OK GTT and bad reaction and annoyed with provider

[dakotablue]

Last time I took the glucose tolerance test it was very very bad. I explained all of this to my MW and she agreed we could do something different. I am hypoglycemic have always been since childhood along with many members of my family, no history of diabetes anywhere.

Today I went in and they said I couldn't do anything different and sugar was sugar...I should have fought, but they said either today or you do it at a diagnostic center which with DS not a good idea.

15 minutes after drinking the straight junk I start to crash, They then start saying I need to go to endocrinologist and to start monitoring my blood sugar levels and my baby could end up in NICU.

So maybe having the numbers might be a good thing. I have already done work ups, everything is fine. I am healthy I just am careful about what I eat, always have snacks on me and don't drink straight sugar.

So when I talking to them they were asking about if this happens when I drink a big glass of juice or eat oranges, I said I don't do that. I always have protein with sugars and I eat every 2 hours.

They then kept saying it doesn't matter sugar is sugar....But my understanding is that sugar is not sugar what you eat with it changes the way your body metabolizes  the sugar...Is this wrong?

I'm just annoyed I even had to do this again. Fortunately unlike last time I was able to eat breakfast before taking the test and I bounced back after 45 minutes. They did not draw during my lowest point but rather at the 1 hour mark when I had mostly bounced back.

Realistically should I be worried? DS had no issues and I don't usually crash unless its something odd like not eating for 12 hours, asthma attacks without eating or drinking junk like that. Is this really a NICU baby scenario?

When I was with my OB my reaction was much worse and he didn't seem to be worried, just said I was hypoglycemic and it was fine as long as I was managing it.

Oh and also, I'm gaining more weight then they'd like, but I gained a ton with DS too and I don't eat junk.. They said to cut back on carbs...but I follow pretty much the brewers diet or high protein...which might be part of the weight gain.

[A-mac]

You're right, they don't know what they're talking about. The glycemic index addresses this issue. As someone who has gestational diabetes I can tell you that there is a huge difference between eating refined sugar and natural plant sugars as well as eating those things with or without protein and fat.

The advice to see an endocrinologist might not be all bad. They can get you set up with a monitor at least so that during pregnancy when your hormones that control blood sugar get all whacky you can keep a closer eye on it.

I didn't respond well to the gtt either (even though I failed) so in future pregnancies I'm going to decline it and monitor my sugars at home. I just don't think that test is healthy for people who have either high or low sugar problems. It can't be good for the baby.

[MegBoz]

Originally Posted by dakotablue 

So when I talking to them they were asking about if this happens when I drink a big glass of juice or eat oranges, I said I don't do that. I always have protein with sugars and I eat every 2 hours.

They then kept saying it doesn't matter sugar is sugar....But my understanding is that sugar is not sugar what you eat with it changes the way your body metabolizes  the sugar...Is this wrong?

Wow! Just, wow! WHO was saying this to you?

You are entirely & completely correct. Anyone saying, "it doesn't matter, sugar is sugar " is so grossly ignorant of basic nutrition, I'd run screaming from them!!!!!!!!!!!!! It's called "The glycemic index!" It's a measurement of the rate at which something affects your blood sugar - we all know how if you eat sweets, your blood sugar spikes & crashes, whereas a whole piece of fruit - complete with fiber - doesn't have quite the same effect.

Well, eating a high GI food (spikes blood sugar fast) such as orange juice WITH a low GI food (generally most fats, proteins & many high-fiber foods like oatmeal) results in a low GI meal! You are exactly right. Eating a bowl of oatmeal & an egg with your OJ completely & totally changes how your body metabolizes the sugar versus drinking that OJ alone. TOTALLY changes it...

High GI food + Low GI food= moderate GI meal.

and "moderate GI" means your blood sugar does not spike quickly, and come crashing back down.

Most HB MWs do a food-based test and give you a glucometer to test yourself at home, so you could try that. (I was thrilled not to have to drink that nasty drink and not having to deal with the incredibly rude women in the lab & take my time out to go & sit there.) Instead, I get to have my DH make whole wheat pancakes with 100% maple syrup, go for a walk with DS, and prick my own finger. :) Awesome!

ETA:

I'm a professional fitness instructor & certified as a personal trainer & find nutrition just fascinating in general. I've read a book on the glycemic index & years ago considered becoming a registered dietician (RD). I've heard repeatedly that American medical doctors are given a horribly inadequate amount of education on nutrition. The last source from which I heard this was an MD who also happened to be a fitness trainer presenting a workshop on getting kids to eat healthy - so she obviously knows as an MD herself.

