Mommies! There are many risks during pregnancy that we have to watch out for as it may endanger ourselves and our babies.
What can you read in this article?
- 7 important things to know before you take the Oral Glucose Tolerance Test (OGTT)
- What is gestational diabetes?
- Who is at risk to have GDM?
- Diagnosis and Tests
- Risks and possible effects of GDM to the pregnant woman and the baby
- Management of GDM
Glucose or blood sugar level is one of the significant information that your doctor needed to have clues about your health and wellbeing especially now that you are pregnant which is why taking the glucose tolerance test is necessary.
Are you familiar with the word oral glucose tolerance test? How about gestational diabetes? If not and especially if you are a first-time mommy, you would know in this article all the important things about gestational diabetes and OGTT.
7 important things to know before you take the Oral Glucose Tolerance Test (OGTT)
Glucose tolerance test in pregnancy. | Image from iStock
1. Gestational diabetes, what you need to know
Gestational diabetes mellitus (GDM) is a type of temporary diabetes in a pregnant woman who never had diabetes prior to becoming pregnant.
For some women, gestational diabetes affects them in more than one pregnancy. This complication usually manifests itself in the third trimester of pregnancy between the 24th and 28th week where doctors are most likely to screen for it.
Gestational diabetes happens when the hormones in the body that is made by the placenta prevent the insulin to work effectively resulting in blood sugar levels becoming high. The glucose in the body which was supposed to be absorbed by the cells builds up in the blood.
Last August 27, 2021, in the online webinar done by theAsianparent Philippines in their campaign named Project Sidekicks entitled “Pregnancy Complications: Gestational Diabetes & Obesity”, Dr. Kristen Cruz-Canlas, an Obstetrician-Gynecologist, lead a discussion about gestational diabetes and maternal obesity among pregnant women.
During the talk, Dr. Canlas started by explaining the types of diabetes. The two types of diabetes are overt diabetes and gestational diabetes in which the first one is the type where you already have it even before you get pregnant and the second one is the type you get during pregnancy.
Dr. Canlas stated,
“‘Yong gestational diabetes, actually itong dalawang mga complications na ito o mga sakit na ito is talaga nga na everyday natin nababasam napapakinggan, lagging advise sa atin n gating mga doktor, kahit hindi lang sa OB.
So gestational diabetes ito po ‘yong diabetes or yung pagtaas n gating blood sugar level during pregnancy. So technically may types po kasi tayo yung overt diabetes na tinatawag and then yung gestational.”
Moreover, Dr. Canlas added that overt diabetes has 2 types, type-1, and type-2 diabetes. Type-1 diabetes is juvenile and it is where the patients need to use insulin while type-2 diabetes can also be insulin-requiring but still can be done through other medical procedures.
Gestational diabetes usually lasts for the duration of pregnancy and disappears after the delivery however, this still poses a great danger to your baby and increases your chance of developing type-2 diabetes later in your life so you may want to take some precautions to ensure your and your child’s wellbeing.
“Yes. Una is yes nawawala. Lalo na kung talagang geststional diabetes. So, babalik ako doon sa screening. ‘Yon nga may mga values kami na chinecheck, nakikita po ‘yon lalo na kung FBS or ‘yong OGTT po ‘yong ginamit natin.
‘Pag kasi RBS, ‘yon ‘yong hindi na, random blood sugar, bigla lang pong nagcheck. ‘Pag more than 200 or yung Hb1c nyo is more than 6.5 % overt diabetic na po tayo sa first prenatal.”
2. Who is at risk to have GDM?
Whilst any pregnant woman can acquire gestational diabetes, there are still some factors in which may increase the risks. In the webinar, Dr. Canlas listed obesity as one of the top causes of GDM. “If you have obesity the percentage is 50%, it’s high,” she said.
She further explained that obesity is a huge factor that can affect our health were not only gestational diabetes but also other complications that might come from it.
Due to the Asian group having a variety of good food, it is not impossible to enter into obesity. Among the Asians, the BMI or Body Mass Index of 27 is already on the verge of being overweight as the normal and ideal index is 18-24.
The other risks factors that may increase GDM among pregnant women are:
- Have GDM in the previous pregnancy or multiple pregnancies
- Race and older age of conception
- Physically inactive o have a sedentary lifestyle
- History of diabetes among family members
- High blood pressure
- Other diabetes-related complications or pre-diabetes
- Have PCOS (Polycystic Ovary Syndrome)
- Have had a miscarriage or given birth to a child with birth defects
- Delivered a baby
According to Dr. Canlas, the symptoms of GDM is also just the same as non-pregnant people encounter on a normal basis. The symptoms of gestational diabetes include:
- Frequent urination
- Extreme thirst and hunger
- Frequent urination
- Blurred vision
- Skin, bladder, and vaginal infection
3. Diagnosis and Tests
While the webinar progress, Dr. Canlas continued to explain the screenings that doctors recommended during the first prenatal visits. This universal screening is where all ob-gyne doctors check the sugar level of the pregnant woman.
