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Dr Rahul Sen | Specialist care for birth and beyond | Sydney, Australia

Clinic conveniently located in Edgecliff : Freecall 1800 890 964

Diabetes Screening and the GTT in Pregnancy

It is currently recommended that all women undergo screening for gestational diabetes.

The only currently validated test is the fasting, 1 hour and 2 hour glucose tolerance test (GTT).

Because of the risk associated with being in a confined space with an unknown number of other people for 2-3 hours, many of whom may have respiratory symptoms and cough I recommend NOT doing the GTT in pregnancy at this time, as the first line test for gestational diabetes

I recommend instead doing a fasting blood sugar level. That is the first part of the test. If I have already given you the form just cross out the 1 hour and 2 hour BSL.

You do not need to book the test, just fast overnight (ideally 10 hours)

You can leave as soon as the test is done. No sugar drink. No waiting.

Look for testing centres where there is some fresh air – Coogee Bay Road there is a small courtyard outside for waiting.

Go early in the morning, not on a Monday, as there are generally fewer people.

For women with a LOW result (less than 4.7 mmol/l): you are clear, no gestational diabetes.

For women with a HIGH result (5.1 mmol/l or more): you have gestational diabetes. You need to see a diabetes educator, which you can do via telehealth. You need a glucose testing kit and a book to record your results, and you need to do finger prick sugar testing four times daily, probably for the remainder of the pregnancy.

For women with a BORDERLINE result (4.7-5.0 mmol/l) we need to decide what the best option for you is. Options include doing the full GTT, starting finger prick testing, starting a diabetic diet and exercise programme without testing, and doing no testing. We need to discuss which approach is right for you.

Women who have already done the test at 26-28 weeks– you do not need to do anything.

If I have already given you a form for a GTT I need to provide a new form, as DHM will not allow you to step down from GTT to fasting BSL without my signature