So all you pregnant mommas know and love the infamous “1-hour glucose tolerance test” — or if it’s your first pregnancy, and you are early on, you will come to know and love it! If you’re like I was, particularly with this pregnancy, I had to psych myself up for it. I failed the first time because I threw up the fruit punch flavored concoction after 45 minutes of the hour long wait. The second time, I was lucky enough to keep it down to get my blood drawn, and thank goodness passed with flying colors, therefore I did not have to proceed to the even more heinous 3-hour test.
But why do we do it and why is it important? It was recognized as early as the 1800s that high blood sugar in pregnancy was very dangerous to both the mother and the child, and over the 1980s a protocol was developed to help better diagnose and manage these women who suffer from high blood sugars only when pregnant.
Treatment varies depending on the situation and can range anywhere from diet and exercise changes to needing insulin injections, depending on how difficult the blood sugars are to control.
Uncontrolled gestational diabetes can cause a lot of problems for the baby and mother. Babies born to moms with constantly high blood sugars tend to be very large, with broad shoulders, and are at much higher risk of getting stuck when coming down the birth canal, which is an emergency for both mother and child — called “shoulder dystocia.”
Another risk for these infants is difficulty controlling their own blood sugar once out of the womb. After being constantly exposed to high blood sugars while developing, their pancreas (the organ that produces insulin) has been working overtime and producing much more insulin than normal, so once they are removed from the high-sugar environment of mom’s uterus, their blood sugars can drop dangerously low. It’s also possible for these babies to end up in the NICU on IV drips to keep their blood sugars up until the pancreas returns to normal.
Another important thing for mothers to know is that their risk of developing gestational diabetes in future pregnancies is higher, as well as developing type 2 diabetes throughout their life, and they should make sure to be monitored for this regularly after they deliver by their primary care provider.