Gestational Diabetes Testing?

[AnastasiaM]

Hello,

I'm supposed to go for GD testing end of Dec/beg of Jan, and I'm sort of freaked out about it.  Everything I've read about GD is alarmist, and what I've heard from friends does not make me look forward to this test.  I've finally gotten over being afraid something will go wrong here, and now I'm worried about this.

Is it really necessary to do the testing? Is GD common? Does it go away after the baby is born?  What, if anything, can I do in the month before the test to help?  I'm really freaked out at the thought of taking it the week after Christmas, when I KNOW there will have been too many baked goods and candy around to resist!

Or is this really not a big deal and I shouldn't be worried?

I think one of my biggest fears is that if I turn out to have it, the baby will be too big, and need to be a c-section.

Thanks, everyone!!

[Kyamo]

It's relatively common, about 3-8% of pregnancies. It usually goes away after the baby is born. Opinions vary wildly on how necessary the testing is, but most doctors will recommend it because it is relatively common and usually doesn't have symptoms. Your fear about the big baby - it's my understanding that really large babies and the other negative effects are the result of uncontrolled GD, not just GD. So even if you do have it, you should be able to use diet (or if that fails, insulin) to control your blood sugar, and baby will be fine.

I am at higher risk for GD since I have PCOS, so I did not feel comfortable refusing to do the screening test. I didn't do anything special with my diet other than to make sure the meal I ate several hours before the test had plenty of protein. (I do try to eat whole grain carbs instead of white as much as possible all the time.) I passed!

[Dandy Lion]

I will not be doing formal testing, but I am monitoring my blood sugar levels. I am at a high risk because my mother had it when she was pregnant with me, and my levels are getting more and more erratic. Testing my blood sugar several times a day has been very helpful for me to determine what foods I can and can't eat, and also when I need to eat.

Eating a low sugar diet the week before the test will actually make your body react more strongly to the test, so eating baked goods might not be such a bad thing. Keep in mind that the test isn't that accurate, but it could be helpful in spotting a problem if there is one. You can control your blood sugar to some degree with diet and excersize, and also use insulin if necessary to keep your baby from making too much insulin. My mother had GD with 3 pregnancies and had natural births with all of them.

[bluebutterfly]

By nature, pregnancy is somewhat of a diabetic state so elevated levels to some degree are normal.  If you have severe GD and it went completely uncontrolled then the baby could gain excess weight or have low blood sugar after birth.  I didn't do formal testing with my first and won't with this one either.  That said, I did monitor my blood sugar levels fairly closely and kept it under control.  I did have a few elevated readings but was able to keep it under control by watching what I ate and interestingly, when I ate it.  I gave readings to my midwife regularly.  Mornings were the worst for me.  So breakfast was always mostly protein.  I also realized certain foods were worse than others and they didn't always go "by the book."  I couldn't eat a drop of ketchup.  Cooked potatoes and breakfast cereals were also bad.  The best meals for me were balanced meals at dinner time.  Eating protein with every meal and eating it before anything else also helped.

If you want to keep an eye on it yourself - which, IMO, is a better thing to do than a one-off reading - get a glucose meter and test 2 hours after meals for a week or so.  Ideally it shouldn't be above 120.   A week's worth of tests will help you identify if you have a problem and what works to keep it low.  I saw a couple readings around 140 with my first (and one of 160ish after trying shredded wheat) but like I said, that wasn't the norm since I could keep it under control with diet.  My baby was 7 lbs 4 oz. :)

At 24 weeks, I haven't started to monitor yet with this pregnancy but I know I need to start in the next week or two, which is likely going to mean the ice cream indulgence will have to stop. :)

[JMJ]

Well, it's not terribly common, but there are certainly people who have GD, and if you have it, you'd probably want to know about it so you can take steps to control it and prevent the big baby needing a C-section.  The problem with the glucose tolerance test is that it is highly inaccurate and (in my opinion) the test itself is unhealthy since nobody should ever consume that much glucose at one time, ever.  It's very easy to get false positives (like if you don't ever consume sugar, your body may overreact to it) or false negatives (like if you exercise during the test window, you could lower your blood sugar enough that you get excellent test results, but that doesn't help you if you do actually have GD).

