# How necessary is the glucose test?



## kgreenemama (Dec 31, 2008)

I hated the glucose test when I was pregnant the first time. Not only did it make me feel sick all night, baby was bouncing all over his womb. I also have aversions to sweets during pregnancy, and just choking down the juice was torture.

So, my question is, if a woman were prone to gestational diabetes, wouldn't she have other symptoms? How terrible would it be to decline the glucose test and risk not knowing one had GD?

Anyone out there glad they had the test because it revealed GD?

THANKS!


----------



## tracymom1 (May 7, 2008)

I had the test with my first and I failed it. I had to go for the 3 hour GTT and that revealed that my sugars were actually on the low side.

IMHO, having worked in Ob/Gyn, seeing so many women "fail" the 1 hour and then pass the 3 hour with flying colors, unless you have pre-determined risk factors for diabetes I do not see a reason to have the 1 hour GTT performed. Blanket testing for every pregnant woman is just absurd. Why should every single woman be tested for something if they are not symptomatic, have no family history and are otherwise healthy?

This was taken from the VERY mainstream WebMD site:
Pregnancy and Gestational Diabetes Screening
All pregnant patients should be screened for gestational diabetes during their pregnancy. Screening may be *done via patient history, clinical risk factors, or laboratory screening (the oral glucose tolerance test.*

Needless to say, I did not test with pregnancy #2 and will not this time around either. If you have high risk factors, go for it.


----------



## Mamatoabunch (Sep 23, 2007)

I skipped it after my first pregnancy 17 years ago.


----------



## ~Demeter~ (Jul 22, 2006)

I didn't do it my last 2 pregnancies. My first 3 I passed the 1 hr but felt awful afterward... there are alternatives to drinking the glucola though if your doctor is interested in alternative ideas.


----------



## EllisH (May 29, 2010)

I was on the fence whether or not to take it. Problem is that there may be no other symptoms than a baby that weighs (too) much, so it is good to know whether being pregnant made you worse at processing glucose.

I decided to get a home glucose test. That way, I don't have to down an artificially large amount of glucose and I get the real life view on my glucose situation. I measured a few times in the morning (sober), a few times one hour after a normal meal and a few times one hour after a sweet attack (high-glucose meal or having eaten too many chocolates). It gave me a good view on my glucose tolerance (OK) and it also confirmed that eating high-glucose meals isn't healthy (as gd is not black-and-white: a lot of glucose is bad for you / the baby even if on the high end of normal and not the result of gd).

I looked online for the normal ranges in these situations; don't have the website (my dh looked for them), but it's pretty uncontroversial.


----------



## nova22 (Jun 26, 2004)

I had the standard fast & glucose drink test during my first pregnancy and I haven't had it since. I don't have a high opinion of that testing method; it's completely unnatural and I don't feel like a pregnant woman should fast and then overload her body with sugar, it's bound to cause serious discomfort at best. There are some people who go so far as to say Gestational Diabetes doesn't even exist, and I'm not totally convinced that they're wrong.

In my first pregnancy, I did the regular test, failed, and had to go back for the three-hour test. I passed with flying colors.

I didn't have any test at all during my second pregnancy.

During my third, I fasted for an hour and then had a candy bar before having blood drawn.

During my fourth, fifth, and sixth (this pregnancy), I ate normally and then told my midwife exactly what I'd eaten. She did a finger prick. Results were normal.

If I ever end up with a health care provider who is not willing to do a modified test, I will waive it altogether. The only reason I take it in the first place is because there are so many diabetics in my family; if my risk were lower I wouldn't do it.


----------



## leahmn12 (Sep 18, 2007)

I have gestational diabetes with this pregnancy and both of my other pregnancies. I have no risk factors. I control it very well by eating very healthfully and monitoring my blood glucose with a meter. This time, as soon as I had my first OB visit, I asked to skip the glucose tolerance test and just get a meter. He agreed. I don't know why anybody couldn't just do a few standard blood glucose tests (fasting first thing in the AM, and one and two hours after eating a normal meal- called post-prandial blood glucose tests). If the values are normal, according to your physician's guidelines, then I'd say you probably have nothing to worry about. If they're questionable, a test called A1C can give you a six-month average of your blood glucose. I agree that inundating your body (and baby's body!) with unnecessary sugar doesn't make much sense.


