Diabetes that begins and ends in pregnancy is called Gestational Diabetes. This term sets it apart from pre-existing disease, but may include women with mild to moderate high blood sugar, or hyperglycemia, during pregnancy. Recent controversies in glucose tolerance, or glucose challenge testing could mean that more pregnancies than ever before will be labeled with a diagnosis of gestational diabetes, which makes this subject an important one to women who want to have the healthiest pregnancy possible.
Gestational Diabetes Testing Errors: False Positive, False Negative
The American Diabetes Association’s position statement of 2005 recommends that women with average risk be evaluated at 24 to 28 weeks of pregnancy by one of two testing approaches:
The first approach has two steps.
- For your initial screening, you do not need to be fasting. The lab gives you a 50 gram dose of glucose in a sweet-tasting drink – you must consume all of it within ten minutes. The lab then draws your blood an hour later. If the result is normal, no further screening is necessary. Unfortunately, the one hour screening has a high incidence of false positive results.
- The next step is to determine whether you actually have gestational diabetes, if your first test was positive – you’ll need to undergo a three-hour glucose challenge after you’ve been fasting for at least 8 hours. The lab will draw your blood before you drink a solution containing 100 grams of glucose, and the lab compares your level to subsequent draws taken at one, two and three hours. If two or more levels are above normal, doctors consider this a confirmation of the diagnosis of gestational diabetes. Researchers consider the three-hour test to be highly accurate.
- In the second approach to testing, doctors use a single two-hour challenge using a 75 gram glucose drink for all women. As in the three-hour test, you’ll fast at least eight hours and will have your blood drawn at 1 and 2 hour intervals. If any one of the three values is above normal, doctors will consider your test ‘positive’ for gestational diabetes.
According to Helen Varney, author of the textbook Varney’s Midwifery, two-hour tests have a lower rate of false positives than one-hour tests but they are not as accurate as three-hour tests.
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