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Abby's Magazine - Volume 5 Issue 4| Page 51 and non-pregnant pa ents turn their diabetes around using ini al tes ng followed by at home blood sugar monitoring. Tes ng itself does not have to alter the course of a natural pregnancy – and for some women with blood sugar problems, it can lead to dietary changes that keep the pregnancy on a more natural course. The best approach would be to teach all women how to eat well during pregnancy to achieve and maintain op mal weight, and completely prevent GDM. It is en rely possible. But it is not part of rou ne prenatal care in the medical world. Most physicians get less than one hour of total nutri on training in all their medical school and residency! O en the extent of medical educa on in prenatal nutri on, is to make sure pregnant women are taking a prenatal vitamin, or 2 Flintstones Chewables daily if they can't stomach a regular prenatal mul . That level of training is hardly going to allow doctors to prevent GDM. Is GDM Testing Required? I have heard from so many pregnant women or new moms that they were bullied into GDM tes ng at prenatal visits with threats about their health – or their baby's health. One thing that I know for sure is that you can't be forced to have GDM tes ng, and nobody should bully or "guilt" you into it. Autonomy is one of the founda onal principles of modern medicine – pa ents, including pregnant women, have the right to choose what is best for them. Bullying does happen to pregnant women too o en in prenatal encounters. It is unacceptable. We all have the right to stop and consider tests and procedures on an individual basis; medicine would be a much be er profession if more doctors did so! So, should you get the test? It really comes down to a prac cal and personal choice. If you are high risk for diabetes then yes, in my opinion, you should get tested, make the appropriate dietary adjustments, and track your progress with periodic home glucose tes ng. Who's at Risk and Who's Not? According to the American Diete c Associa on, pregnant women with any of the following characteris cs appear to be at increased risk of developing gesta onal diabetes; the risk increases when mul ple risk factors are present: • Personal history of impaired glucose tolerance or gesta onal diabetes in a previous pregnancy • Member of one of the following ethnic groups, which have a high prevalence of type 2 diabetes: Hispanic American, African American, Na ve American, South, or East Asian, Pacific Islander • Family history of diabetes, especially in first-degree rela ves • Pre-pregnancy weight ≥110% of ideal body weight or BMI >30 kg/m2, significant weight gain in early adulthood and between pregnancies, or excessive gesta onal weight gain • Maternal age >25 years of age • Previous delivery of a baby >9 pounds (4.1 kg) • Previous unexplained perinatal loss or birth of a malformed infant • Maternal birth weight >9 pounds (4.1 kg) or <6 pounds (2.7 kg) • Glycosuria at the first prenatal visit • Medical condi on/se ng associated with development of diabetes, such as metabolic syndrome, polycys c ovary syndrome (PCOS), current use of glucocor coids, hypertension Women mee ng the following characteris cs are considered low-risk: • Age <25 years • Weight normal before pregnancy • Member of an ethnic group with a low prevalence of GDM • No known diabetes in first-degree rela ves • No history of abnormal glucose tolerance • No history of poor obstetric outcome