----------



## L&K'smommie (Aug 23, 2007)

I would also ask if they may be open to alternative methods. My MW just has me eat a large breakfast and then does the blood draw an hour after that. She feels that the glucola just overloads your body in an unnatural way and is not accurate as far as determining GD.

If you have no past history or family history I wouldn't feel bad declining it.


----------



## Aleka333 (May 15, 2010)

I didn't take the test and this is my first pregnancy.
thought it was strange to screen everyone for it... it's not something my mother or any my sister-in-laws ever had done, and I don't have any family history with GD or any type of diabetes.
my midwife didn't care either way, and when I asked her about it, I could kind of tell she thought it was unnecessary. But I decline most tests.


----------



## StillWaters (Feb 22, 2008)

The three-hour test made me sick, sick, sick. It was sheer torture. I am never doing that again.


----------



## luckiest (Apr 29, 2009)

Like a couple of PPs, my midwives had me eat a normal breakfast and tested my blood sugar with a glucometer an hour after I finished eating. The glucola is kind of an insane practice - why would you overload your system with sugar and use those results to determine how your body processes sugar in your daily life? Hopefully you aren't consuming 100g of sugar on an empty stomach regularly. It makes so many women sick and dizzy, there's no way it's good for mama or baby.

If you're concerned I would ask for the "real-life" test with a glucometer, otherwise I'd be tempted to skip it, especially if you have no family history of diabetes.


----------



## katelove (Apr 28, 2009)

If you have any risk factors then I would ask for the 3 hour test. I wouldn't ever bother with the 1 hour test, it is a screening tool it isn't diagnostic. In fact the hospital where I had my antenatal care doesn't do it at all. If someone has risk factors then they offer the 3 hour diagnostic test.

If you do have risk factors then it is worth doing IMO

- as a PP mentioned, sometimes the woman will not experience symptoms
- macrosomia is not the only potential problem uncontrolled GD can cause for the babe
- GD increases a woman's risk for DM Type II. I, *personally*, would want to know if my risk was increased so I could modify my lifestyle risk factors accordingly and be aware of early symptoms of DMII so I could start treatment immediately.
- home glucose monitoring is not a reliable way of diagnosing GD. As unpleasant as many people find it, the 3 hr test is the best diagnostic we have at the present time.


----------



## MyFullHouse (Apr 23, 2010)

I've done the test five times now (six, if you count the only 3-hour I've done). The last 3 times, I've used a 50g glucose healthy breakfast.

If my hcp "required" me to use the glucola drink, I think my view might change. I distinctly remember feeling awful after those, and I'm not sure I'd believe it was worth the effort.

Personally, I want to check on how my sugar is doing, and getting one blood draw appeals to me more than getting my own glucose monitor. But getting my own glucose monitor appeals to me more than doing a 3-hour glucose test, if it were to have come to that this time. Everyone has their own individual limits.









I think the fact that my first two babies were such different sizes (7lb9oz then 9lb2oz) plays into it. I have no reason to think any of my pregnancies is going to be the same as the previous, so it makes me feel better to "check in" on them.

Also, I don't do any blood draws before that (unless otherwise indicated). So this trip to the lab was for more than just glucose testing.

The fact that I could get it done at 7am, not have to go hungry, not have to drink the icky stuff, and only have to deal with 1 needle the whole time really makes it no big deal in my book, and gives me some peace of mind.

If circumstances were different, I'd have to reweigh all the factors, and might come to a different conclusion.


----------



## msmiranda (Apr 22, 2009)

Quote:


Originally Posted by *katelove* 
- home glucose monitoring is not a reliable way of diagnosing GD. As unpleasant as many people find it, the 3 hr test is the best diagnostic we have at the present time.

Please explain why home monitoring is not reliable and why the 3 hour test is. This is the first time I have ever heard anyone say this.


----------



## EllisH (May 29, 2010)

Quote:


Originally Posted by *msmiranda* 
Please explain why home monitoring is not reliable and why the 3 hour test is. This is the first time I have ever heard anyone say this.

I'd be keen to hear why as well. After all, diabetics depend for their life on that test. I'd say that a one-off test would not give the full picture either (?).


