Refusing The Glucose Test / Gastric Bypass Surgery

[elf_babykins]

At my next appt with my midwife I'll be at 24 weeks and she mentioned something about discussing the glucose test. I've been afraid to tell her that I'm going to refuse it this go 'round.
I did it with dd1, failed the first and passed the 3 hour one (even though I promptly threw up the sugar solution, a big no-no). I tried to tell her before hand that for someone that has had gastric bypass surgery this test is pretty pointless not to mention makes us ungodly ill. I know there are alternatives to this test that don't involve extreme amounts of sugar, but not sure what they are.
Are there any other gastric bypass surgery mommas out there who have done an alternate test?

[umsami]

I've had two different forms of bariatric surgery. Yes, if you had a Roux-en-Y, you can't handle that amount of sugar. What I would recommend is borrowing/buying a blood glucose monitor (you can get one at Wal-Mart for $9...Wal-Mart brand).. and check your fasting a.m. blood glucose levels, as well as 1 hour and 2 hour post-prandial (after eating) for lunch and dinner. Do this for a few weekdays and on the weekend. Based on those numbers, your midwife (and you) can tell if you have any form of gestational diabetes.

Basically, for fastings, you want the number to be under 95.

For one hour post-prandials, under 140.

For two hours, under 120.

Good luck And yes, absolutely refuse the glucose solution. You'll be miserable for nothing!

[elf_babykins]

Thanks for the recommendation! I knew I should have stood up more strongly for myself last time but didn't. :{ This time there is no way! I will give her this info at my next visit!

[Tiffanoodle]

I second the testing at home.

I haven't had gastric bypass, but I did refuse the GD testing this time. Last time I was very ill (my system was thrown off for days) with the 1 hour. My OB at the time was a witch and even though I was on the border, she insisted that I do the 3 hour test. I knew that I would get even more sick, so I asked if I could just test 4x a day for a couple weeks. I did that and even though there were only a couple numbers that were off (my fastings were like 120 a couple times, but I had a bad habit of taking a sip of soda before getting out of bed and testing and I know those days I did that, so it nullifies my fasting number.) I switched OB's.

This time, I have the same wonderful OB that I switched to last time. She knows my history of all of that. We discussed at my first visit that I did not want to do the 1 hour. She took a Ha1c, which showed that my blood sugar has been consistently normal to low the last 3 months. At about 26-28 weeks, I'm going to randomly do some fastings as well as after meals (she said most women don't want to do that and would rather just be uncomfortable for an hour, but for me it's so much more than that). If all looks good, we'll consider it all good. Unless any of the symptoms start, then I will probably end up doing the testing just to be sure.

[sharr610]

Why don't you do the blood tests? My midwife just did that with me and believes its much more accurate anyway. Test for the Ac1, glucose and insulin, fasting.

[elf_babykins]

Blood tests? No sugar, just fasting and a blood draw?

[sharr610]

Originally Posted by elf_babykins

Blood tests? No sugar, just fasting and a blood draw?

yeah! thats what my midwife recently did with me. she likes it much better. I had to do an overnight fast and blood draw in the morning. Test results back in a few days. She tested for glucose, insulin and the ac1 thing...thats normally just used for long term glucose production for type 2 diabetes, though, so not sure if you'd need it.

I don't know, I have no idea if it tests the same things, but she was talking about how inaccurate the GTT can be and how she much prefers the blood test...

[curvyred]

You should absolutely be able to refuse this! It could be seriously dangerous for you and your bariatric surgeon should be able to write you a letter if you have trouble.

I'm a lapband patient, so I don't have the dumping syndrome, but I might ask about doing blood tests anyway. I don't usually eat that much sugar, so I'm sure my results might be a bit wonky anyway (not to mention that sometimes that drink is carbonated, which is a no-no for me.)

[umsami]

HbA1C tells you how your blood sugars have been the past 2-3 months--so it's not really useful in diagnosing gestational diabetes which occurs at the end of the 2nd trimester/beginning of 3rd trimester due to the increasing size of the placenta. It's great for Type 2s...and sometimes OBs will check this near the end of your pregnancy if you have GD just to see how things have been going.

The fasting blood glucose is a great indicator--as fasting is often the most difficult to control--but it doesn't tell you how your body is handling carbs throughout the day.

If you have a Lap-Band or Sleeve Gastrectomy (or anything where carbonation is an issue, but not dumping), you can ask them to open the drink an hour or so before you come so it is flat. (Or a little flat.) I know that when I had to take the test back when I had my Lap-Band w/a pretty tight fill (not pregnant), I was completely miserable. It was impossible for me to handle the carbonation...and I couldn't get the drink down in time due to it.

[chamberfamfl]

NO NO NO NO... I am a Rue-En-Y graduate of almost 5 years, 31 weeks pregnant.  I tried to explain to my obgyn, that this kind of test is not recommended for GB patients for 2 reasons- 1) we cant get it DOWN in the amt of time they wish 2) the results even if we do, are not going to be accurate- considering we will have dumping syndrome most likely. She still made me go.  Sooo I failed of course the first test with a 174 (whatever that means)- When she ordered the 3 hour- I was NOT informed that this was a DIFFERENT DRINK- it contains DOUBLE the sugar load the first test does. Well I am currently 1/2 hour before my last blood draw and just stopped crying from the pain.  They put me in a relaxation room- where there isnt a call button-  10 min after I got the drink down, I was on the floor gasping for breath from the pain- I was trying to keep it down and calling for help- but no one came and I couldnt control it, it all came up, but I have been in pain ever since on my side.  Im just replying to this because I wish I had known how serious it was to refuse this test. Im TICKED off that DRs are not doing their research for patients with this surgery- because my first obgyn failed to acknowledge me having anemia at the beginning of pregnancy- I ended up having to have a blood transfusion and now Iron IV treatments every 2 weeks!!!! 

Listen, make your doctors listen to you. IF they wont- be SMARTER than I was. Call that Dr that gave you the GB and release permission for HIM/ HER to contact your OBGYN regarding these tests. I dont even know what I did to my stomach today, but I could have ended up in the ER from this.. 

God bless you ladies== but DONT get this test done.  THERE ARE ALTERNATIVE SOLUTIONS!!

T