I am 28 weeks pregnant.
Last week, I went in for my glucose screening test. I just got a letter from my doctor saying that my glucose test came back "a little high" (no numbers included) and that they want me to come in for a 3 hour fasting test.
I read online (dangerous, I know), that different doctors have different cutoff numbers for the glucose test. According to baby center.com: "Different practitioners use different standards for determining whether your level is too high. Some will say that if your one-hour blood sugar level is 140 milligrams of glucose per deciliter of blood plasma (mg/dL) or more, you need to have the glucose tolerance test. Others put the cutoff at 130 mg/dL to catch more women who may have gestational diabetes, even though there are likely to be more false positives this way."
So my question for the collective wisdom and experience of Coth is this: If my doctor uses the 130 cutoff, and my levels fall somewhere in the 131-139 range, is this fasting test really necessary? The thought of drinking that junk again on an empty stomach and having my blood taken from me 4 times in a couple of hours strikes unreasonable amounts of fear into my little heart. (I have a pretty sizable psychological problem with needles.)
I do not have any of the risk factors associated with diabetes/gestational diabetes, and no symptoms (I realize this is not a good indication of whether or not I have g.d.).
Of course, if I need to do it, I will. I intend to talk to my doctor about it. I am just wondering if this is my doctor being overly cautious, or if I would be running much of a risk by opting out.
While I can't answer your questions, I have found the web site listed below very informative on all things diabetes.
I do not understand the notion of having someone with impaired glucose metabolism 'challenging' themselves with the glucose tolerance test.
If I were you, I would go out and buy an inexpensive blood glucose meter and test, test,test.
I think the conventional wisdom is that 140 or above is starting to cause damage but there are problems with the testing that make me think you are better off testing on your own - when you get up, before every meal, 1 2 and maybe 3 hours after. If you see it is high you can adjust your carb intake and if you or your Dr feels it necessary, you can start on meds. But IMHO, you should take the testing into your own hands and decline the glucose overdose.
Gestational diabetes is not something to mess around with, which is why the blood glucose thresholds for diagnosis are actually lower for pregnancy than they are for the general population. Prolonged hyperglycemia (elevated blood sugar) can have ill effects on both mother and baby at ANY point during your pregnancy. Keep in mind that the fasting glucose tolerance test is used for diagnosis, which may be necessary in order for your doctor to provide certain services like nutrition counseling or referring you to a dietitian (insurance companies are silly like that). Especially if you have no other risk factors or prior history, lifestyle modifications during your pregnancy *might* be all you need to keep your sugars in check, and having those services available to you will make your life MUCH easier rather than trying to do it on your own.
I'm a healthcare student with a strong interest in diabetes care and I'm currently shadowing part-time at an OB/GYN clinic. If it were me or anyone else I cared about, I would say deal with the discomfort for a few hours and take the test.
The glucose tolerance test is used as a diagnostic tool, not as a therapy. The idea is for the patient to fast and then give them a known quantity of glucose. That way if the 2 hour blood glucose measurement is high, it's more likely to be from diabetic mechanisms (decreased insulin sensitivity) than from other possible confounding variables.
Originally Posted by sketcher
And keep in mind that while most blood glucose meters are indeed very cheap, the test strips tend to be hellishly expensive (especially testing four times a day, as is recommended in gestational diabetes). Most insurance companies will at least partially cover the cost of test strips if there is a diagnosis of GDM.
I was diagnosed with GD when I was pregnant. Failed my first test (forgot I was having it and ate a doughnut before!) and was barely out of normal with the second. If you're totally freaked about needles (I am and I'm a terribly difficult stick) request a saline or heparin block so they can do multiple draws with one stick. I ate carefully, tracked my glucose levels the rest of my pregnancy and had no issues after the test. At one point, the endocrinologist actually told me he wasn't sure I was GD, but we still tracked it. Actually, if I was ever off it was being too low. Baby came out perfect so whatever I did was worth it.
I also had no risk factors, was extremely active (I coached volleyball and basketball during my pregnancy) and ate relatively well. There was no reason that I should have had it but it wasn't wroth taking any chances for.
I was diagnosed with gd and delivered a healthy baby last Wednesday. :D I was also borderline so my ob let me retake the one hour test before the three hour test. I then went to a class to learn about the gd diet and how to test. After a couple of weeks of consistent testing i stopped. My levels were only high prior to eating in the morning so there was little I could do. It wasn't that big of a deal and not worth compromising your or baby's health. During the 3hour test they let me lay down on a bed.
Sorry for typos, trying to respond one-handed while breast feeding my new bundle of love!
THIS! This is about the baby, not you -you need to follow through because numbers will change, the farther into your pregnancy you get. But if your tests are borderline, monitor it -if you don't want to take the full fasting test, speak with your doc about going on the diet and doing the quick test more regularly. But the diet is most likely what he/she will suggest anyway. Frankly, it is a healthier diet whether you are or aren't gestational diabetic and you will gain so much less weight during your pregnancy, if that is an issue for you (which it will be if you have gestational diabetes).
Originally Posted by Chef Jade
Basically, cut out sugar, white flour, control calories -that means low fats/oils and cut out processed foods. Basically, you get on a really good diet. Do it with your doc's advisement and if you can, get to a dietician or a class.
My first son, I had undiagnosed gest. diab. I gained 55 pounds and he was a full month early at almost nine pounds. My second son, I was diagnosed early and I followed the diet to a tee and he was full term and around seven and a half pounds. I essentially gained no weight during the pregnancy.
I was SO much healthier in the second pregnancy -the diet made a huge difference to my well being as well as my baby's.
Now -19 years later, -I find that the diet that was advised back then is what keeps my body healthy now. I never developed diabetes after (it runs in my family) but if I let myself get really overweight -I KNOW I would soon have it. So, once you have the baby -I will put the bug in your ear, keep yourself healthy and in a normal weight zone, if you don't want to be dealing with the big "D," which tends to develop in those of us with gestational diabetes down the road.
Take the test for the health of your baby.
My oldest daughter was diagnosed with GD and like you, showed no outward signs. She has been able to manage her levels with diet and daily test. She is due June 11 though the practice has told her they want to induce at 39 weeks for the safety of the baby.