"A huge Canadian study demonstrated that the only effect of routine glucose tolerance screening was to inform about three per cent of pregnant women that they have gestational diabetes (20). The diagnosis did not change the birth outcomes." Quoting from Dr. Michel Odent at http://www.wombecology.com/maternalemotional.html and the study he quotes is Wen SW, Liu S, Kramer MS, et al. Impact of prenatal glucose screening on the diagnosis of gestational diabetes and on pregnancy outcomes. Am J Epidemiol 2000; 152(11): 1009-14.
I know that many midwives look for ketones in the urine strip, and if there is an indication of ketones then they recommend the woman eat a meal high in simple carbs (white rice or pasta with a dessert) and then test their blood sugar using a glucometer at intervals after the meal. I would be interested in a link to the research that indicates that urine strips are not effective.
Dr. Michel Odent recommends (at same website as above) "Another routine screening practiced in certain countries is for so-called gestational diabetes. This is the reason for using the glucose tolerance test. If the glycaemia (amount of glucose in the blood) is considered too high after absorption of sugar, the test is positive. This diagnosis is useless because it merely leads to simple recommendations that should be given to all pregnant women. These are recommendations regarding lifestyle, particularly dietary habits and exercise."
I also know that there is much debate about the current method of testing for gestational diabetes, because it is not an actual measure of how a woman's blood sugar would fluctuate, since hardly anyone would drink such a sugary drink as part of their diet. Some midwives think that using a glucometer is more accurate because it gives a more accurate overall picture of how eating a meal affects the woman's blood glucose levels.
It is my understanding that Group B strep is another controversial issue, where the evidence is not entirely clear, particularly when it comes to treatment. I would be interested if you could point me to the research you are referring to about the tests being accurate for 5 weeks. I think it is also important that women are aware that even if in the majority of cases the tests are accurate for 5 weeks, in some cases there is no GBS at birth, which means if they opt to receive IV antibiotics during the birth they may be receiving treatment for something that doesn't exist. Also, it is not the testing protocol that is effective at preventing transmission of GBS, it is the IV antibiotics. And routine antibiotics for something like 30% of the birthing population, some of whom may not even have the bacteria present, has significant risks of its own. For more on this see http://www.mothersofchange.com/2010/09/group-b-strep-look-at-facts.html
Originally Posted by nashvillemidwife
MDC should not be a forum for posting potentially harmful misinformation like that posted above.
Gestational diabetes can occur without signs. In several of your points you referenced research, yet you seem to be unaware of the research indicating that routine urine dips for protein and glucose in pregnancy are not evidence-based and it is recommended that they be abandoned. Also, I am not sure how you can claim that home glucose monitoring with a glucometer (that by industry standard is only accurate to within +/- 15%!) when recommended standard for the glucose tolerance testing is what has been shown by evidence to be the most effective at diagnosing gestational diabtes.
Group B strep is a normal bacteria to be found in the gut, not in the vagina or urinary tract. True, it is transient and just because you have it today does not mean you will have it when you give birth. However, again, the evidence is that the results of the test are accurate for 5 weeks, and that the testing protocol is the most effective at preventing transmitting group B strep to your newborn.