Gestational diabetes is a common concern during pregnancy, affecting between 5% to 10% of expectant mothers. 

This condition, characterized by high blood sugar levels that develop during pregnancy, can pose risks to both the mother and the baby if not managed appropriately. 

Understanding the screening process for gestational diabetes can help alleviate anxiety and ensure that you are well prepared. Here's a detailed look at what to expect during a gestational diabetes screening.

When and why screening is done

Screening for gestational diabetes is a critical part of all pregnancies. It can help identify and manage health risks for both the mother and baby.

“Every pregnant patient will be screened at some point for gestational diabetes,” says Maternal-Fetal Medicine specialist Neil Hamill, MD. “When the screening happens will depend on whether they have any risk factors.”

The screening schedule is usually as follows:

• Standard screening: For most women without significant risk factors, the traditional time for screening is between 24 and 28 weeks of pregnancy.
• Early screening: Women with risk factors, such as a pre-pregnancy BMI over 40, a history of diabetes in a previous pregnancy or other metabolic concerns, are often screened in the first trimester.

The screening process

There are different types of gestational diabetes screenings, and some women will only undergo the initial screening or glucose challenge test. Generally, tests are conducted as follows:

Glucose challenge test:

• Preparation: No special preparation is needed. You do not need to fast before this test.
• Procedure: Upon arrival at the clinic, you will be given a sugar solution to drink. This solution is similar to flat orange soda and contains 50 grams of sugar.
• Waiting period: After drinking the solution, you will wait one hour.
• Blood draw: After the waiting period, a blood sample will be taken to measure your blood sugar level.

Results and follow-up:

• No further testing is needed if your blood sugar level is within the normal range. If your blood sugar level is elevated, you will need to undergo a follow-up test known as the glucose tolerance test.

Glucose tolerance test:

• Preparation: For this test, you will need to fast overnight.
• Procedure: The test involves multiple blood draws. Initially, a fasting blood sample is taken. You will then drink a glucose solution with a higher sugar content. Additional blood samples will be collected at one-hour, two-hour and three-hour intervals to monitor how your body processes the sugar.

Addressing test anxiety

It's not uncommon for expectant mothers to experience anxiety about undergoing gestational diabetes screening.

“We know that if a family has had an adverse health outcome in a pregnancy complicated by diabetes, they're going to worry about that with their next pregnancy,” Dr. Hamill says. “So those are great opportunities to touch base with their health care provider or obstetrician before pregnancy and express those concerns.”

Dr. Hamill suggests considering these points if you're feeling anxious about the test:

• Recurrence risk: While there is a risk of gestational diabetes recurring in future pregnancies, it's important to remember that this risk is not a certainty. Discussing your specific risk factors with your provider can help put your mind at ease. Understanding that the likelihood might be lower than you fear can be reassuring.
• Alternative methods: If you have had a negative experience with the sugar challenge test (such as nausea, vomiting or diarrhea), discuss these issues with your provider. They can suggest alternative testing methods if necessary.
• Communication: It's crucial not to avoid testing due to anxiety. Instead, talk to your provider about your fears and concerns. They can provide information, support and possibly alternative options that could make the process more comfortable for you.

Support and resources

Nebraska Medicine offers a specialized program to support women with gestational diabetes. This includes classes conducted in both English and Spanish and follow-up appointments.

Participants in the program can expect:

• Collaborative care: Specialists from various areas work together to provide comprehensive care.
• Education: Providing information and resources to help manage gestational diabetes effectively.
• Emotional support: Addressing concerns and anxieties related to the diagnosis and its implications for pregnancy and beyond.

Gestational diabetes screening is a critical component of prenatal care. Understanding the process, recognizing risk factors and knowing how to manage the condition can significantly improve outcomes for both mother and baby.