Exams and Tests

Experts debate whether all pregnant women need to be tested for gestational diabetes. The U.S. Preventive Services Task Force has found insufficient evidence to recommend screening women with no risk factors for gestational diabetes.³ But most doctors routinely test all pregnant women who are in their care. The American Diabetes Association recommends that all women who are not already diagnosed with diabetes be tested for gestational diabetes between the 24th and 28th weeks of pregnancy using the oral glucose tolerance test.¹

Tests during pregnancy

If you have gestational diabetes, your doctor will check your blood pressure at every visit. You will also have certain tests throughout your pregnancy to check your and your baby's health. These tests include:

• Home blood sugar monitoring. Testing your blood sugar at home every day helps you know if your blood sugar level is within a target range. You may need to give yourself insulin shots to help control your blood sugar. Some doctors are using pills called glyburide and metformin to treat women who have gestational diabetes.
• Fetal ultrasound. This test may be used to estimate the age, weight, and health of your baby. The ultrasound test also can measure the size of your baby's head and abdomen. This measurement along with other information can be used to help your doctor decide on your care. If your doctor thinks your baby is bigger than normal for his or her gestational age and your blood sugar is high, then your doctor may decide you need to start taking insulin or diabetes pills. Taking insulin when you have gestational diabetes will help keep your blood sugar in a target range, which can stop your baby from growing too big. Keep in mind that ultrasounds cannot always accurately estimate how much your baby weighs or whether there are other problems.
• Nonstress test. A nonstress test can help you know how well your baby is doing by checking your baby's heartbeat in response to movement.

Some doctors may recommend you have a hemoglobin A1c (glycosylated hemoglobin) or a similar test every month during your pregnancy. The A1c test estimates your average blood sugar level over the previous weeks to months.

Gestational Diabetes: Checking Your Blood Sugar

Tests during labor and delivery

During labor and delivery, you and your baby will be monitored very closely.

• Fetal heart monitoring is used to see how well your baby is doing while you are in labor.
• Blood sugar tests are done regularly to make sure your blood sugar level is within a target range.

Tests after delivery

After your baby is born, your blood sugar level will be checked several times. Your baby's blood sugar level will also be checked several times within the first few hours after birth.

Follow-up

Even though your gestational diabetes will probably go away after your baby is born, you are at risk for gestational diabetes again and for type 2 diabetes later in life. Up to 60 out of 100 women who develop gestational diabetes will develop type 2 diabetes later in life.²

You will have a follow-up glucose tolerance test 6 to 12 weeks after your baby is born or after you stop breast-feeding your baby. If the results of this test are normal, you will still need to be tested for type 2 diabetes at least every 3 years. Even if your sugar level is normal, you are at increased risk of developing diabetes in the future. Eating healthy foods and getting regular exercise can help prevent type 2 diabetes.

If you want to get pregnant again, you should be tested for diabetes both before you become pregnant and early in your pregnancy.