First of all, understand that all pregnant women will be tested for gestational diabetes during their pregnancy. Even if you’ve had no prior issues with blood sugar levels in your day-to-day life or in previous pregnancies, you will still be tested during this surrogate pregnancy. You’ve likely had this test done before in your own pregnancies, but in case it’s been a while, here’s a refresher on how the process works.
Gestational diabetes testing is typically done around the 24th week of gestation. It includes a non-fasting laboratory test wherein you are asked to consume eight ounces of highly sugared glucose drink. You will then remain at the lab for one hour before having your blood drawn. Technicians will analyze that sample to see if your glucose levels are elevated or within a normal range. (In some cases you may be asked to consume the beverage at home and then arrive at the lab an hour later. This is a normal variant for this test and is no cause for concern.)
While being a surrogate does not raise the odds of developing gestational diabetes, there are certain elements of a surrogate pregnancy that may contribute to a more significant insulin resistance and, as a result, the development of gestational diabetes.
According to the Mayo clinic, the risk for developing gestational diabetes rises with the following factors:
- Increasing maternal age, starting in women more than 25 years of age.
- Multiples gestation
- Excessive weight
- Non Caucasian race
Since multiples pregnancies are more common in cases of IVF, and most surrogates tend to be over age 25, you naturally carry a few extra risk factors than you may have had in your personal pregnancies. Additionally, most women will gain a bit of weight during the medical cycle that precedes a transfer and, if needed, additional transfer cycles incurred before the development of a viable pregnancy. As a result of these factors, many women have elevated glucose levels at the conclusion of their one hour glucose tolerance test.
If the one hour glucose tolerance test does come back elevated, know that this does not automatically mean that you have or will be diagnosed with diabetes. Instead, you will be asked to take a three hour version of the test. This test will be used to diagnose diabetes, if present.
For that test, you will be asked to fast for a period of twelve hours before the test. Next, you show up at the lab and give a baseline blood draw before consuming the sugared glucose drink. Your blood will be drawn again at one hour, two hours, and three hours after consumption. This time doctors are looking to see not only if your glucose levels are elevated, but also if your body is able to self-regulate and lower those levels within a certain time frame. If levels are elevated, and you are not able to regulate without intervention, you will be diagnosed as a gestational diabetic.
If you do wind up with a diabetes diagnosis, it is important to understand that there is nothing you could have done to prevent this. This is not a lifestyle issue and you have nothing to feel guilty or ashamed about. Unlike type 1 diabetes, which is typically inherited, or type 2 diabetes, which typically is the result of excessive weight and poor diet, gestational diabetes tends to be linked to how the body regulates pregnancy hormones.
For most women, gestational diabetes will go away once the child is born. The American Diabetes Association women who developed gestational diabetes should have a two hour glucose tolerance test at six weeks postpartum in order to ensure that the diabetes has cleared up. Women who have developed gestational diabetes will be at an increased risk to develop type two diabetes later in life, so you should also plan to have your sugar levels tested every three years following delivery.