Glucose Test & Pregnancy: Yay or Nay?

 

“I do not believe that all pregnant women must receive universal screening for GDM. We know that at least 30% of all GDM could be prevented if adults maintained healthy weight, and that as many as 93% of pregnant women will test negative.”
–Aviva Romm, MD

According to the American Dietetic Association, pregnant women with any of the following characteristics may be at an increased risk of developing gestational diabetes (more factors = most risk):

  • Personal history of impaired glucose tolerance or gestational diabetes in a previous pregnancy
  • Member of one of the following ethnic groups, which have a high prevalence of type 2 diabetes: Hispanic American, African American, Native American, South or East Asian, Pacific Islander
  • Family history of diabetes, especially in first-degree relatives
  • Pre-pregnancy weight ≥110% of ideal body weight or BMI >30 kg/m2, significant weight gain in early adulthood and between pregnancies, or excessive gestational weight gain
  • Maternal age >25 years of age
  • Previous delivery of a baby >9 pounds (4.1 kg)
  • Previous unexplained perinatal loss or birth of a malformed infant
  • Maternal birth weight >9 pounds (4.1 kg) or <6 pounds (2.7 kg)
  • Glycosuria at the first prenatal visit
  • Medical condition/setting associated with development of diabetes, such as metabolic syndrome, polycystic ovary syndrome (PCOS), current use of glucocorticoids, hypertension

Women meeting the following characteristics are considered low-risk:

  • Age <25 years
  • Weight normal before pregnancy
  • Member of an ethnic group with a low prevalence of GDM
  • No known diabetes in first-degree relatives
  • No history of abnormal glucose tolerance
  • No history of poor obstetric outcome

If you are low risk, then you can probably safely avoid the test but should still eat a healthy, low glycemic diet.

“The best approach would be to teach all women how to eat well during pregnancy to achieve and maintain optimal weight, and completely prevent GDM. It is entirely possible. But it is not part of routine prenatal care in the medical world. Most physicians get less than one hour of total nutrition training in all of medical school and residency! Often the extent of medical education in prenatal nutrition is to make sure pregnant women are taking a prenatal vitamin, or 2 Flintstones chewables daily if they can’t stomach a regular prenatal multi.”
–Aviva Romm, MD

Read Dr. Aviva Romm’s full advice on the subject here.