----------



## cristeen (Jan 20, 2007)

I really suggest reading up on GD. And apparently there are several people on this thread even that could use some boning up on the subject. Henci Goer has some great online articles on the subject.

I didn't do the test. I refused with both pregnancies. The first time, they tried to scare me into doing it, using "big baby". The 2nd time, I chose my care provider a bit more carefully and made it clear during the initial interview that I wouldn't be doing it. Since she was of the same mindset (and taken some of the same classes) as me, it wasn't an issue at all.

GD is a completely unstudied diagnosis. There is no evidence of it's existence. And being labeled GD does nothing to improve outcomes, but it can definitely lead to more interventions. Make your choices fully informed.


----------



## Ola_ (Sep 5, 2008)

This is very interesting as it's something I was planning to decline, but still researching.


----------



## Mamatoabunch (Sep 23, 2007)

http://www.gentlebirth.org/archives/gdhgoer.html

Here is the article by by Henci Goer.


----------



## phathui5 (Jan 8, 2002)

I took the standard overly sugary soda when I was pregnant with my 10yo and "passed."

With my 7yo, I did the test, but used 1/2 banana and a pint of orange juice, "passed" again.

I chose not to do the test with my 3rd and 4th children. It wasn't something that I was concerned about and I was more comfortable declining things.


----------



## katelove (Apr 28, 2009)

Quote:


Originally Posted by *msmiranda* 
Please explain why home monitoring is not reliable and why the 3 hour test is. This is the first time I have ever heard anyone say this.


Quote:


Originally Posted by *EllisH* 
I'd be keen to hear why as well. After all, diabetics depend for their life on that test. I'd say that a one-off test would not give the full picture either (?).

Home monitoring is not as sensitive as the 3hr GTT. The home monitors are intended to be an adjunct to treatment not a diagnostic tool.

In the presence of GD a woman's BGL will rise higher and drop more slowly following a glucose challenge than in a woman who does not have GD. That's why 3-5 blood tests are done during the test. And lab machines not bedside (or home) monitors are used to analyse the samples. The large glucose load combined with more sensitive testing tools allows this to be seen clearly. Eating normal food and testing randomly is less likely to produce changes which will be identifiable by a home monitor as pathological.

The GTT is not 100% sensitive either, meaning that it will fail to diagnose a percentage of women who do it. However random home monitoring is *less* sensitive, meaning that it will fail to identify even more women.

If a woman desperately didn't want to do the GTT then, I guess, the home monitoring would be better than nothing but she should be advised of the decreased sensitivity and the implications of that. Personally I don't see the point of a testing regime which requires more effort for less result. However, as with all things, it's a matter of weighing the pros and cons. We just need to move away from the idea that we're comparing apples with apples when choosing which test to go for.

ETA - My DH read this post and he added that the lab test of blood is much better at giving a *true* BGL. The home monitors are influenced by a variety of components within the blood and were designed more to show trends over time rather than one off levels.

In terms of treatment for pepole with diabetes they also have the advantage of being cheap (relatively), portable and easy to use. All these things are factored in when considering anything ffor long-term home use. Often, a degree of reliability or sensitivity is sacrificed for the other factors I mentioned.


----------



## Maisea (Apr 14, 2008)

I had GD with my first pregnancy and was diagnosed early with this pregnancy as well. Other than being slightly overweight (I wear a size 12), I have no other risk factors. My mother had normal size babies and was never tested for GD. Me and Sibs were 6-7 lbs each, however her pregnancies were very different than mine (for one, she smoked through her pregnancies). I also had no symptoms of GD and was shocked when my 1hr result was 197.

I have never doubted the diagnosis -- once I started monitoring my sugars, I could see clearly how certain foods (even healthy foods, like oatmeal with fruit for breakfast) send my blood sugar into a dangerous range. It was a lot of work and a lot of diet control to manage my sugar during the last pregnancy-- ending with a full term 8.13 baby. I thankfully delivered in a very baby-friendly hospital whose protocol for managing that was to check baby's sugar (right before nursing) until it was greater than 50 three times in a row. There was no alarm that it was low, because baby was just about to eat. It took 5-6 checks before that was true, but no other interventions were offered/suggested.

