. Your doctor assesses whether you have a risk factor.
How is the glucose challenge test done?
The test is done by taking a fasting blood sample, then drinking a drink containing glucose, resting for a time and taking a second blood sample; blood sugar is measured before and after the glucose drink. Details may vary according to the method used.
Is the same test applied everywhere?
The details of the test may vary by country and healthcare institution; the doctor decides which test will be used.
How should you prepare before the test?
Fasting may be needed for the test. Follow the instructions the doctor or the laboratory gives about fasting and medicine use.
What happens if your screening result comes out high?
A high screening test does not necessarily mean a diagnosis on its own; the doctor plans the next step and, if necessary, an additional test. Interpret the result with your doctor; do not start using medicines or supplements on your own, and do not change your current treatment.
How is follow-up done if gestational diabetes is diagnosed?
Management includes diet adjustment, regular activity and blood sugar monitoring; if necessary, tablets or insulin are added. An additional ultrasound and closer monitoring may also be planned. Your doctor determines the target values and the treatment plan specifically for you.
What does gestational diabetes mean for the mother and baby?
High blood sugar can increase the likelihood of the baby being born large and, with it, difficulties during birth; low blood sugar in the baby may also be seen after birth. For the mother there is also a risk of developing type 2 diabetes in the future. These are among the reasons why monitoring and treatment are planned when the diagnosis is made.
What is done after birth?
In people diagnosed with gestational diabetes, it is recommended that the diabetes test be repeated after birth and that monitoring then be done at regular intervals. Your doctor will tell you the timing of the test and the monitoring interval.
What should you ask your doctor before the test?
- Tell them if you have had gestational diabetes, a very large baby or a family history of diabetes.
- Ask which test will be used in this pregnancy.
- Find out when the test will be done and whether fasting is needed.
- Tell them about the medicines you use regularly.
- Ask what the next test will be if the result comes out high.
Frequently Asked Questions
If I am not overweight, do I have no risk of gestational diabetes?
No; advanced age and a history of bariatric (obesity) surgery are also counted among the situations in which the test is recommended, that is, weight alone is not the only thing looked at. Your doctor assesses whether you have a risk factor.
Does gestational diabetes recur in later pregnancies?
In people who have had gestational diabetes, the risk of developing gestational diabetes also increases in later pregnancies. For this reason, telling your doctor your earlier diagnosis in a later pregnancy helps to plan the timing of the test.
Do I need to continue taking diabetes medicines after birth?
Generally no. Diabetes medicines used because of gestational diabetes are stopped after birth, and blood sugar is measured before discharge. The doctor who follows you decides when the medicines will be stopped and how monitoring will continue.
Does gestational diabetes affect the baby's health later on?
The risk of obesity and type 2 diabetes later on may increase in the babies of people who have had gestational diabetes; you can consult your doctor about the baby's later follow-up.
If I have no complaints, is glucose screening not done?
No. The aim of screening is to detect high blood sugar and plan monitoring and treatment. Screening can be done even if you have no complaints.
Is glucose screening done at the same time in everyone?
No. It is generally planned in the second half of pregnancy; in people who have risk factors, an earlier assessment can be made. Your doctor determines the timing.
Is the same preparation necessarily needed for the test?
Preparation may vary according to the method used. You should follow your doctor's or the laboratory's instructions for fasting and medicine use.
If my screening result is high, is the diagnosis settled?
No. A high screening result may not mean a diagnosis on its own. If necessary, your doctor plans an additional test and the next step.
Is insulin started straight away in everyone diagnosed?
No. Management includes diet adjustment, regular activity and blood sugar monitoring; if necessary, tablets or insulin are added. The plan is determined specifically for you.
Are diabetes known before pregnancy and gestational diabetes the same?
No. Diabetes known before pregnancy is a different condition and requires separate monitoring.
Is the test repeated after birth?
Yes. If gestational diabetes was diagnosed, it is recommended that the diabetes test be repeated after birth and that regular monitoring follow. Your doctor will tell you the timing of the test and of monitoring.
Is developing gestational diabetes my fault?
It should not be interpreted in this way. Some of the risk factors are outside your control. Your history and your other findings are assessed together with your doctor.
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