Women at risk for diabetes should get tested -- preferably before pregnancy, or as soon as they know they are pregnant. Since most birth defects happen within the first three to six weeks after conception, it's important that diabetes be controlled even before you get pregnant.

However, most cases of gestational diabetes develop late in pregnancy and are diagnosed during routine screening tests at 24 to 28 weeks of pregnancy.

Although some guidelines suggest that only women at risk for gestational diabetes be screened during pregnancy, it is likely that your health care provider will recommend you have a glucose challenge test between your 24th and 28th week of pregnancy, even if you are not at risk. You'll be given a very sweet drink containing exactly 50 grams of sugar. An hour after you've drunk this, a blood sample will be tested to determine your blood sugar level.

If your glucose challenge test comes out abnormally high (higher than 130 to 140 mg/dL), you'll be asked to return to the doctor's office for a slightly more involved test, called the glucose tolerance test. For this test, you may be given special dietary instructions to follow for several days before the test. You'll need to fast for 8 to 12 hours before the test. At the time of the test, you'll first have your blood tested to determine your fasting blood sugar level. Then you'll be given a drink containing exactly 100 grams of glucose. Your blood sugar will be tested one, two, and three hours later. The diagnosis of gestational diabetes is made if two or more values are abnormally elevated.

What Are the Treatments for Gestational Diabetes?

If you have gestational diabetes, it's best if you consult a registered dietitian to help you design a reasonable diet plan -- one that will address the gestational diabetes but still provide your growing baby with sufficient calories and nutrients. In addition to adjusting your diet, reasonable exercise (approved by your health care provider) four to five times a week also helps the body use insulin more efficiently, which helps control blood sugar levels.

Your dietitian will recommend the number of total daily calories appropriate for a woman your height and weight. About 2,200 to 2,500 calories per day is usually recommended for women of average weight. Overweight women may be asked to stick to diets of about 1,800 calories per day.

Your dietitian will teach you how to balance your diet, probably suggesting that about 10% to 20% of your calories come from protein sources (meats, cheeses, eggs, seafood, and legumes); less than 30% of your calories come from fats (with less than 10% of those from saturated fats); and the rest of your calories should be from carbohydrate sources (breads, cereals, pasta, rice, fruits, and vegetables).

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