Volume 5 Issue 4

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Page 47 of 63

Page 48 | Abby's Magazine - "Gesta onal diabetes is one of those condi ons where we just can't seem to decide how to define it and how we should screen for it." ~ Michelle Williams, Chair of the Department of Epidemiology, Harvard School of Public Health, August 2013. Tests should be done on the basis of individual risk. It's rare, that a test needs to be universally done – meaning that everyone gets it, pre y much no ma er what. And healthy women should not be bullied into ge ng tests, as many pregnant women who report happens when the 24- week mark rolls around signaling their doctor or midwife that it's me for glucose tes ng. But should all women get glucose tes ng in pregnancy? This ar cle explores just that… Pregnancy is Natural; Diabetes is Rampant… So What Should a Pregnant Mom Do? My strong belief in our ability to grow and birth healthy babies usually leads me to say less is more when it comes to pregnancy tes ng. In fact, if you'd asked me ten years ago, I'd have said, "nope, rou ne glucose tes ng in pregnancy is just another example of the medicaliza on of a natural life process." Glucose Testing in Pregnancy: Should it be Routine? While I s ll don't recommend universal rou ne tes ng, here's an interes ng twist on the subject that has caused me to revisit my opinion on the poten al value of glucose tes ng: The high rates of obesity, insulin resistance, and diabetes in our country, and our growing knowledge of the risks posed to the developing baby from chronic exposure to mom's elevated blood sugar suggest that many pregnant women – and their babies – might actually benefit from knowing their blood sugar status and adjus ng their diets if their sugar is found to be chronically high. That said, there is uncertainty about whether glucose tes ng makes a difference in pregnancy outcomes, which glucose tolerance tes ng methods are best, and what results tell us that blood sugar is too high. There are also psychological, medical, and economic costs to women and society due to the over-medicaliza on of pregnancy. The decision regarding whether to get the rou nely recommended glucose tes ng in pregnancy can be confusing, and is some mes made even more difficult by the bullying behaviors many women report, experiencing at prenatal visits when they ques on whether they need – or want – it done. This ar cle dives into the pros and cons of glucose tolerance tes ng in pregnancy, helps you to iden fy your risks, and provides op ons for tes ng alterna ves. I hope it helps you in making the best decision for you. What is GDM and Why Is It Important to Identify? Diabetes that first arises during pregnancy is called gesta onal diabetes (GDM). While self-limited to pregnancy, women who develop GDM have at least a 50% increased risk of becoming diabe c later in life. Current es mates in the US are that 5%-7% of pregnant women in the U.S. develop GDM. (Keep in mind that this means as many as 93% won't.)

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