Learning that your surrogate’s initial glucose tolerance test came backelevated is a conversation that no intended parent hopes to have during their journey. Your initial reaction is probably surprise, “She’s never had THAT in her history!” That shock may lead to confusion, “What does this mean for the pregnancy?” and even anger, “What did she do to ‘fail’ this test when she’s never failed it before?”
Let’s start by establishing a baseline that having an elevated one-hour glucose test result is not a “failure.” While this may be the term used, the impact of language is evident here. If the test result is elevated (a “fail”) then there is nothing that could have been done differently by your surrogate to “pass.” Additionally, many women will have elevated levels in a one hour standard test, and go on to pass their three-hour screening and have no problems. However, in some cases, an elevated result on a one-hour glucose screening will be the first indicator that your surrogate has developed gestational diabetes. In either event, it’s important to note that this test result is not the result of any action or inaction on the part of your surrogate.
Next, understand that there are certain factors at play in a surrogacy situation that may make your surrogate more susceptible to having elevated glucose, even if she has never had it before. Women are more likely to have elevated glucose and develop gestational diabetes as they age. Since all of our surrogates have had children of their own prior to becoming a surrogate, she’s obviously older now than with her previous pregnancies. Additionally, conceiving a twin (or greater) gestation significantly increases the potential for developing gestational diabetes. The more placentas there are, the greater the risk for gestational diabetes.
Glucose tolerance tests monitor the body’s ability to turn sugar into energy. In pregnancy, the additional hormones can confuse the pancreas, rendering it unable to break down glucose properly. When this happens, blood glucose rises and, on occasion, the patient will develop gestational diabetes. Unlike type 2 diabetes, gestational diabetes is purely hormonal. If a diagnosis of gestational diabetes is given, it is not the result of your surrogate’s food and exercise choices. This is not a diagnosis that could have been avoided with different behaviors.
After an elevated one hour screening, your surrogate will be asked to a complete a similar test. This test lasts for three hours and will definitively reveal if she has developed gestational diabetes. There is nothing that she can do to alter the results of this upcoming test.
Understand that your surrogate is likely having an emotional reaction to these results, as well. Despite not being able to control the results, she likely feels guilty and perhaps even a bit scared. The kindest thing that you can do for her is to offer reassurance that she hasn’t lost your trust and that you’re still in this together.