I contrast this experience with a friends, also low risk for GD who controlled her sugars poorly, had a large baby born by c/s at 36 weeks who spent 4 weeks in the NICU. She never breast fed after the first few days (partly because of lack of motivation, partly because she didn't have a home pump and didn't want to be at the hospital every 3 hours). I see her obese 11 year child (which is not solely related to the GD, but I certainly believe that is a contributing factor), and wonder what the future holds for his health and am sad he got a poor start in life.

I must be the only one on MDC who likes candy and sweets(maybe that is my risk factor for GD?) A box of Hot Tamales, a Starbucks pumpkin spice latte (oh how I miss you!) are tremendous, yummy glucose loads, equivalent to the dreaded glucola. If I didn't have GD I would be eating crap like that on a regular basis -- and I think that would be detrimental to my child.

I did once check my BG between pregnancies after eating a tremendous amount of candy. It was 92. My HbA1c at my first prenatal visit was 5.2% (excellent). My blood sugar one hour after eating 1/2 cup steel cut oats with 1 cup whole milk (for the fat and protein to slow absorbsion of glucose) the other day was 184. My glucose metabolism is different during pregnancy. I don't know why people are so resistant to that idea -- a lot of hormonally controlled things are different for me during pregnancy. My sex drive, my acne, my sense of smell, my sleep cycle, my thermoregulation and more . Just like some people have a great sex drive and awesome skin, some people don't.

I accept that it is safer for me and my babies to carefully monitor my blood sugar at least 4 x per day. If I didn't believe that I had GD I would not carry my monitor with me, interrupt my work, socialization, etc to continue to check my BG -- and that is why "checking things a few times at home instead of doing the glucola" is a terrible idea in my opinion. I need the constant feedback from the meter to help me shape my food choices. Fruit in morning after breakfast = out of control sugar, fruit after lunch = no big deal.

I am extremely suspicious of people on this thread who say things like "GD is a completely unstudied diagnosis." I don't know what they mean by this. There are thousands of pages of studies and millions of dollars of research that have been poured into this. Is it the research I would do? Not always. But it is heavily-studied, if not well-studied.


----------



## katelove (Apr 28, 2009)

Quote:


Originally Posted by *Mamatoabunch* 
http://www.gentlebirth.org/archives/gdhgoer.html

Here is the article by by Henci Goer.

This article is 14 years old. And some of the papers she quotes are now 30 years old. There has been a bit more work done since then.


----------



## NicaG (Jun 16, 2006)

I've had gd with two pregnancies and assume I will have it with #3.

I had no risk factors with my first pregnancy (well, I was over 30, 32 to be exact, but that's it). At the time I was running 3-6 miles most days, was at a healthy weight, etc. There are no symptoms for gd. The diagnosis took me completely by surprise.

When people (on MDC) say there is no such thing as gd, I'm puzzled and annoyed. I understand that some women are probably borderline and can control their blood sugar levels with diet and exercise. Fine. But in my case, even small amounts of carbohydrates sent my blood sugar to extremely high levels. I needed insulin to control my blood sugar levels (in spite of excercising regularly and following the low-carb diet). Even with insulin my dd was close to 9lbs.

I never see anyone who was diagnosed and treated for gd recommending Henci Goer. Also, if Henci Goer's theories are gospel truth, why are there no other sources that show scientific evidence supporting her theories?

To the OP: if you did not have gd with your first pregnancy and didn't have a 9+lb baby, you're probably fine.


----------



## purplestraws (Sep 13, 2006)

One of my best reasons for advocating for testing for GD (not necessarily the way that it is currently done in an office setting) is because out of control blood sugar can cause high blood pressure.

With my 2nd my blood pressure started climbing at about 24 weeks...by 30 weeks it was 140/90 and my midwife was getting concerned. 30 weeks is also the same time that I was diagnosed with GD...I failed the test, literally, by just 1 point. A different day would have yielded different results...and I very well could have passed. However, I'm SO thankful for the diagnosis. After just 2 weeks of modifying my diet and exercise my blood pressure had dropped to a consistent 110/70 and it stayed that way for the rest of my pregnancy. I did have to take a small amount of glyburide to keep my fasting levels down, but other than that it was totally manageable and I felt 300 times better once I started the diet. And let me say too...my diet before the diagnosis wasn't bad...I had my occasional splurges, but overall it would've been considered healthy.

