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Gestational Diabetes Screening

Gestational diabetes screening

Pregnant women who have not been previously diagnosed with type 1 or 2 diabetes mellitus but have high blood sugar levels during pregnancy are said to have gestational diabetes. It starts when your body is not able to make and use all the insulin it needs for pregnancy. Once the baby is born, it usually goes away.

Who is at risk

Several factors increase a woman's risk, including obesity, increased maternal age, history of gestational diabetes, family history of diabetes, and belonging to an ethnic group that has increased risk for developing type 2 diabetes mellitus (Hispanic, Native American, South or East Asian, African American, or Pacific Island descent).

Symptoms

You may have no symptoms, but see your doctor if you are feeling more thirsty, feeling more hungry and eating more, or need to use the bathroom more.

What you can do

  • Eat a healthy pregnancy diet.
  • Get regular exercise.

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Asymptomatic Pregnant Women

The USPSTF recommends screening for gestational diabetes mellitus in asymptomatic pregnant women at 24 weeks of gestation or after. 
Pregnant women with risk factors for either type 2 diabetes or gestational diabetes

HRSA recommends screening for gestational diabetes mellitus before 24 weeks of gestation – ideally at the first prenatal visit
Screening for diabetes after pregnancy

HRSA recommends screening for type 2 diabetes in women with a history of gestational diabetes mellitus who are not currently pregnant and who have not previously been diagnosed with type 2 diabetes. Initial testing should ideally occur within the first year postpartum and can be conducted as early as 4–6 weeks postpartum. Women who were not screened in the first year postpartum or those with a negative initial postpartum screening test result should be screened at least every 3 years for a minimum of 10 years after pregnancy. For those with a positive screening test result in the early postpartum period, testing should be repeated at least 6 months postpartum to confirm the diagnosis of diabetes regardless of the type of initial test (e.g., fasting plasma glucose, hemoglobin A1c, oral glucose tolerance test). Repeat testing is also indicated for women screened with hemoglobin A1c in the first 6 months postpartum regardless of whether the test results are positive or negative because the hemoglobin A1c test is less accurate during the first 6 months postpartum.


Why screening is important

If you have gestational diabetes, you are at increased risk for complications, including preeclampsia, high birth weight, and low blood sugar in your baby. You are also at increased risk for developing type 2 diabetes mellitus.

What the screening is

Screening is recommended after 24 weeks of gestation. Screening for may occur earlier than 24 weeks of gestation in high-risk women.

Screening with a 50-g oral glucose challenge test (followed by a 3-hour 100-g oral glucose tolerance test if results on the initial oral glucose challenge test are abnormal) is preferred.

Treatment

Treatment includes moderate physical activity, dietary changes, support from diabetes educators and nutritionists, and glucose monitoring. If your glucose is not controlled after these initial interventions, you may be prescribed medication (either insulin or oral hypoglycemic agents) or need to see your doctor more often.

Additional tips

  • If you are diagnosed with gestational diabetes, monitor your blood sugar often.
  • Get tested for diabetes after pregnancy, 6-12 weeks after your baby is born.
  • Watch your blood pressure and cholesterol levels.