These types of tests and screenings can tell if you have a high risk of getting diabetes or if you already have it. The first one that Dr. Canlas stated is the Oral Glucose Tolerance Test (OGTT), then HbA1c, Random blood sugar test, and Fasting Blood Sugar (FBS).
The measurement you might see in tests is written as mg/dL stands for milligrams per deciliter where the normal blood sugar is below 140.
If your measurement goes between 140 and 199 then it means you have impaired glucose tolerance or pre-diabetes while having 200 or above means you already have diabetes.
Gestational diabetes is a common occurrence in pregnancy but it still very much poses a huge threat to both the mother and the baby.
A glucose tolerance test in pregnancy is important and very necessary as it will help in detecting the condition early in the pregnancy where threats can still be prevented.
4. What is Oral Glucose Tolerance Test (OGTT)?
Oral glucose tolerance test or OGTT shows how well your body handles sugar from foods. This test is usually done between the 24th and 28th week of pregnancy where gestational diabetes also starts.
According to Dr. Canlas, the normal sugar level for a pregnant woman that took a fasting blood sugar should be 92 – 125 ml/dL while 126 ml/dL and above is already high.
5. How do you get ready for glucose tolerance test in pregnancy?
Eat and drink normally as you always do before the days leading up to your screening. If your schedule is early on the next day, do not eat or drink anything 8 hours before your test as fasting is a needed procedure for OGTT.
- A glucose tolerance test is done in several steps and at the start of the procedure, a nurse or a doctor will take a sample of your blood from a vein in your arms. This sample will measure the fasting blood glucose level.
- Before the procedure, doctors might take you on screening and ask you several questions to know if you have a high or low risk of getting gestational diabetes. For women with low risk, it is recommended to do a short 60-minute test where you’ll drink a liquid-type glucose solution provided by the doctor and take the blood test again after an hour.
- If you are determined to be at a high risk of getting GDM, doctors might advise you to take the 3-hour test where you’ll drink 8 ounces of glucose solution and take a blood glucose test again.
After the procedure, your doctor will determine your result and give advice fitted for your case. Those who have been diagnosed with gestational diabetes can still prevent any further complications that might arise in the duration of your pregnancy.
6. Risks and possible effects of GDM on pregnant woman and the baby
Gestational diabetes poses a great danger during pregnancy to both the mother and the baby. According to Dr. Canlas, diabetes or GDM can cause both maternal and fetal complications.
The maternal side may include both short-term and long-term complications which include high blood pressure and preeclampsia while babies have a higher risk of developing congenital anomalies and could be born in a larger size.
When the baby is growing in a larger size, this is called fetal macrosomia. As the mother have diabetes, the baby’s blood in her womb would be high resulting in the baby being overfed and growing larger.
When this happens, the mother could have dystocia or difficulty in delivering the baby through vaginal delivery which might result in a C-section.
One of the most dangerous that fetal macrosomia may cause is shoulder dystocia. According to Dr. Canlas, when the baby’s head comes out but the shoulder gets stuck as it’s too big. “It is a nightmare for us ob-gynes’ too,” she said.
Image from iStock
Meanwhile, high blood pressure and preeclampsia in the mother is a serious problem that must be managed immediately. This complication can cause the baby to be born pre-term and even a seizure or stroke resulting in blood clot to the brain to the mother during labor or delivery.
Dr. Canlas further explained that pregnant woman who has GDM has 50% more chance of having miscarriage and stillbirth than that of women who do not have it. A woman who has diabetes should monitor their HbA1c at the optimum level which is 6.5%.
Other possible effects of gestational diabetes are:
- Hypoglycemia or low blood sugar
- Type-2 diabetes later in life
- The baby getting type-2 diabetes when they grow
- The child to be obese as it grows
7. Management of GDM
After taking the glucose tolerance test in your pregnancy, those who have been diagnosed should be closely monitored and taking safety practices.
Following a healthy diet and getting enough exercise
If you are a person with diabetes, you should make a healthy diet plan to control your blood sugar. Your diet could include whole grains, lean proteins, healthy fats, fruits, etc.
Meanwhile, exercising regularly could keep your blood sugar under control as it helps regulate the body’s sensitivity to insulin. Consult your doctor on what type of exercises you can take during your pregnancy to ensure safety.
Monitor blood sugar levels regularly
With the direction of your doctor, check your blood sugar level often as pregnancy causes a lot of change in the body which also changes the blood sugar level.
If needed, use insulin
If ordered by your doctor, take insulin to keep the level of your blood sugar under control.
To check and prevent further complications to your baby, schedule an ultrasound with your doctor so you can monitor their health.
Get a glucose tolerance test again after your pregnancy
Gestational diabetes can turn into type-2 diabetes after your pregnancy, you should get tested again to ensure that it has not developed into the other type of diabetes.
CDC, Medical News Today, HopkinsMedicine
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