Q&A: I've been told to schedule a gestational diabetes test, but I don't know what it is.

A gestational diabetes test (also known as an oral glucose tolerance test or OGTT) is done as a routine screening for all pregnant women. Your doctor will let you know when it is appropriate for you. It is routinely done between weeks 24 and 28 of your pregnancy. This test looks at how well your body copes with glucose (or sugar levels). Diabetes occurs when your body cannot process circulating sugar in an efficient way. Insulin, a naturally occurring substance produced by your pancreas, helps your cells utilize this sugar to give you energy. When appropriate amounts of insulin are made, this helps to keep the circulating blood sugar at a healthy level. However, for those with diabetes, the amount of insulin produced may not be enough. Over time, high levels of circulating glucose can lead to problems with blood circulation, wound healing, eyesight, and can also cause damage to your organs. Gestational diabetes is a form of diabetes that happens when you are pregnant and will usually resolve itself right after your baby is born. Pregnancy hormones make it difficult for insulin to do its job. Most women can produce enough insulin to keep levels stable, but for unknown reason, certain women's bodies can't keep up with this demand. In the case of pregnancy, one of the risks of being undiagnosed is having a baby who is too large. Babies that are LGA (large for gestational age) can pose problems for mom hoping to deliver vaginally. These babies may also have issues after birth, such as difficulties maintaining their own blood sugar and other complications. Risk factors for developing gestational diabetes include:

• Race (Hispanic, black and Asian women tend to be at higher risk)
• Prepregnancy weight
• Age (above age 25)
• Family history
• Your history (you are more likely to develop this in subsequent pregnancies)

How the OGTT is performed: You will be given a sweet drink one hour before having some blood drawn. The lab then looks at how much glucose is circulating. If it is normal, then you have no worries. If the levels are high, a second test will be done to confirm the diagnosis. The second test involves fasting over night (this usually means no food after midnight). When you arrive at your OB's office for the test you will again be given a sweet drink. Your blood will be drawn at one-, two-, and three-hour intervals after you drink the solution. If two of the three levels are elevated, then you are considered to have gestational diabetes.

So what does this mean? You will be counseled on dietary modifications. Your doctor may refer you to a nutritionist that specializes in dealing with pregnant women and their nutritional needs. You may also be asked to monitor your blood sugar three to five times a day. Many hospitals have diabetes educators that can teach you how to monitor your blood sugar. Exercise is also an important part of keeping your sugar under control. In some cases, diet and exercise may not be enough and some women need to take oral medication or injectable insulin to keep your sugar in a healthy range. This diagnosis is one that is very manageable for most women. With proper management and monitoring, the end result is a healthy mom and a healthy baby!