First of all, understand that all pregnant women will be tested for gestational diabetes during their pregnancy. Even if they’ve had no prior issues with blood sugar levels in their day-to-day life or in previous pregnancies, they will still be tested during this surrogate pregnancy.
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.
Gestational diabetes testing is typically done around the 24th week of gestation. It includes a non-fasting laboratory test wherein the surrogate is asked to consume eight ounces of highly sugared glucose drink. She then remains at the lab for one hour before having her blood drawn. Technicians will analyze that sample to see if her glucose levels are elevated or within a normal range. (In some cases she 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.)
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, your surrogate naturally carries a few extra risk factors than she may have had in her 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 your surrogate has or will be diagnosed with diabetes. Instead, she 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, your surrogate will be asked to fast for a period of twelve hours before the test. She then shows up at the lab and gives a baseline blood draw before consuming the sugared glucose drink. Her 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 her glucose levels are elevated, but also if her body is able to self-regulate and lower those levels within a certain time frame. If levels are elevated, and are not able to regulate without intervention, your surrogate will be diagnosed as a gestational diabetic.
In most cases gestational diabetes can be managed by closely monitoring diet and adding a bit of additional exercise. However, some women are simply unable to control their blood sugar levels, even with strict adherence to diet and exercise. In these instances she may be asked to begin taking oral medication or injected insulin in order to keep the body’s chemistry in check.
It’s important to understand what gestational diabetes is, a hormone driven resistance to insulin, and what it is not–poor dietary choices or inability to follow a diet. Your surrogate will likely feel some level of guilt in the case of a gestational diabetes diagnosis, even though there is nothing she could have done to prevent it. This is a great time to show her that you support her, and will stand by her side moving forward.