In round terms that’s 40,500 pregnant women that will develop gestational diabetes each year.

The report also found that pregnant women with gestational diabetes were more likely to require caesareans, have their labour induced, and suffer pre-eclampsia and gestational hypertension.

Gestational diabetes usually manifests itself usually between the 24^th and 28^th week of pregnancy.

For most women it’s a temporary situation and they will return to normal after their baby is born, but in some cases, it will become a permanent condition.

After winning the 400-metre event at the 2000 Sydney Olympics, Cathy Freeman became a household name, receiving wall-to-wall coverage for her athletic prowess.

A paragon of health and well-being, one wouldn’t have figured her as a candidate for diabetes but whilst pregnant with her first child she discovered she had developed gestational diabetes.

Associate Professor Graham Jones, an Australian Clinical Biochemist and pathologist, comments on the cause of gestational diabetes:

‘The exact mechanisms remain uncertain, however there is a resistance to the action of insulin (the key hormone which controls blood sugar levels) which becomes worse during pregnancy, combined with an inability of the pancreas to secrete enough insulin.

‘And especially if your body already struggles with insulin resistance, you may develop gestational diabetes.’

And because gestational diabetes is a condition which can sneak up on a woman despite enjoying robust health, guidelines from the Australian Diabetes in Pregnancy Society (ADIPS) recommend that pregnant women should be tested for gestational diabetes between weeks 24 and 28 of their pregnancy.

The test should be taken earlier by pregnant women at increased risk of developing diabetes.

There is an extensive list of risk factors, which include:

• Having gestational diabetes in a previous pregnancy
• being 40 years of age or older
• having a family history of type 2 diabetes
• having a mother or sister who has had gestational diabetes
• being above the healthy weight range
• being of Aboriginal and Torres Strait Islander backgrounds

• being of Melanesian, Polynesian, Chinese, Southeast Asian, Middle Eastern or Indian background
• history of polycystic ovarian syndrome

How to test for gestational diabetes

The test for gestational diabetes is called the oral glucose tolerance test (OGTT) which requires you to fast overnight, after which a blood sample will be taken. You will then be asked to drink a sugary solution and be tested one, and two hours after the drink. The test is designed to see how your body responds to this challenge.

If the blood glucose levels are above the normal range at any of the three stages of testing, the results indicate you have gestational diabetes.

If you are found to have gestational diabetes, your clinician will be able to direct you on the best course of action, which may include a healthy eating plan, regular activity and the continued monitoring of your blood sugar levels.

While most women will return to normal blood glucose levels after pregnancy, there is an increased risk of ongoing diabetes and for developing type 2 diabetes in the future. The ADIPS guidelines recommend a routine OGTT 6 – 12 weeks after delivery.

The post Report: 9% of women in Australia will develop gestational diabetes, complications first appeared on Know Pathology Know Healthcare.

The post Pathology testing and diabetes first appeared on Know Pathology Know Healthcare.

These labs process tests for 1.25 million Australians living with diabetes. For every diabetes test performed, at least ten people are involved including collectors, couriers, medical scientists, technicians, IT specialists, registrars and pathologists.

Pathology Awareness Australia ambassador, Associate Professor Graham Jones says: “Pathology tests help to give you an idea of how you are going with your diabetes management and what changes may be required to reduce your risk of complications.”

This is the journey of an HbA1c test.

Sample collection

This is the only part of pathology that is seen by the public. Phlebotomists, more commonly known as collectors, are trained to accurately collect and store patient samples and to provide the correct paperwork with each one.

Specimen delivery

A special courier transports your test sample to the lab making sure it is kept at the right temperature and that it arrives within a suitable time-frame. On arrival in the lab the staff at specimen reception ensure it is distributed to the correct department. Due to the volume of samples delivered daily, staff can be on duty 24/7.

Sorting

It is important that samples are inserted into the correct tube. Professor Jones explains: “With glucose tests, for example, the blood cells in the collection tube are hungry and “eat” glucose. This can lower glucose levels, leading to an inaccurate reading. These samples should be kept in grey top tubes which block glucose use or in a tube which can create a barrier between the glucose and the blood cells.

High Pressure Liquid Chromatography

A medical scientist uses high pressure liquid chromatography (or HPLC) to measure the HbA1c in your blood. The blood sample is mixed with special liquids called reagents, and then passed under pressure through columns filled with a material that separates the blood into its component molecules.

HbA1c occurs when glucose binds to haemoglobin. These molecules differ in size and electrical charge from the other blood molecules so they can be separated. The machine then calculates a percentage of how much haemoglobin in the blood is made up of HbA1c.

Results and reporting

The test results are reviewed and a report is prepared. Patient details such as age and sex are important in deciding whether a test result is normal.

Other conditions can also affect HbA1c results including pregnancy, severe kidney and liver disease, iron deficiency and certain blood disorders.

A pathologist oversees the whole process to ensure it meets Australia’s high quality standards.

With HbA1c results, two sets of numbers are usually reported; the traditional percentages, plus the new Systeme International (SI) units, shown as mmol/mol. These new units were developed by the International Federation of Clinical Chemistry (IFCC) and are sometimes known as IFCC units.

The results are provided to the patient by their doctor but pathologists are always available to answer doctors’ questions about pathology tests.

Find out more about diabetes tests at Lab Tests Online.

The post Behind the scenes – how pathology analyses your diabetes tests first appeared on Know Pathology Know Healthcare.