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Diabetes Screening
Diabetes during pregnancy is more common than most of us realize. In fact, 3% of all expectant moms develop the condition during pregnancy. In most cases, pregnancy-induced diabetes, also known as gestational diabetes, occurs in the last trimester. Some of you may wonder why we screen for diabetes. The answer is simple: gestational diabetes can lead to some problems for the fetus. Too much sugar allows the baby to grow and grow and grow–and I doubt that you want to be the next tabloid headline, "Eighteen Pound Baby Speaks French at Birth!" Seriously, too much sugar means more Caesarean sections, more birth injuries and sad outcomes. So, it is important to have the screening done.

The test is performed between the 24th and 28th weeks of pregnancy. At this time, you will be given a sweet drink called Glucola (it doesn't matter if you fast first). One hour later, you will have your blood drawn. If your glucose level is under the cut-off—which is generally 140mg/dl--you passed the test. Congratulations, and enjoy your favorite treats in moderation.

For those who flunk the test, do not fear. You'll have a second chance to see if you have gestational diabetes. This time, you will be given the three-hour glucose tolerance test. For this test, you must come to the lab fasting. They will draw your blood before you have the drink and then every hour for three additional hours after you drink the glucose solution. If you have two out of four abnormal values, you will be diagnosed with gestational diabetes.

This is no time to go crazy! Most of you can change your eating pattern and control the sugar count. Many doctors will refer you to a dietician or nutritional counselor to help you learn how to alter your eating habits. To check on your progress, there are simple home sugar monitors that can be used to determine your sugar level. On occasion, one of my patients will require shots of insulin to manage gestational diabetes, and they will need careful monitoring.

For those women who are diabetic prior to pregnancy, speak with your obstetrician and diabetes provider about proper management during your pregnancy.

As a parting note, some women despise the Glucola drink. For them, I offer an alternative sugar choice: 18 jellybeans. It's true! A study found jellybeans to be an effective and tasty substitute. Of course, please check with your healthcare provider before taking your own sugar solution.

Craig L. Bissinger M.D.