Testing for gestational diabetes

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1 Testing for gestational diabetes A Parent Information Leaflet

2 What is gestational diabetes? Diabetes is a condition which means people have higher levels of sugar (glucose) in their blood than normal. In a person who doesn t have diabetes a hormone called insulin keeps blood glucose at a normal level. Some women develop diabetes during pregnancy. This is because of changes in the way the body responds to insulin and how sugar is metabolised (processed). Some women do not produce enough insulin to meet the extra needs of the pregnancy. This is called gestational diabetes. Gestational means it is to do with pregnancy. If you develop diabetes in pregnancy it is important for the health of you and your baby that it is diagnosed so that it can be controlled properly. Most women will be able to control their glucose levels by making changes to their diet and exercise levels. Some women will also need to take tablets (oral hypoglycaemic agents) or insulin. If gestational diabetes is not controlled, there is a small risk of birth complications. If you are diagnosed with gestational diabetes we will recommend increased monitoring of you and your baby during your pregnancy and labour (NICE 2008). This will be arranged for you. What is is the the test test for for gestational gestational diabetes? diabetes? There are two types of test for gestational diabetes. One is a screening test which tells us if you are at risk of having diabetes. The other test is a diagnostic test which tells us whether you have diabetes. These are both blood tests. 2

3 Which test test will will I have? I have? Some people are more at risk of developing gestational diabetes. The tests we will recommend you have will depend on which risk group you fall into. Your midwife will discuss this with you in more detail. The tests described below are the ones recommended by the obstetricians (doctors who look after pregnant women) and endocrinologists (doctors who look after people with diabetes) in this Trust as the best way to test for gestational diabetes. You may also like to look at other sources of information, for example the references at the end of this leaflet. If you had gestational diabetes in a previous pregnancy We recommend you have a diagnostic test at 16 weeks pregnant and then every four weeks until 36 weeks. This is because gestational diabetes can develop at any stage of pregnancy. If your BMI (body mass index) is 30 or over BMI is a measure of body fat based on height and weight. If your BMI is above 30 you are more at risk of developing diabetes. We recommend a diagnostic test when you are first pregnant and then again at 28 weeks. If you have polycystic ovarian syndrome This condition makes you more at risk of developing diabetes. We recommend a diagnostic test when you are first pregnant and then again at 28 weeks. If you are not in the above groups (everyone else) We recommend a screening test when you are 28 weeks pregnant. If the result of this is high, we recommend a diagnostic test. Please be aware that this schedule of tests for gestational diabetes is different from the one recommended by NICE (National Institute for Clinical Excellence). It was devised by the doctors in this Trust and is based on their knowledge and experience of caring for 3

4 women with gestational diabetes. If you have any questions or concerns about this please discuss them with your midwife or ask to speak to one of our doctors. What happens during during the tests? the tests? If you have the screening test This test involves taking a sample of blood after you have a sugary drink. It tells us how your body responds to sugar and whether you are at risk of diabetes. You will need to buy a small bottle of Original Lucozade for this test. Please do not use any other type of Lucozade or other drink. Measure out 275mls and drink this straight away, at the most over 5 minutes. Arrange to drink it about 45 minutes before your appointment time as the blood test will be taken one hour after you have finished the drink. During this hour you should not have anything else to eat or drink except sips of water. You can use the toilet as normal during the test. If the results of the test are normal, it means you are at a very low risk of having gestational diabetes and you do not need to do anything else. Your community midwife will give you the result at your next appointment. If the results of the test are high, you are at higher risk for having diabetes and we will recommend that you have a diagnostic test. 4

5 If you have the diagnostic test This test involves two blood samples, before and after a sugary drink. Comparing these two blood samples tells us whether or not you have diabetes. Before the test you need to fast for 12 hours. This means you can have nothing to eat or drink except sips of water. Please also do not smoke or chew gum as these can affect the results of the test. When you arrive for the test we will take a sample of blood from you. We will use this to compare with the second sample. You will then have a sugary drink. The hospital will provide this drink. After two hours we will take the second sample of blood. During these two hours you can still only have sips of water. You will need to stay in the waiting area for the two hours. You can use the toilet as normal during the test. You might want to bring something to read or have someone come with you. You can also bring a snack to eat after the second blood test. Please arrange for someone else to look after any small children as any activity will affect the results of your test. The results of your test will be available on the next working day. If the result is normal it means that you do not have gestational diabetes. You may need further tests in your pregnancy according the schedule above. If the test result is high, it means that you have gestational diabetes and we will refer you to the specialist diabetic team. 5

6 What will will happen happen if I don t if I don t have have the test? the test? If you would prefer not to be tested for gestational diabetes you can decline the tests. However there is no other reliable way of telling whether you have gestational diabetes. What will will happen if I have if I have gestational gestational diabetes? diabetes? If you do develop gestational diabetes we will refer you to a specialist clinic so that the doctors, nurses and dieticians can work with you and your midwife to provide extra care for you and your baby. There are different ways of managing diabetes during pregnancy and the specialist team will discuss which is the most appropriate for you. You will be shown how to check your blood glucose levels regularly and given the equipment you will need for this. Your care will include regular visits to the specialist Diabetes Pregnancy Clinic where you will see doctors, a diabetes nurse specialist and a dietician. You will also be offered regular scans to check your baby s growth. If you would like further information about testing for gestational diabetes, please speak to your midwife or doctor or see the references below. References NICE, 2008, Diabetes in Pregnancy CG63, London: NICE. 6

7 7

8 Brighton and Sussex University Hospitals NHS Trust Disclaimer The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner. Ref number: 473 Publication Date: September 2012 Review Date: September 2014 C P I G carer and patient information group approved

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