I had horribly high BP at the end of my first pregnancy and in retrospect I'm sure that it would have been MUCH better had I been following a better diet. (My diet at that point was pretty crappy.) I failed my 1-hr, but passed my 3-hr at 24 weeks with that one...but I'm sure that testing at a later date would have given a much different result being as how my baby did have several "symptoms" of a GD baby (difficulty breathing, low blood sugar, CRAZY jaundice...).

I do understand that the test isn't fun and I think the 1-hr test is pretty much worthless, but I do believe that GD DOES exist and that treating it has many benefits for both mom and baby.


----------



## Sharlla (Jul 14, 2005)

ive never taken one
_Posted via Mobile Device_


----------



## EllisH (May 29, 2010)

Quote:


Originally Posted by *katelove* 
Home monitoring is not as sensitive as the 3hr GTT. The home monitors are intended to be an adjunct to treatment not a diagnostic tool.

In the presence of GD a woman's BGL will rise higher and drop more slowly following a glucose challenge than in a woman who does not have GD. That's why 3-5 blood tests are done during the test. And lab machines not bedside (or home) monitors are used to analyse the samples. The large glucose load combined with more sensitive testing tools allows this to be seen clearly. Eating normal food and testing randomly is less likely to produce changes which will be identifiable by a home monitor as pathological.

The GTT is not 100% sensitive either, meaning that it will fail to diagnose a percentage of women who do it. However random home monitoring is *less* sensitive, meaning that it will fail to identify even more women.

If a woman desperately didn't want to do the GTT then, I guess, the home monitoring would be better than nothing but she should be advised of the decreased sensitivity and the implications of that. Personally I don't see the point of a testing regime which requires more effort for less result. However, as with all things, it's a matter of weighing the pros and cons. We just need to move away from the idea that we're comparing apples with apples when choosing which test to go for.

ETA - My DH read this post and he added that the lab test of blood is much better at giving a *true* BGL. The home monitors are influenced by a variety of components within the blood and were designed more to show trends over time rather than one off levels.

In terms of treatment for pepole with diabetes they also have the advantage of being cheap (relatively), portable and easy to use. All these things are factored in when considering anything ffor long-term home use. Often, a degree of reliability or sensitivity is sacrificed for the other factors I mentioned.

Thanks for the explanation, katelove!


----------



## katelove (Apr 28, 2009)

Quote:


Originally Posted by *EllisH* 
Thanks for the explanation, katelove!

My pleasure


----------



## msmiranda (Apr 22, 2009)

Hmmm ... interesting responses. If I may project my own feelings about GD onto others on MDC, I think that the reason many of us sound skeptical of GD is because it is used as an excuse to push unnecessary interventions on women who don't need them.

My story is that I barely passed the 3-hour with my first, but I now believe that I did develop GD during that pregnancy. I was eating a ton of desserts and drinking chocolate milk, etc. (shudder) and during the last week my blood pressure went up a bit (into the 130s/80s range) and risked me out of the birth center. Had I known then what I know now, I would have been on the GD diet and probably would have had my birth center birth.

With my second pregnancy, I declined the GTT and did home monitoring, and the reason I did that is because I didn't want the GD label. I modified my diet, exercised regularly, and kept my blood sugar under control for the remainder of the pregnancy. I gained less weight (25 lbs v. 35 in my first pregnancy) and did not have the blood pressure spike toward the end. I had my baby at home with a midwife, again because I did not trust that an OB would have our best interests at heart and treat me like an individual who (a) has small babies, even with GD and (b) worked her ass off to keep her numbers perfect from 24 weeks on. I did not want to be pushed into induction or to have a big red "C" on my forehead. I also did not want my baby to be stuck a dozen times for nonexistent low blood sugar or to have supplementation pushed on us by paranoid nurses. I went into labor at 38w6d and had a 6 lb. 14 oz. perfect baby boy after less than 7 hours.

If doctors didn't freak out about GD to the extent they do, or could somehow distinguish between patients who truly have a problem and those who just need to stop eating so many carbs during pregnancy, I would be a lot more inclined to go along with their testing regime. In fact, I could say the same thing about a lot of things -- postdates, blood pressure, body weight, and so on. I take GD seriously, but I'm not about to put myself or my baby at risk for unnecessary interventions because of someone else's paranoia. I don't remember the stats about what the GD label does to your chances of interventions, esp c-section, but as I recall it was pretty significant. Maybe it's the case that those numbers correlate with non-compliance, but I wasn't going to take the chance.


