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DIABETES: Screening for Gestational Diabetes
2010-03-23
By Lifescript


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According to the U.S. Department of Health and Human Services Office of Minority Health, American Indian and Alaska Native adults are 2.3 times as likely as white adults to be diagnosed with diabetes. The disease is the fourth leading cause of death for American Indians and Alaska Natives, affecting about 16% of the population. Information about diabetes from Tanka friend Lifescript runs every other week in our blog, Walking the Way of Wellness.

The purpose of screening is early diagnosis and treatment. Screening tests are usually administered to people without current symptoms, but who may be at high risk for certain diseases or conditions.

Your doctor should assess your risk for gestational diabetes at your first prenatal visit. If you have a fasting blood sugar greater than 126 milligrams per deciliter (mg/dl), or a random blood sugar greater than 200 mg/dl, that is confirmed on another day, you meet the criteria for the diagnosis of diabetes and you do not need to be screened.

If you are at high risk of developing gestational diabetes -- very obese , prior history of gestational diabetes, prior delivery of a big baby, glucose in your urine, or a strong family history of diabetes -- your doctor may recommend that you undergo glucose testing as soon as possible. If your initial test is not positive, you should be retested between 24 and 28 weeks of gestation.

Women who are of average risk should be given the 50-gram screening test between 24-28 weeks of gestation.

Newer guidelines do not require glucose testing for low-risk women, but to be low risk you must meet all of the following criteria: less than 25 years of age, normal weight before pregnancy, not a member of an ethnic group with a high risk of diabetes (Asian American, African American, Hispanic American, Native American or Pacific Islander), no known diabetes in any siblings or parents, no history of abnormal glucose tolerance, no glucose in urine, and no history of poor obstetric outcomes.

Screening Tests


50-gram glucose screening test -- You do not need to fast before this test. You are given a drink that contains 50 grams of glucose. One hour later, your blood sugar level is tested.

If your blood sugar level is less than 130 milligrams per deciliter (mg/dl) at the one-hour mark, the likelihood that you have gestational diabetes is low, and you do not require further testing.

If your blood sugar level is greater than 130 mg/dl, the test is considered abnormal or positive. Your chance of having gestational diabetes mellitus is 90%. You will need to take the 3-hour oral glucose tolerance test to confirm the diagnosis. Not all women that have an abnormal or positive 50-gram glucose test have gestational diabetes.

For more on gestational diabetes: LifeScript
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