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ORAL GLUCOSE TOLERANCE TEST (OGTT) FOR DIAGNOSIS OF GESTATIONAL DIABETES
Why would your doctor send you for an Oral glucose tolerance test (OGTT)?
OGTT is a test used to check how the body is able to tolerate or handle glucose during pregnancy. Pregnancy can impair glucose metabolism because of the various pregnancy hormones like human placental lactogen, progesterone, cortisol etc. The resulting hyperglycemic state ‘increased blood glucose state’ is neither good for the fetus or the mother and can result in immediate complications such as fetal demise/still birth and preeclampsia or intermediate complications during delivery like macrosomic baby (big baby), shoulder dystocia, difficult delivery with perineal tears, Caesarean delivery, hypoglycemic newborn and long term complications like development of Diabetes in mother and child later on. Of note is that many pregnant women are able to deal with the state by the body compensating for the increased glucose state by increasing insulin secretion. There are scientific theories as to why some pregnant women (about 11%) do not have this compensatory mechanism.
When will your doctor request for an OGTT?
OGTT is a laboratory test performed to screen for gestational diabetes (GDM) which typically manifests from the later half of pregnancy i.e., 20 weeks gestation onwards and universal screening-applicable to all pregnant women- is carried out between 24 and 28 weeks gestation. However; the screening can be offered at initial visit for those at extra risk -those who have BMI >30kg/M2, with history of GDM in previous pregnancy; history of still birth or baby with congenital anomalies or macrosomic baby( >4kg); those with family history of DM; history of polycystic ovarian syndrome (PCOS) etc. and if they are found to have normal OGTT values, the test is repeated between 24-28 weeks.
How is the OGTT test done and how should you prepare for the test?
You will be requested to fast overnight (8-12 hour fast) before coming into the hospital laboratory for the OGTT, Blood sample will be withdrawn to check your fasting blood sugar level after which you will be given a drink with 75g glucose load to take within a short time. Blood sugar tests are the taken after one hour and 2 hours and if there any abnormal of the sugar values are abnormal you are diagnosed with gestational diabetes mellitus (GDM). Your doctor will the advice you on the necessary steps to take like frequent sugar monitoring, nutritional counselling and weight management with increased physical activity. Insulin therapy may be instituted as well depending on the blood sugar control. All this is done to avoid the bad outcomes associated with hyperglycemia. More frequent clinic visits with extra obstetric ultrasounds performed and a multidisciplinary approach employed in your management.
What should you expect after delivery?
Your baby’s blood sugar will be tested as well to avoid the risk of hypoglycemia and you will be retested again at 4-12 weeks post-delivery with OGTT and every 2 years. The blood glucose control and monitoring also continues till normal levels. Good news is that the body will most likely readjust and get a good grip of the sugar control.
At Nyalife Women’s health clinic; we take the baby steps and walk with you throughout your pregnancy journey, whether your pregnancy is low risk or high risk we will take care of you and link you up with more sub-specialists/other specialists care as need arises.
Give us a call to start your prenatal or antenatal care with our team
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+254746516514
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info@nyalifewomensclinic.com
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JemPark Complex building suite A5 in Sabaki
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