----------



## forest~mama (Mar 16, 2005)

Quote:


Originally Posted by *purplestraws* 
One of my best reasons for advocating for testing for GD (not necessarily the way that it is currently done in an office setting) is because out of control blood sugar can cause high blood pressure.

This is interesting. I didn't do testing with my 1st, and I had a 7.5lb baby BUT my BP climbed pretty darn high. I would eat protein and that seemed to lower it, but it would go right back up. I was eating a ton of ice cream and vanilla milkshakes at the end of my pregnancy, and now I'm wondering about the supposed correlation you mentioned. I'm open to doing a more "normal" test where I can eat some food instead of drinking crap.

And for the person who said they must be the only mama on MDC who eats sweets, no you are not! Sometimes I see that trend as well, but I have been on a home made cinnamon roll binge the past few days! I have actually been noticing that I need to slow down on the sweets. I don't usually crave them, but this pregnancy I do.


----------



## kgreenemama (Dec 31, 2008)

What a fantastic dialogue here. You have all given me much to consider, and I think I will weigh my options with my OB before I decide what to do. Thank you, Thank you for all the input!


----------



## Maprilynne (Oct 22, 2004)

I don't know what it is that i get while pregnant, but technically, it is not GD. However, it mimics all the symptoms of GD. (Big baby, blood pressure, polyhydramnios, etc.) ending with a rather scary situation with my third child including hemhoraging from a distended uterus and a nearly 11 pound child. (Not necessary a complication, but considering he was over two pounds larger than my next largest child, definitely out of the ordinary for me.) So this pregnancy, right from the beginning I did a lot of research on eating like I was diagnosed with GD. So when I hit about 28 weeks and my midwife offered me the test, i declined, because it would not have made a difference in the way I was eating/exercising, and I am one of those people who has a REALLY hard time getting back on the wagon, but not such a hard time staying on the wagon, so I was afraid the glucose drink would mess up my good eating habits. So that is why I declined it. I continue to eat low sugar, high protein, watching my carbs especially in the morning. I am due tomorrow and my midwife says my fluid is great, I am measuring one cm small, and she estimates my baby between 7.5 and 8 pounds. (I guess we'll find out soon!) I think there is a lot to be said for knowing your body. But the first time? I can definitely be hard to know. However, if you do have it--or, like me, something that mimics it--I think carefully managing it is well worthwhile.

I don't know that that really answers your question.


----------



## Marissamom (Dec 17, 2009)

with DD my OB didn't have me do it, he said since there's no diabetes in my family and I hadn't had a lot of weight gain and didn't have sugar in the urine there was no real reason to screen me. he said if I did start gaining a lot of weight or had sugar in my urine then he would do the test then.


----------



## Mamatoabunch (Sep 23, 2007)

Quote:


> Originally Posted by *katelove*
> 
> Quote:
> 
> ...


Share w/ us, I'd love to see links on that work.


----------



## HappyMamaBeth (Sep 14, 2010)

So... if I did the glucose test and they diagnosed me with GD, wouldn't they just have me monitoring my blood glucose at home with a glucometer and eating accordingly?? If that's the case, then why can't I just skip the glucose test and monitor my blood glucose at home as though I have GD? That's why I don't understand why the 3 hour GTT is so much better. If the outcome is the same (monitoring levels regularly at home), why can't I just do that? I'm not talking about randomly checking my blood sugar here and there. I'm talking several times a day over a week (and if that is fine, maybe do it again a few weeks later).

Thoughts?


----------



## scrappin-mama (May 12, 2010)

My OB does the test itself using a glucometer.


----------



## ~adorkable~ (Nov 7, 2007)

Quote:


> Originally Posted by *katelove*
> 
> ETA - My DH read this post and he added that the lab test of blood is much better at giving a *true* BGL. The home monitors are influenced by a variety of components within the blood and were designed more to show trends over time rather than one off levels.


it seems to me that learning your bodies "trends" are more useful than "one off levels" i decided to ask for a meter to get to understand my body better rather than just getting a 3 hour or the like. i have learned a lot and part of that is about getting real time feedback on better or worse food choices.

i dont think the issue is if i or the doctor can get me to spike, but if i am getting to high as i go about my life. i test fasting one and two hour, and have learned alot and also learned to keep it in the zone i want.


