A failed 3-hour glucose test during pregnancy can cause worry. This routine screening assesses how your body processes sugar. While an abnormal result is concerning, it is common and does not mean you have done anything wrong. This article explains what typically happens next, offering guidance and reassurance.
Understanding the Diagnosis
Failing the 3-hour glucose test often leads to a diagnosis of gestational diabetes (GD). This form of diabetes develops during pregnancy when hormones interfere with the body’s ability to use insulin effectively, leading to elevated blood sugar levels.
The diagnosis is confirmed when specific blood glucose levels are met or exceeded during the 3-hour oral glucose tolerance test. For example, a diagnosis is typically made if two or more readings are elevated: a fasting level of 95 mg/dL or higher, a 1-hour level of 180 mg/dL or higher, a 2-hour level of 155 mg/dL or higher, or a 3-hour level of 140 mg/dL or higher. Even a single abnormal value may indicate an increased risk, sometimes prompting closer monitoring or a repeat test.
Managing Your Health During Pregnancy
Managing gestational diabetes during pregnancy involves strategies to keep blood sugar levels within a healthy range. Dietary modifications are a primary focus, emphasizing balanced meals, careful carbohydrate control, and limiting refined sugars. Eating regularly, often three meals and two to three snacks per day, can help stabilize blood glucose levels.
Regular physical activity also plays a role by improving the body’s sensitivity to insulin. Engaging in moderate aerobic exercise, such as walking, for at least 30 minutes on most days of the week, or at least 150 minutes weekly, is recommended. Walking for 10 to 15 minutes after each meal can further contribute to better blood glucose control.
Consistent blood glucose monitoring at home is a regular practice to track levels and inform management decisions. You will be provided with a glucose meter to self-test blood glucose levels daily, often first thing in the morning (fasting) and then two hours after your main meals. If lifestyle changes alone are insufficient, medication may be prescribed. Insulin injections are a common and safe treatment option during pregnancy, as insulin does not cross the placenta. Oral medications like metformin may also be used, which work by reducing glucose production by the liver and increasing insulin sensitivity.
Potential Effects on Mother and Baby
Uncontrolled gestational diabetes can pose several risks for both the pregnant individual and the developing baby. For the mother, there is an increased likelihood of complications such as preeclampsia, a serious condition characterized by high blood pressure during pregnancy. Individuals with uncontrolled gestational diabetes also face a higher risk of needing a C-section delivery, especially if the baby grows larger than average. There is also an increased risk of developing type 2 diabetes later in life.
For the baby, potential effects include macrosomia (larger than average birth weight), potentially leading to difficult deliveries or birth injuries. Babies born to mothers with uncontrolled gestational diabetes may also experience hypoglycemia (low blood sugar) shortly after birth and can have breathing problems. In the long term, these children may have a higher risk of developing obesity or type 2 diabetes. Miscarriage and stillbirth are also risks associated with poorly controlled blood glucose levels during pregnancy.
Postpartum Care and Long-Term Health
After delivery, gestational diabetes typically resolves as pregnancy hormones subside. Follow-up care is important to confirm that blood sugar levels have returned to normal. A glucose tolerance test is recommended around 6 to 12 weeks postpartum. This test helps determine if blood glucose levels have normalized or if there is an indication of impaired glucose tolerance or type 2 diabetes.
Individuals who have had gestational diabetes face an increased lifetime risk of developing type 2 diabetes, with some studies suggesting up to a 50% higher risk within the first five years after delivery. Continuing healthy lifestyle choices, including a balanced diet and regular physical activity, is encouraged after pregnancy to help mitigate this risk. Children of mothers who experienced gestational diabetes may also have an increased risk of becoming overweight or obese and developing diabetes later in life, highlighting the importance of healthy habits for the child.