So if this WAS your OB telling you "sugar is sugar," then this could just be an example of a common problem regarding ignorance of nutrition by American MDs. Perhaps not cause to leave the OBs practice for your maternity care, but if that came out of his mouth, I would NOT look to him for input on my blood sugar issues cuz, again, that belies a serious ignorance. I agree -if you're concerned - see a specialized such as an RD or someone who specializes in diabetes (is that an endocrinologist? IDK.)

[MarineWife]

If your midwife said you didn't have to do the GTT, where did you go and who are they that insisted you do it and told you such misinformation? I'm just curious.

But, yeah, like the PPs said, "they" are wrong in their implication. I think the GTT is a perfect example of an outdated and completely inaccurate medical practice. It does not show how your body normally and naturally metabolizes sugar. The studies that routine use of the test are based on are outdated and inaccurate. I know you've already done it so you can't take it back but remember for the future that "they" cannot force you to do anything you don't want to do. You can just walk out if they are using fear and intimidation to coerce you into doing something that you know is not good for you.

[dakotablue]

Originally Posted by MarineWife 

If your midwife said you didn't have to do the GTT, where did you go and who are they that insisted you do it and told you such misinformation? I'm just curious.

My MW who is the main one had said I could do something I could tolerate better like juice or a candy bar. When I tried to explain this that is the first time they started well...sugar is sugar. They being the newer MW and the MW in training who was/is an ER nurse.


 

Originally Posted by A-mac 
 I didn't respond well to the GTT either (even though I failed) so in future pregnancies I'm going to decline it and monitor my sugars at home. I just don't think that test is healthy for people who have either high or low sugar problems. It can't be good for the baby.

I'm defiantly going down this road next time. And that's the piece I couldn't wrap my head around. They were telling me how horrible unstable blood sugars are and I was kinda like, "Then WHY are you making mine unstable? "


This was said by the other people, who honestly I was just getting around to meeting in my MW practice. I did have a misinformed incident with this other MW once before when I called to ask about cervical pain, she insisted I couldn't feel my cervix and that it was a UTI. The main MW said "Of course you can its normal, you feel your cervix during sex don't you?  I'll have to talk with her."

Thanks so much for the explanation. This is what I thought and how I have been managing my sugars since I was a kid, although truthfully I don't really manage them I just am aware that eating otherwise is not a good idea. I rarely have bad reactions like this...and by rarely I mean once a year or every few years, once I learned to eat.

It was just so frustrating trying to talk and think through slurring and the cloud of fuzziness I was feeling.

Originally Posted by MegBoz 

Wow! Just, wow! WHO was saying this to you?

You are entirely & completely correct. Anyone saying, "it doesn't matter, sugar is sugar " is so grossly ignorant of basic nutrition, I'd run screaming from them!!!!!!!!!!!!! It's called "The glycemic index!" It's a measurement of the rate at which something affects your blood sugar - we all know how if you eat sweets, your blood sugar spikes & crashes, whereas a whole piece of fruit - complete with fiber - doesn't have quite the same effect.

Well, eating a high GI food (spikes blood sugar fast) such as orange juice WITH a low GI food (generally most fats, proteins & many high-fiber foods like oatmeal) results in a low GI meal! You are exactly right. Eating a bowl of oatmeal & an egg with your OJ completely & totally changes how your body metabolizes the sugar versus drinking that OJ alone. TOTALLY changes it...

High GI food + Low GI food= moderate GI meal.

[LaurenAnanas]

Sugar is sugar? As PPs have said, totally false. It's a "glucose" tolerance test not a "sugar" tolerance test.

For a more accurate and relevant picture of your sugar tolerance/response, you can check your own blood sugar levels throughout the day over a week. 

Also, I would mention to the more experienced midwife that you're getting different answers from the newer midwife. If it's a group practice where you rotate or they have equal responsibility, that's a big deal.

[MarineWife]

Originally Posted by dakotablue 
And that's the piece I couldn't wrap my head around. They were telling me how horrible unstable blood sugars are and I was kinda like, "Then WHY are you making mine unstable? "

I've never been able to understand that, either. It makes no sense for doctors to go on about how dangerous unstable blood sugars are and then subject us to just that.

When I was pg with ds3, after failing the 1 hour test, I refused the 3 hour test. They make me very sick, too. I just cannot stand to do them. I was able to work out a compromise with my OB where I ate a normal breakfast at home and came to her office for blood draws at 1, 2 and 3 hours. My sugars were normal. This time I'm not going to do it at all. If my MW really wants, I'll monitor my sugars at home. I'm sure I could get my insurance to cover another monitor and strips since I take meds for insulin resistance and was sort of diagnosed with GD when I was pg with ds2.

I agree that getting conflicting info from 2 care providers in the same practice is an issue that should be discussed.