----------



## MrsBone (Apr 20, 2004)

I declined it last time and will again, and if I ever thought I was developing symptoms of GD, I just tested my blood sugar with a blood sugar monitor. My DH is diabetic though, so those things were pretty available to me. I tested my blood sugar once a week upon rising and after a meal for the last 12 weeks of pregnancy, and they were always normal. I just have heard there's so many false positives, so it seemed silly to do it.


----------



## Miller (Aug 28, 2011)

tracymom01 got it right with her comment:

This was taken from the VERY mainstream WebMD site:
Pregnancy and Gestational Diabetes Screening
All pregnant patients should be screened for gestational diabetes during their pregnancy. Screening may be*done via patient history, clinical risk factors, or laboratory screening (the oral glucose tolerance test.*

also check out http://texanesemama.blogspot.com/2011/08/prenatal-glucose-test-is-it-necessary.html


----------



## MommyMatsumoto (Feb 9, 2010)

I did it with my first pregnancy and it was fine, so I'm skipping it this time.


----------



## 1love4ever (Jan 5, 2011)

Hi, I havent read the other posts, but yes there may be other signs of GD such as glucose may show up in your urine. Did you pass the test last time? The results will likely be the same. I refused mine this time. I am very healthy, my test was negative last time, and there is no family history of diabetese or GD so I felt good refusing it and my Dr and midwife agreed.


----------



## Flor (Nov 19, 2003)

I have gestational diabetes and I have absolutely no symptoms. In fact, I have it pretty badly. I am a healthy weight, have only put on 12 pounds (at 30 weeks) and my baby is not measuring big at this point. So, when I found out I have it, they said I'd be one of those people who just tweek your diet and exercise and everything is fine. Even though I follow the diet PERFECTLY, and I am on a way lower carb diet than most people with GD, my numbers keep going up. Not because I'm not doing everything right, but because my pancrease is freaking out with these pregnancy hormones. Wednesday I start insulin injections. Even at this point, when my numbers spike, I have no symptoms. I feel totally fine. I wouldn't have any clue that my baby is being flooded with glucose if I hadn't taken the test. My risk factors were that Im 35 (didn't have any problem in previous pregnancy) and I have some family members with type 2, but I assumed it was because they had terrible diets.


----------



## Flor (Nov 19, 2003)

Also wanted to add, that my OB is in no way freaking out over the diagnosis. She keeps telling me "This is normal pregnancy stuff" like a cheerleader, even though I'm freaking out. She isn't planning any changes to the birth other than checking baby's blood sugar after birth.


----------



## Sukhada (Jul 24, 2011)

I did the screening for GD this pregnancy, but will not do it again in the future. I didn't have any risk factors, but ended up screening high. Then I was obligated to take the 3 hour diagnostic test by my midwife or risk losing my midwife. I had already tweaked my diet and had done some home blood testing that indicated my sugars were fine so I didn't think I should have to do the test. For the majority of people, GD can be managed with diet and exercise anyway. In the end, I took the test and my sugars were well within normal. Had I failed the test, I could have lost my midwife and my dream of a home birth. I certainly wouldn't have risked a home birth if I had GD that could not be managed through diet and exercise. However, it seemed to me that my midwife felt that the diagnosis itself might be enough to have my care transferred. The entire exercise was very stressful and I wouldn't elect to go through it again.


----------



## lifeguard (May 12, 2008)

This conversation has been much better than I anticipated - I expected to read this & get angry at all the misinformation but I think it's been a pretty good conversation overall.

It seems to me that most people are more concerned about how they will be treated if given the label than anything else & I think that is more about who you have chosen as your care provider over anything else. This is my 2nd gd pregnancy & really I haven't had a terrible experience with care providers - slightly more monitoring than I would like but nothing invasive or upsetting has been pushed on me.

