How to self-test for gestational diabetes

Written by Li Lang Bo
Endocrinology
Updated on March 14, 2025
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Gestational diabetes refers to conditions where there was no diabetes before pregnancy, and during the course of the pregnancy, specifically between the 24th to 28th weeks, a standard glucose tolerance test is conducted to screen for glucose metabolism. The specific procedure involves not eating after 8 p.m. the night before, though drinking water is allowed, followed by fasting for more than ten hours. The first blood sample is taken on an empty stomach. Then, 75 grams of anhydrous glucose, as prescribed by the doctor, is dissolved in 250 to 350 milliliters of water and consumed within 3 to 5 minutes. Starting from the first sip of this glucose solution, blood samples are taken again one hour and two hours later. The results from these three blood samples are used to determine the possibility of gestational diabetes.

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Gestational diabetes screening time

The screening time for gestational diabetes refers to all pregnant women undergoing a 75-gram glucose tolerance test between 24 to 28 weeks of pregnancy to measure blood sugar levels and determine the presence of gestational diabetes. However, for pregnant women at high risk, including those with a history of gestational diabetes, delivery of a large fetus, obesity, polycystic ovary syndrome, a family history of diabetes, positive urinary glucose in early pregnancy, or unexplained recurrent miscarriages, fetal malformations, stillbirths, or even a history of childbirth with neonatal respiratory distress syndrome, blood sugar should be monitored as early as possible to understand the situation.

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Gestational diabetes manifestations

Gestational diabetes refers to hyperglycemia that either develops or is first identified during pregnancy, including previously unrecognized glucose intolerance and diabetes prior to pregnancy. Typical symptoms of gestational diabetes include frequent urination, increased thirst, and increased hunger, or recurrent vulvovaginal candidiasis. High vigilance for gestational diabetes is warranted if the pregnant woman weighs over 90 kilograms, or if the current pregnancy is complicated by excessive amniotic fluid or a macrosomic fetus. The danger of this condition is that, in severe cases or where blood sugar control is poor, it can easily lead to miscarriage and preterm birth, as well as infections, and in severe cases, may lead to ketoacidosis. Treatment involves two aspects: one is dietary control, and for patients who cannot control their diet effectively, insulin treatment can be used. (Medication should be used under the guidance of a doctor.)

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Endocrinology
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Steps for Gestational Diabetes Testing

The screening steps for gestational diabetes involve, for most women, the recommendation to undergo a 75-gram glucose tolerance test at the hospital between 24 to 28 weeks of pregnancy. The method includes fasting blood draw, consuming 75 grams of glucose, and monitoring blood sugar levels one hour and two hours after glucose intake, to determine the presence of gestational diabetes. However, for pregnant women at high risk for diabetes, it is recommended to complete the 75-gram glucose tolerance test early in pregnancy to detect gestational diabetes early and initiate treatment promptly to reduce the risks to both the fetus and the mother.

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What is gestational diabetes?

The group of people who were diagnosed with diabetes before pregnancy is called gestational concurrent diabetes. Those who were not diagnosed with diabetes before pregnancy, but were diagnosed after becoming pregnant, are referred to as having gestational diabetes. Eighty percent of women are diagnosed with gestational diabetes, while twenty percent have gestational concurrent diabetes.

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How to control gestational diabetes

For diabetes during pregnancy, it is important to manage the condition in pregnant women. Initially, for blood sugar control during pregnancy, we recommend that the blood sugar levels before meals and two hours after meals be less than or equal to 5.3 mmol/L and 6.7 mmol/L, respectively, and nighttime blood sugar levels should not be lower than 3.3 mmol/L. For patients with diabetes complicated by pregnancy, the blood sugar control during pregnancy should meet the following targets: early pregnancy blood sugar control does not need to be overly strict to prevent hypoglycemia. Blood sugar levels before meals and during the night, as well as fasting blood sugar, should be controlled between 3.3 to 5.6 mmol/L, and post-meal peak blood sugar levels should be between 5.6 to 7.1 mmol/L. For both diabetes during pregnancy and diabetes complicated by pregnancy, if blood sugar levels cannot meet the above standards through diet and exercise management, insulin or oral hypoglycemic drugs should be used for further blood sugar control. Pregnancy is a special physiological period, and blood sugar control in diabetic pregnant women must not only be within the normal range but also ensure reasonable nutrient intake for the mother and fetus, reducing the occurrence of maternal and fetal complications. Most patients with gestational diabetes can control their blood sugar satisfactorily through reasonable dietary control and appropriate exercise therapy. The total daily nutrient intake should be determined based on the weight before pregnancy and the rate of weight gain during pregnancy.