1 hr glucose test numbers were elevated, considering declining the 3 hr test, what to do?

[beautifulboy]

What is the treatment for mild GD?  I'm 28 weeks pregnant with my 2nd baby (and had no indication of GD with the last babe).  My 1 hr glucose test levels, taken last week, were elevated.  Instead of taking the 3 hr test I am considering going straight to the treatment - i.e.: dropping sweets and other bad foods out of my diet, drinking more water and exercising more.  I usually eat pretty well (whole grains, organic foods, no sugar except the occasional treat, no juice, def no other drinks/soda etc) but I have to admit that I have been eating a lot of sweets lately (frozen yogurt and chocolate mostly) and since we're moving this month (beginning this week)  I've been neglecting the exercise.  I should know better!  I am so disappointed in these test results.  I started this pregnancy with great healthy intentions and felt like I was in pretty good physical shape and now because our lives have been a little crazed I feel like it has gone down hill.  :(    I would really like to skip the 3 hr test, a day of fasting, hospital and the sugar drink are just what I don't need right now.  I've read a lot about GD online and here on MDC.  Has anyone found themselves in the same boat?   

[lifeguard]

Check out the gestational diabetes thread - there is some good info. The old thread is very long but might be worth looking at as well.

The problem with the 1 hour is it has a high false positive rate - so MANY women fail it but pass the 3 hour - so it may be less hassle to do the 3 hour than to go directly to treating as if you have gd. It's so much more than cutting out sugar - it's about managing all your carb intake & what works is very individual for each person.

[scottishmommy]

Definitely go in for the three hour test. You easily could have had a false positive. Basically, in order to manage my GD I have to test my blood sugar 4 times a day. Once first thing in the morning, then 2 hours after breakfast, lunch and dinner. I also had to start seeing my midwife every week instead of every two weeks. You may be able to just test at home for a week to see how your sugars work, but honestly, it's a pain in the butt! And the test strips are expensive. I hope you pass the three hour test!

[cinderella08]

I would definitely not skip the three hour test.

[kathrineg]

I can't give too much advice about GD treatment, although I do know that it varies from person to person depending on how your body reacts to different things. 

I do know that I have a friend who is the healthiest, best eater ever and she got GD.

I ate horribly in the first half of my pregnancy (think gummi worms, soda, and ramen...embarrassing but true) and I do not have GD.

So if you do end up testing positive at the 3-hour test, please don't blame yourself! A lot of it is just luck/genetics.

[Flor]

If you do want to skip the 3 hour and go straight to treatment, it is more complicated than just cuting sweets. I do fingerpricks 4x a day. It takes a while to understand what your body can eat. I get 15 carbs at breakfast, 15 snack, 30 lunch, 15 snack, 30 dinner. From day to day my body reacts differently. Somedays the same meal gives me high blood sugar, the next day it is fine. Even following the diet perfectly, I had to go on insulin because my fasting numbers (the most important) are too high. It's more than just healthy diet-- a GD serving of whole wheat pasta or brown rice is 1/3 a cup. I can hardly eat fruit (like a couple strawberries a day is about all I can handle and work into my carb allowances, 1/2 an apple is a serving-- It is a lot of work! I spend large periods of time each day staring into the fridge wondering how to get enought calories and protein into a tiny amount of carbs. I keep losing weight. If I didn't have to do it, I wouldn't.

[beautifulboy]

Hi Everyone

Thank you for all of the replies.  Sorry that it's taken me so long to follow up but I wanted to wait until after I took the 3 hr GD test (yes-I decided to take it) and then write up my results in case anyone is reading this in my boat. Everyone is completely correct in advising that if your numbers are elevated in the 1 hr test that yes, you should do the 3 hr test no matter how yucky the drink is or how it cuts into your week because... I passed the 3 hr test--hooray!  My 1 hr test was 142 and my midwife said she wanted it below 130.  in the 3 hr my numbers were 80 (they wanted it below 95), 133 (165), 118 (145) and 46 (125).  I'm going to cross post my numbers and write more in the GD thread.

http://www.mothering.com/community/t/1309375/the-new-gestational-diabetes-support-thread/140#post_16662042

Edited by beautifulboy - 9/18/11 at 3:51am

[OurGift]

Congratulations! I was going to say, it's not just sweets, it's breads, grains, cereals and pasta too. It's a real pain. I had elevated #'s on my 1 hr test last pregnancy and went straight to treatment.

[emmaegbert]

I always find myself wanting to post on these kinds of threads even though I know its probably annoying... but you absolutely do not get GD (or Type I or Type II diabetes, for the matter) *because* of what you eat. When you are unfortunate to have impaired glucose tolerance (in pregnancy caused by placenta hormones which affect some of us differently than other) then you must change the way you eat if you want to maintain normal blood sugar. I think many people look at the restrictive diets of diabetics and assume that somehow we gave ourselves the disease due to eating a lot of sweets or something, and this is not the case at all. And many things considered super healthy (like oatmeal) are absolutely off the table for diabetics who are using diet as part or all of their control. (many if not most diabetics must use a combination of diet and medication. I just have relatively mild GD and use only diet for control, but my diet is quite restrictive when pregnant).

Sugar and sweets are certainly capable of exacerbating diabetes. Other issues are complicated as well: like being overweight. Being insulin resistant can cause you to gain weight. AND carrying excess weight can exacerbate insulin resistance. So its a vicious cycle- not necessarily that just being overweight causes the insulin resistance- does that make sense? The insulin resistance can just as much be causing the excess weight as the reverse.

OP- glad to hear you had such a normal 3-hour test. I had a similar situation with my first, and then with my second I was screened twice for GD, and only came up as borderline with my second 3-hour test during that pregnancy, but when I began self-monitoring, for sure I had to be very strict and careful with my diet to keep normal numbers.