I “failed” my glucose test…
You drank that not so wonderful orange (or maybe you go lemon-lime?) drink and got a call the next day. You “failed”. What does that mean and what happens now?
During pregnancy the placenta starts releasing a hormone that makes women insulin resistant. Most of the time the body can still maintain blood sugars in a normal range, but approximately 6% of the time is pushes women over into diabetes. The insulin resistance is typically temporary and resolves after the placenta is delivered.
It is important not to miss the diagnosis of gestational diabetes as there is increased risk to both mom and baby. Moms have an increased risk of blood pressure problems, preeclampsia or toxemia of pregnancy and long term are at higher risk of type 2 diabetes. The fetus is at risk of growth problems, birth trauma such as shoulder dystocia, bone fracture and nerve palsy, as well as higher chance of still birth. Scary as all of these issues are, they are largely avoidable if diabetes is diagnosed and well controlled.
So that we don’t miss anyone that might have gestational diabetes, the first orange drink test “failure” is set at a low enough level that it will catch everyone that has it. The problem with the low cut-off is that it also catches a lot of people that do NOT have diabetes. This is what we define as a screening test. So the next step is the diagnostic test to weed out the “false positive” results. We do this through a longer, 3 hour test. I will be honest- it is not a fun test. Our office will give you instructions to carb load for a few days prior to the test. This sounds counter-intuitive because we just told you your body may not be able to process carbs and now we want you to to eat extra carbs. The reason behind this is that this gives the pancreas the best chance to prepare for the extra sugar load of the second drink. The day of the actual test you will come to the lab fasting and get a blood test, drink another lovely orange drink, then get a blood sugar test every hour for 3 hours. It’s long. It’s boring. You are pregnant and hungry. So again- we know it’s not a fun test, but it is really important.
No one wants gestational diabetes. But with appropriate testing and treatment we can work together to make sure that at the end of the pregnancy you have a healthy baby and a healthy mama.