Originally Posted by pregnant@40
I read last night that testing for urine glucose is an unreliable screen for gestational diabetes, unlike with normal type II diabetes. It leads to false negatives and false positives. Family history is also a poor predictor for your GD risk.
I've heard the same thing but I've always heard that GD is a good predictor of your personal risk for developing type II diabetes. As someone with a pretty strong family history of Type II diabetes, I find it reassuring that my GD tests (1- or 3-hour) are always VERY negative (e.g., 70s on the last one and I was definitely not fasting.. I had a pretty big meal before drinking the glucola). It takes a real effort, even in pregnancy, to get a reading over 100 for me.. haha. But I'm one of those overweight-but-healthy women.. my numbers are all excellent, except for my weight.
.. and just to throw this out there, I love my CNM. She's extremely "crunchy" when it comes to birth itself but is able to treat genuine medical problems when they arise. For example, I get frequent **severe** UTIs (ones that rapidly convert into kidney infections if not treated) because of neurogenic bladder secondary to MS, and she does prescribe antibiotics and do a urine culture. Were it not for her, I'd have to try to find another medical practitioner willing to prescribe, but that's tricky around here. No one is willing to do *anything* to a pregnant woman (not even tests that are really very safe during pregnancy) except for OBs and CNMs.
She does routinely *offer* the 1-hour GTT to patients she feels have risk factors, family history included. I went ahead with it for peace of mind because it's such a benign test (though REALLY gross to me, because I normally don't consume sugar at all... I just don't like sweet things.) But she doesn't order it so much as offer it.. e.g., "I see from your history that you might be at a higher risk of GD than some patients. Chances are that you're fine, but would you like to take a glucose tolerance test?"