24 weeks pregnant: the glucose test for gestational diabetes

At 24 weeks pregnant, your glucose test is due. In Singapore, all pregnant women are offered screening for gestational diabetes with an oral glucose tolerance test (OGTT) between 24 and 28 weeks, KKH says. Your womb is now above your belly button, about the size of a soccer ball.

How the OGTT works

1. Fast overnight: nothing to eat or drink except water.
2. Have a blood test in the morning.
3. Drink a 75g glucose drink.
4. Have your blood glucose tested again 1 hour and 2 hours after the drink.

The drink is sweet and can make you feel sick. Rarely, it makes someone vomit, and then the test has to be redone on another day. Bring something to pass the two hours.

Some women test earlier. If you had gestational diabetes before, have glucose in your urine, or have symptoms that suggest diabetes, KKH does the OGTT earlier in pregnancy and repeats it at 24 to 28 weeks if the first result was normal.

Who is at higher risk

Gestational diabetes can happen to anyone, KKH says, which is why everyone is offered the test. Its planner lists groups at higher risk:

• women over 35
• glucose in the urine more than once
• obesity
• long-term steroid treatment
• a family history of diabetes
• gestational diabetes in an earlier pregnancy
• an unexplained stillbirth or miscarriage before
• a baby measuring larger than expected

If you're diagnosed

KKH puts you under a specialist team: obstetricians, endocrinologists, specialised nurses and dietitians. You'll have an HbA1c blood test, which shows your average blood sugar over 3 months, and a day session to learn to use a glucometer: checking before meals, 2 hours after meals and at bedtime. A dietitian helps with food.

KKH's planner says treatment doesn't always mean insulin, and good sugar control can often avoid it. It suggests cutting back on very sweet foods such as sugar, desserts, chocolate and sweet sauces like ketchup. Our guides to gestational diabetes and the gestational diabetes diet have meal ideas.

What's due in Singapore at 24 weeks

You may notice Braxton Hicks contractions from now: painless tightenings that KKH calls false labour pains, because they don't open the cervix.

When to go to the hospital

Regular or painful tightening, leaking fluid, bleeding, or pre-eclampsia signs such as a severe headache, blurred vision or sudden swelling need the hospital now.

From 22 weeks on, KKH sends leaking fluid, bleeding and labour signs to its Delivery Suite, Level 2 of the Women's Tower. NUH's is Ward 22 on Level 2 of the Main Building. Save your own hospital's delivery suite number in your phone now, so nobody has to look it up in a rush.

Frequently asked questions

Do I need to fast before the glucose test?

Yes. KKH asks you to fast overnight, with nothing but water, before the morning blood test.

Is the glucose test compulsory?

It's offered to every pregnant woman in Singapore, and KKH strongly encourages it because gestational diabetes is common and carries risks if it isn't found and treated.

Can gestational diabetes be controlled without insulin?

Often, yes. KKH's planner says good sugar control can often avoid insulin; your team decides.

24 weeks pregnant is how many months?

About five and a half months, counted from the first day of your last period.

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