No dancing around the truth here. Find out what to eat for the glucose screening test, what to do for the best results, and a few helpful tips for testing day.
I'll give you the bottom line up front, but stick around to understand the why behind it.
It's simple, Mama - 2-3 hours before the glucose test, eat what you would normally eat for that time of day. This will give you the best results!
The Best Chance of Passing
The best chance you have of passing the test is to eat a healthy diet throughout pregnancy that focuses on:
- nutrient-dense foods
- lean meat
- fruits and vegetables
- complex carbohydrates
- whole grains
- portion control
- lots of water
Healthy lifestyle changes that also influence blood sugars are regular movement and exercise, adequate sleep, and minimal stressors.
But the glucose test is less about passing and more about a healthy pregnancy.
What the Test Results Mean
We have to address the mindset around the gestational diabetes test, because the terms "pass" and "fail" have created a fear of testing, and stigmatized moms.
LET'S BE CLEAR
The gestational diabetes test is NOT a grade of your health, body, or pregnancy! Moms that "pass" are not rewarded, and moms that "fail" are not penalized.
Instead, the test is a discovery of whether or not your body produces enough insulin to maintain blood sugars at safe levels. It's knowing and understanding what's happening to your body as you journey through this pregnancy.
Risks of Unmanaged Gestational Diabetes
If you have gestational diabetes and it goes undiagnosed, or untreated, the risk of pregnancy complications is increased. For mom, this includes high blood pressure, preeclampsia, and c-section. Baby is subject to macrosomia (large baby or excessive birth weight), shoulder dystocia, jaundice, low blood sugars, and stillbirth.
Long term health risks include problematic blood sugars for mom and baby, resulting in a diagnosis of diabetes.
Managing high blood sugars with only dietary changes and exercise is ideal, but it's not always the best option depending on the circumstances.
Medications are available; a common one being Metformin. When diet and exercise aren't effective, medications are next in line of treatment, but meds come with side effects.
If medications don't work out, insulin injections are next in line. Some moms have to, or choose to, take insulin from the beginning to keep blood sugars safe.
Discuss options with your health care provider to determine what is best for you.
Early Glucose Screening
Normally, your healthcare provider will test you for gestational diabetes between 24 and 28 weeks of pregnancy with the Oral Glucose Tolerance Test (OGTT).
Sometimes, early testing takes place if you have:
- had gestational diabetes in a previous pregnancy
- a family history of diabetes
- multiple risk factors
It's a good idea to test early, and some health care providers test every mom early as a best practice, because the earlier it's detected, the better for mom and baby.
The great thing about testing early is that it's done during initial bloodwork at the first prenatal appointment. It requires no special effort from you. Best of all, you don't have to drink the OGTT glucose drink...yet.
Here's the catch - If you test early and your blood glucose levels are normal, the doctor will still test you during the 24 to 28 week period with the OGTT.
Insulin resistance is natural in pregnancy, and 24 to 28 weeks is normally when blood sugars start to rise.
On the other hand, if you test early and your blood glucose levels are already high, the doctor will likely treat you as a gestational diabetic for the remainder of pregnancy.
1-Hour Glucose Test Procedure
Your health care provider will give you the glucola drink. Some providers allow you to take it home, and some require you to drink it at your appointment.
If you are required to drink it at the appointment, plan to be there over an hour.
It has to be consumed within 10 minutes. The time you finish is recorded; then your blood is tested one hour later. This blood test will likely be a finger prick with a handheld glucose monitor in the doctor's office.
Eating prior to the 1-hour test is necessary to reduce the chances of a false positive or false negative.
The purpose of the test is to see how your blood sugar reacts to pure glucose without other influencing factors.
This is why it's important to eat 2-3 hours before the 1-hour test. In 2-3 hours you will have digested your meal, and blood sugars returned to normal (normal for you). If you wait to eat 1 hour before the test, your body will still be processing the meal, and it will influence what happens to your blood sugar when you drink the glucose solution. This could produce a false positive or false negative.
If you do not eat before the test, your blood sugars might be in a yo-yo (up and down) state to compensate for not having any food. This could also give an inaccurate result.
What to Eat Before the Glucose Test
Now that you know results can easily be skewed, you can see how eating what you would normally eat for that time of day is the best option.
Attempting to "cheat" for a positive result will give you inaccurate information and put you and baby at increased risk for complications.
Not changing a thing about what you eat is how you will get the most accurate results.
- Eat before the 1-hour test
- Eat 2-3 hours before the test
- Eat what you normally eat
3-Hour Test Procedure
The three-hour glucose test requires you to fast at least 8 hours. This test requires 4 blood draws. The procedure is as follows:
- Arrive at the appointment in a fasting state
- 1st blood draw
- Consume the drink in 10 mins
- 2nd blood draw one hour later
- 3rd blood draw one hour later
- 4th blood draw one hour later
You will be at this appointment for 3-4 hours. During this time you cannot leave or eat. Some places don't even allow you to drink water.
- Bring a granola bar or other quick snack that you can scarf down after the last blood draw.
(By the end of the appointment your blood sugar will have likely crashed: you'll feel low-energy, light-headed, and hungry!)
- Make the appointment as early as possible.
An afternoon appointment is far too long to go without eating, unless that's normal for your schedule.
It's worth knowing the alternative methods, because drinking the glucola drink is harder than it sounds. Many find the taste displeasing, and it must be finished within 10 minutes of starting. If you can't drink it within 10 minutes, and keep it down (not throw up), you have to try again a different day.
(There are a handful of flavors to pick from. Reportedly, the lemon-lime flavor causes less discomfort and tastes better.)
Side-by-Side Glucose Tests Review
Gestational Diabetes Diagnosis Criteria
If you've heard that moms have different cut-off numbers, like 90 as opposed to 95 for fasting, it's because different governing organizations determine the criteria.
Many doctors abide by the American Congress of Obstetricians & Gynecologists (ACOG) standards for diagnosis:
1-Hour Test - 50 grams of glucose consumed in 10 minutes and blood tested 1 hour later
- No diagnosis if reading is 139 or less.
- If reading is between 140 and 199, proceed to the 3 hour test.
- If reading is 200 or more, gestational diabetes is diagnosed.
3-Hour Test -100 grams of glucose consumed in 10 minutes from a fasting state
- 1st blood draw (fasting blood glucose level) should be 94 or less.
- 2nd blood draw should be 179 or less.
- 3rd blood draw should be 154 or less.
- 4th blood draw should be 139 or less
- If any TWO readings are above range, gestational diabetes is diagnosed.
The American Diabetes Association (ADA) and the International Association of Diabetes and Pregnancy Study Group (IADPSG) recommend the following:
- 1st trimester early testing
- If blood glucose reading is 92 or more, gestational diabetes is diagnosed.
- If reading is 91 or less, test with 75-gram OGTT at 24-28 weeks.
- 75-gram OGTT
- Fasting reading should be 91 or less.
- 1-hour reading should be 179 or less.
- 2-hour reading should be 152 or less.
- If any ONE of these is exceeded, gestational diabetes is diagnosed.
Testing is about giving you and your baby the best possible outcomes.
Jorden's gestational diabetes went undiagnosed for weeks. Click here to listen to what ensued during pregnancy and after birth.
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