I really want to reiterate what pp have said that you may NOT experience other symptoms. I feel fine. I felt fine last time too. I get NO poor symptoms when my bg is high & my bg has too dangerously low before I feel bad. How you are feeling just simply is not good enough a measure.

As well, diet is not necessarily a big risk factor. With my first it probably contributed a bit but this time there was literally nothing the dietician could suggest to improve my diet. Many women develop gd without risk factors - they simply tell you you are at higher risk - they don't guarantee you will or will not develop it.


----------



## Mummoth (Oct 30, 2003)

I have three risk factors... age, overweight and family history (grandparents siblings, so it's pretty far off) and decided against the test. I was actually planning on taking it this time because I'm a lot older this time around, and DH has type 2 so I know this baby will be more likely to have diabetes and I was thinking I might be able to improve it's chances of not having it if I try really hard not to have GD (keep your logic away from me!!)

The midwife asked why I don't just monitor myself at home, so that's what I've been doing. DH even had an extra monitor so it's MINE now. I test about 5X a day, one day a week to see how I'm doing. I am to test the following day if I get any high numbers. I've done a few random tests at opportune times... like after the kids and I went for a slurpee. My average is 5.2, and I don't often see a number higher than 6 (anything under 8.0 is good)

Often I get suddenly exhausted and feel like I need to lay down, and one day I tested my blood sugar when I felt like that. It was close to the tipping point to being too low, 4.2! Anytime that feeling hits if I check myself, it's in the low 4's... I wouldn't know this about myself if I had taken the 1 hour screening test. I'm being more careful not to forget lunch now!


----------



## onetwoten (Aug 13, 2007)

I've chosen to do the test after thinking I wouldn't ever agree to it, for several reasons:

DH and I sat down and did some research, and contrary to what you would think, it seems like -most- people don't show any symptoms until the birth or around there. So you could very well have it, and not know.

My doctor does the test with no preparation-- no extra drink, no fasting, so crazy restrictions- it's just done as part of a normal blood draw.

I'm terrified of needles, but even worse with finger pricks- I get anxiety attacks even thinking about them- had my doctor insisted on the test being a prick, I would have said no, but was willing to compromise on the blood draw.

I want to return home ASAP after the birth (hopefully within 12 hours), and logic serves that having the results from this test will make the ped feel better about releasing us early-- I'm willing to have blood drawn for that.

I think it's all about weighing the pros and cons and how it will affect your pregnancy and your choices. For us, it was worth it.


----------



## scottishmommy (Nov 30, 2009)

I think the test is worth taking. I have no risk factors and have GD. Also, I think it's important to realize that managing GD can be more complicated than simply eating a good diet. Some carbs spike my blood sugar and some don't. It isn't just a matter of not eating sugar. You have monitor for weeks to get a sense of what is safe to eat. Honestly, the only thing that has changed as far as my care is that I started going to the midwives every week, and I have to show them my sugar levels. They don't do ultrasounds to check for baby size or anything. If my sugars are controlled there really isn't a problem!


----------



## lifeguard (May 12, 2008)

mushy - having zero risk factors is no guarantee you won't develop gd, but having a larger baby is considered a risk factor. As for the fasting thing - usually they want you to fast 'cause the first draw is supposed to be a fasting one.


----------



## Sukhada (Jul 24, 2011)

So, a non-fasting test is required for the screening glucose test. This test will not provide you with a diagnosis and many women will screen positive despite not having GD. It's usually a simple test involving one blood draw and either drinking a glucose test or eating a high carb meal. If you screen positive, you will be required to do the 3 hour fasting test which involves fasting for 10-12 hours and then getting three blood draws and drinking a much higher dose of glucose. This test can be quite uncomfortable - many people feel faint and vomit. Eating a high carb meal directly before doing the non-fasting test can result in your blood sugars being much higher than they normally would and can cause you to screen positive. This is why the non-fasting test is considered the "gold standard" for diagnosis diabetes, whether gestational or not.

And yes, managing GD is not simply about not eating sugar - it's about eating the right carbs in the right combination. A diagnosis of GD involves a consult with a nutritionist to develop a meal plan to manage it. If it's not managed with diet, then insulin is prescribed. Where I live, midwives can't manage patients who require insulin and thus any diagnosis of GD requires that they at minimum consult with an OB, an endocrinologist, and a nutritionist.


----------