Personally, I don't have any of the risk factors for GD, and I already eat approximately the diet that would be recommended to me if I did have GD.  My midwife checks for glucose in my urine at every appointment, and if I ever found any, I would strongly consider an A1C test, which shows what blood sugar levels have been over a period of time, and since that is more important than how your body reacts to an unnatural situation (since it is overall raised blood sugars that cause problems).  It's also a less invasive test, done by a blood draw rather than by putting an unnatural substance into your body.

[3timesamom]

I passed with all  my kids so far. (Three live children) With the first two I failed the one hour and passed the three. With the third I just passed the one hour. WIth this baby they told me I am overweight and therefore at higher risk and insisted on testing me at 16 weeks. I rocked that test;) I do not have gestational diabetes. I do however have larger than average babies. With no problem:) (9lbs 3oz the biggest I had)

That said, the week before the test, (basically the day after xmas or so) cut sugar out of your diet. I don't mean cereal I just mean like don't eat a hersheys bar or a piece of pie.Then when you take the test it will only measure the sugar you recently ingested and not an overload of grandmas pie. Further for the one hour there is no rule that you can't say drink the drink while you are taking a walk then drive in and get the blood draw. Exercise and water will help you burn some sugar off but not so much that if you TRULY had GD that you woudln't come up with a high sugar. IF you choose to eat breakfast for the one hour test stick to eggs and cheese. NO CARBS!

Gestational diabetes does go away after birth. Woman who have it though usually end up with late onset diabetes later in life.

They are testing how well your body burns sugar. This can give them an estimate of how well your placenta is working. I personally would do the test. If you have it you can avoid sugar and carbs. If not then you know.

[LalaithYamainu]

I was tested at 13 weeks, and passed (barely).  I have a family history of diabetes, and have pcos myself.  

Buuuut...

Doc wanted me to test again at 25 weeks.

I'm almost 26 weeks and she hasn't said anything at the last few appts.  I haven't reminded her. ;)

But I HAVE been watching my sugar intake and such, and getting more exercise, so it's not like I'm blowing it off.  Unless it's a really serious case of GD, that's all they'll have you do anyway.

[AnastasiaM]

Thanks, everyone!  This allays my fears a little bit.

In general, I feel like the medical industry goes *looking* for problems, and then automatically has a tendency to find them.  So I am very skeptical of all this testing . . . I've been having blood and urine testing all along, and they've never said anything, so I'm assuming it's been ok.

My youngest brother (adopted) had a birth mother who had diabetes -- and he was a few ounces under 12 lbs at birth -- so that's where that particular fear is coming from!  But it makes me feel alot better to think it could be managed. 

[cameragirl]

Originally Posted by 3timesamom 

That said, the week before the test, (basically the day after xmas or so) cut sugar out of your diet. I don't mean cereal I just mean like don't eat a hersheys bar or a piece of pie.Then when you take the test it will only measure the sugar you recently ingested and not an overload of grandmas pie. Further for the one hour there is no rule that you can't say drink the drink while you are taking a walk then drive in and get the blood draw. Exercise and water will help you burn some sugar off but not so much that if you TRULY had GD that you woudln't come up with a high sugar. IF you choose to eat breakfast for the one hour test stick to eggs and cheese. NO CARBS!

They freaking MAKE you stay inside their lab and watch you like a hawk here. That is, if you use a hospital or independent lab and don't get it done at the OB or midwife's office. I have to go to an independent lab this time. I may get up a lot to "get magazines" and fidget and tap my toes. That's better than nothing. I'm also planning on eating a little protein before the test. I am having trouble keeping any fluids down at all, so I also need to get some Zofran before the test. Last time I couldn't fast at all, and ate cheese before the appointment. My OB straight up said to lie to the lab tech, which I guess will work as long as I don't vomit.

