When do you test your blood sugar for gestational diabetes

Glucose testing – screening for gestational Diabetes

What is gestational diabetes?

Gestational diabetes (GD) is a type of diabetes that occurs during pregnancy. It happens when your body is not able to produce enough insulin to keep the amount of glucose (sugar) in your blood at proper levels. Untreated GD increases the likelihood of having a large baby, and is associated with birth complications as well as health risks for the newborn (e.g., preeclampsia, shoulder dystocia). Untreated GD also increases the risk of stillbirth late in pregnancy (36-40 weeks). Women who develop GD are at higher risk of developing type 2 diabetes in the future. However, there is excellent treatment for GD, and most women diagnosed with GD have normal deliveries and healthy babies.

Why is it important to screen for gestational diabetes?

All pregnant women should be offered blood glucose screening for GD between 24 and 28 weeks of pregnancy. If you have risk factors for GD, you will be tested earlier in your pregnancy. These risk factors include:

  • Being older than 35
  • Obesity (defined as a pre-pregnancy BMI greater than 30)
  • Aboriginal, African, Asian, Hispanic, or South Asian ethnicity
  • Family history of diabetes
  • Polycystic ovarian syndrome or acanthosis nigricans
  • Corticosteroid use during pregnancy
  • Previous pregnancy with GD
  • Previous delivery of a baby large than 4000 g

What does the blood glucose test involve?

When do you test your blood sugar for gestational diabetes

All pregnant women are offered this screening test between 24-28 weeks gestation. When other risk factors are present, such as obesity, the test may be offered earlier and then repeated if initially normal. The screening test for GD is called a ‘glucose challenge’, which aims to see how your body is handling sugars. The measurement is taken 1 hour after you consume a glucose drink. This test can be conducted at any time of day as it is not a fasting test. If your blood sugar is normal after the challenge, you will not require any more testing. If it is high, you will have a second test. This test is done in the morning while you are fasting and will require you not to eat prior to the test. You will have your glucose tested before consuming a glucose drink and then tested again 1 and 2 hours later. If your glucose is higher than specific cut-off values, it means you have GD. See the table for more specific information.

Screening for gestational diabetes

Step 1 – non fasting, 50 g glucose challenge

1 hour Less than 7.8 mmol/L = no further testing
Between 7.8 and 11.1 mmol/L, go to step 2
Higher than 11.1 mmol/L = GD

Step 2 – fasting, 75 g glucose challenge

Fasting

Higher than 5.3 mmol/L = GD
1 hour Higher than 10.6 mmol/L = GD
2 hour Higher than 9.0 mmol/L = GD

What if I have gestational diabetes?

GD is increasingly common, with about 7% of women having the condition. If you are found to have GD, you will work closely with your health care provider(s) to keep your blood glucose levels in a healthy range. This involves choosing a healthy diet, gaining the recommended weight during your pregnancy, getting exercise, and if needed, taking insulin or pills to lower your blood sugar. Your baby’s wellbeing will be carefully monitored by regular measurements of growth and amniotic fluid volume. If you have GD you will be offered a repeat glucose tolerance test between 6 weeks and 6 months postpartum to detect prediabetes and diabetes. You may also be offered induction between 38-40 weeks of pregnancy. Finally, it is strongly recommended that women with GD breastfeed their infants.

When will I be tested for gestational diabetes?

Testing for gestational diabetes usually occurs between 24 and 28 weeks of pregnancy.

If you have an increased chance of developing gestational diabetes, your doctor may test for diabetes during the first visit after you become pregnant.

How do doctors diagnose gestational diabetes?

Doctors use blood tests to diagnose gestational diabetes. You may have the glucose challenge test, the oral glucose tolerance test, or both. These tests show how well your body uses glucose.

When do you test your blood sugar for gestational diabetes
You will have one or more blood tests to check for gestational diabetes.

Glucose Challenge Test

You may have the glucose challenge test first. Another name for this blood test is the glucose screening test. In this test, a health care professional will draw your blood 1 hour after you drink a sweet liquid containing glucose. You do not need to fast for this test. Fasting means having nothing to eat or drink except water. If your blood glucose is too high—140 or more—you may need to return for an oral glucose tolerance test while fasting. If your blood glucose is 200 or more, you may have type 2 diabetes.

Oral Glucose Tolerance Test (OGTT)

The OGTT measures blood glucose after you fast for at least 8 hours. First, a health care professional will draw your blood. Then you will drink the liquid containing glucose. You will need your blood drawn every hour for 2 to 3 hours for a doctor to diagnose gestational diabetes.

High blood glucose levels at any two or more blood test times—fasting, 1 hour, 2 hours, or 3 hours—mean you have gestational diabetes. Your health care team will explain what your OGTT results mean.

Your health care professional may recommend an OGTT without first having the glucose challenge test.

This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

The NIDDK would like to thank:
Boyd Metzger, M.D., Northwestern University

How many times a day should I test my blood sugar for gestational diabetes?

While you're pregnant, your health care team may ask you to check your blood sugar four or more times a day — first thing in the morning and after meals — to make sure your level stays within a healthy range.

What should my blood sugar be 2 hours after eating while pregnant?

We suggest the following target for women testing blood glucose levels during pregnancy: Before a meal: 95 mg/dl or less. One hour after a meal: 140 mg/dl or less. Two hours after a meal: 120 mg/dl or less.

What time of day is best for gestational diabetes test?

Between weeks 24 to 28 of each pregnancy (possibly sooner, if you're at a higher risk of gestational diabetes), your doctor will conduct a glucose screening, usually in the morning.

When should I take my fasting blood sugar in the morning for gestational diabetes?

Blood sugar monitoring Fasting (in the morning before eating): 60 to 95. One hour after the start of each meal: less than 140.