According to Dr. Barbour and Dr. Alyssa Dweck, M.D., an ob-gyn at CareMount Medical in Westchester County, N.Y., other factors that might increase your risk of gestational diabetes can include:
Getting pregnant at an “advanced maternal age” (clinically age 35 or older, but some doctors use age 40)
A history of polycystic ovarian syndrome (a hormonal disorder that can elevate insulin levels)
Previous delivery of a baby weighing 9 pounds or more
A previous prediabetes diagnosis
A history of high blood pressure, heart disease or high cholesterol
Recognize the signs of G.D.M. — or lack thereof.
The trickiest part of a gestational diabetes diagnosis, according to Dr. Barbour, is that its signs are often imperceptible. “G.D.M. is associated with such mild hyperglycemia that most women won’t notice,” she said.
If you are noticing symptoms — such as fatigue, frequent urination or thirst, said Dr. Barbour — you might actually have Type 2 diabetes, which does not resolve after labor like gestational diabetes. Or, such symptoms could simply be normal pregnancy ones. After all, what pregnant woman isn’t tired?
“The point is that women need to be screened because they’re not going to have symptoms,” said Dr. Barbour. If you’re high-risk, your doctor might recommend that you get tested before the typical window of testing, which is between 24 and 28 weeks of pregnancy.
Between 24 and 28 weeks, your doctor will order a G.D.M. screening test. The type of test will depend on which camp your doctor (or health group) falls into: those that prefer The American College of Obstetricians and Gynecologists diagnostic, a two-step method (the most commonly-used test); or those that prefer the newer, one-step version from the International Association of Diabetes and Pregnancy Study Groups. Both tests are performed between 24 and 28 weeks.
With the first method, you’ll arrive at your clinic, lab or doctor’s office and drink a sweet, syrupy glucose drink. You’ll wait for an hour, then get a blood draw to measure how much glucose is in your blood. If your blood glucose spikes to abnormal levels, you fail the challenge and you’ll need to come back for a glucose tolerance test. The glucose tolerance test is a three-hour test that involves fasting overnight, getting your blood drawn first thing in the morning, then chugging another thick, sugary drink. You’ll then have three more blood draws — at the one-, two- and three-hour marks. If one (or two, depending on your doctor) of those recorded blood glucose levels are elevated, you will be diagnosed with gestational diabetes. (I had one, slightly-elevated, unlucky number.)
During the one-step version, you’ll fast overnight, get your blood drawn once you arrive at the clinic, then drink a glucose drink. Your blood will be drawn at the one- and two-hour marks after you consume the drink. If one of the three plasma glucose values are high, you’ll get a diagnosis.
If you’re diagnosed, discuss a treatment plan with your doctor immediately so that you can have the best possible outcome for your pregnancy. Once on a treatment plan (as discussed below), most women (and their babies) do just fine controlling gestational diabetes. Stay on track with regular visits to your ob-gyn, as well as with a dietician or endocrinologist.