My concern with the test is that it isn't really an accurate test. There isn't a set guideline that all doctors follow. Each doctor seems to have their own idea of how to do the test, and what the cutoff should be. It also is very unnatural to fast for 8-10 hours and then consume soda with 50 g of glucose. Normally, you'd have some fiber and protein in the mix to help regulate blood sugar. The false positive rate for the 1 hour test is pretty high, causing a lot of women to worry and have to deal with the three hour test. (Ick.) I'm at higher risk because of genetics, but so far my blood sugar has been good. (knock on wood!) I've been getting it tested for three days in a row every five weeks when they do the infusions, and it has been normal considering that I eat cereal and sometimes have juice about an hour and a half before the draw. That's reassuring, so I'm really hoping that this test comes back normal.

[3timesamom]

Cameras girl, I would think that you could skip that test. Honestly you are being monitored currently. I don't think its accurate. I mean who downs a pile of sugar and then sits on their butt first thing in the morning?! LOL Yes at the lab during the three hour they do NOT want you to walk around. THat is part of that test though. The one hour doesn't have that rule. If you were truly diabetic you would not burn enough sugar to pass.

[cameragirl]

They claim it is a liability thing around here. So you don't pass out and crack your head. Sounds like bunk to me.

[Dandy Lion]

Originally Posted by JMJ 

Personally, I don't have any of the risk factors for GD, and I already eat approximately the diet that would be recommended to me if I did have GD.  My midwife checks for glucose in my urine at every appointment, and if I ever found any, I would strongly consider an A1C test, which shows what blood sugar levels have been over a period of time, and since that is more important than how your body reacts to an unnatural situation (since it is overall raised blood sugars that cause problems).  It's also a less invasive test, done by a blood draw rather than by putting an unnatural substance into your body.

This test also has it's flaws. Since glucose was found in my urine couple of times, we're doing the A1C test this week even though my midwife doesn't think it'll come back abnormal. My blood sugar has a mild spike after eating, and then drops rapidly down to hypoglycemic levels, then back up, and then back down.. Where it's an average over the past three months, my average will most likely be normal.

[3timesamom]

They would probably say that to me too;) Who knows. How silly! I just get to eat some pancakes:)

[JMJ]

Originally Posted by Dandy Lion 

This test also has it's flaws. Since glucose was found in my urine couple of times, we're doing the A1C test this week even though my midwife doesn't think it'll come back abnormal. My blood sugar has a mild spike after eating, and then drops rapidly down to hypoglycemic levels, then back up, and then back down.. Where it's an average over the past three months, my average will most likely be normal.

Strictly speaking, though, that's not GD, even if it is a blood sugar problem.

[happyblessedmama]

I have had the 1 hour test once during all of my pregnancies and passed all the times.

With my 6th pregnancy baby was measuring ahead - like 4-6 weeks consistently which couldn't be possible - we repeated the test and I took the 2 hour test (fasting draw, then blood draws at 30, 60, 1 and 2 hours). I felt VERY sick after that test. I passed it. Baby was 9#10 oz.

I have limited faith in the reliability of this test but with a sibling with type 1 I'm at higher risk and don't feel comfortable declining it. That said if I "fail" the 1 hour I will *NOT* repeat a longer test with more draws but would opt to assume I need to be on the diet. The longer test really was that bad for me. I *will* *not* ever do that again.

[LalaithYamainu]

I have to have it done.  :P  It's funny though, when Wendy (the nurse) came back in with the paperwork for it, she saw me glaring at it, and said deffensively "She's making me give it to you!  Doctors are evil!".  LOL.

And my doc remembered me telling her about the fiasco last time (I was told to fast for 12 hours by someone who was mistaken about which test I was taking), and she asked if I still had zofran (I do).  She told me to take it about half an hour before, NOT TO FAST, but to have a good protein (bacon and eggs) breakfast a few hours before.  It was funny. :D