or Connect
Mothering › Groups › February 2013 Due Date Club › Discussions › Anyone else been diagnosed with gestational diabetes-13 weeks?

Anyone else been diagnosed with gestational diabetes-13 weeks?

post #1 of 10
Thread Starter 

I am shocked.  All the fruit I have been eating and wonderful juices have put me and my baby at risk.  I am already a celiac and lactose free.....now I have to be ultra careful about my sugar intake?  ugh! I feel like fruit and smoothies got me through my morning sickness.  At least I am feeling much better physically..emotionally, I am scared that I have hurt my baby.  They say it is dangerous when all the vital organs are developing.  GD is not common until the third trimester.  :(

post #2 of 10
This question is based purely on the fact that I just don't know: is it normal to be tested this early?
Are you high risk?

I know I was tested with my first, 7 years ago, and can't remember when that happened. I declined the test with my second and will also not test this time because I'm just not at risk and also because I read "obstetric risks vs research realities" and decided that not being tested was best for me.

So sorry to hear that you'll have to watch one more thing in your diet!!! I also have diet restrictions and I understand how hard it can be. One more thing is just added stress for you.

((hugs))
Hope you can deal with this news in a way that will not cause you any un needed anxiety
post #3 of 10

I'm sorry you are going through this! Can I ask why you had to be tested so early? Doesn't it usually happen at 20 weeks?

post #4 of 10
Thread Starter 

Thanks mamas!!  My midwife ordered various blood tests from the lab.  AIC (hemoglobin level) and blood glucose level was part of this.  I am 41 yrs with several previous losses so maybe this is why they included the tests for diabetes.  It turns out my AIC level is right on the line of pre-diabetic (5.7%)...I am so relieved.  It will be easy to eat less carbs....so I feel confident that I can get my levels down and all will be ok.  We also heard heartbeat again tonight.  Such a beautiful sound.  Thanks again for your support wonderful mamas!!
 

post #5 of 10

Awww...Momma41- I felt so bad reading this post! First of all, YOU HAVE NOTHING TO WORRY ABOUT - let me just put that out there to you. I treat many diabetics in my practice as an NP and my father is a diabetic so I have a lot of knowledge and experience with diabetics.  I just have to ask - did your provider TELL you that you have GDM or did you just get a copy of your test results and see the 5.7 reading? There are so many reasons why you absolutely CANNOT use your A1C test to diagnose Gestational Diabetes. Here are SEVERAL reasons why:

 

1) All major endocrine societies, diabetic associations and expert medical guidelines specifically state that a diagnosis of Gestational Diabetes (GDM) can ONLY be made using the Oral Glucose Tolerance Test (OGTT) done at about 20 weeks. The reason this is NOT done until 20 weeks or so is because there are many changes that occur in early pregnancy that affect glucose and carbohydrate metabolism. Think about it - GDM is considered such a serious condition, that ALL pregnant women are tested for it. Don't you think if there was a way to diagnose it earlier, they would be doing testing at 8 weeks, 12 weeks, 14 weeks etc? They don't test earlier because it is simply not accurate.

 

2) Pregnancy causes changes to red blood cells and other blood parameters that renders the A1C practically useless. Many, many studies have shown that abnormal A1C results in pregnant woman DO NOT correlate with other widely accepted, well-known glucose tests. And it goes both ways - woman with low A1Cs who turn out to actually have GDM and woman with high A1Cs who turn out to NOT have GDM.

 

3) Unless you have a history of GDM with other pregnancies OR you had an elevated A1C prior to being pregnant, the A1C should not even be tested. All of the major diabetes experts and associations recommend against it. A1C testing in pregnant women and even in women who have given birth in the past 12 weeks is notoriously inaccurate. 

 

4) An A1C can be abnormally elevated in a person who has any type of iron deficiency or anemia, which is VERY COMMON in pregnant women. Was your iron level tested?

 

5) The A1C reading alone CANNOT be used to diagnose diabetes in any asymptomatic individuals - pregnant or not. It must ALWAYS be confirmed be further testing  like the Oral Glucose Tolerance Test (OGTT). Medical guidelines are adamant about this!

 

6 ) A reading of 5.7 is BARELY abnormal in the NON-pregnant person, let alone a pregnant woman. 5.7-6.5 is considered "pre-diabetic" which ONLY means that a person is "at-risk" for diabetes, NOT that they have diabetes or will even get diabetes in their lifetime. It is a screening test, not a diagnostic test (if that makes sense?). An A1C in the 5.7-6.5 means "you are heading down the wrong path" in a non-pregnant person. Many people within this range are able to decrease risk by losing weight or modifying diet. Still, this does NOT apply to pregnant woman. 

 

I can literally go on and on about this, but my post is pretty long right now. Momma41, feel free to PM me if you need further information or if you'd like me to give you a list of the dozen or so sources I have to support these points. (You could show them to your provider- sounds like they may not know all of the facts re: A1C in pregnant women). 

post #6 of 10
Thread Starter 

Jess, you are so wonderful!!!  The fact that you took the time to write all this information so I would feel better.  What a caring person...to a stranger!!  Thank you so much!

 

So it all started when one of the midwifes in the practice left me a voice message saying that I tested positive for GDM....that was it.  I called back and no one returned my call. I had an appnt anyway last night.So because my Aic levels are 5.7 I am put in a special category where I see a special diabetes midwife, a dietician, and will be given a glucose monitor to test my levels.  Seems like a bit much to me considering I have no family history, no history of GDM in prior pregnancies.....nothing!  I really was shocked to find out.  I am normal weight and fit, exercise, eat better than anyone I know.  What you are saying really makes sense. I am upset they worried me for probably nothing!!! I will talk to them today and use the points you suggested. 

 

I can't thank you enough!!!  What an amazing relief you just gave me.  I feel like crying....
 

post #7 of 10

Wow that is crazy... I didn't know any of that info either so thank you for sharing Jess!!  And Momma - I hope things work out for you and you can get this sorted out.  I can imagine that would have been very stressful to hear! 

post #8 of 10
Quote:
Originally Posted by JessNP View Post

Awww...Momma41- I felt so bad reading this post! First of all, YOU HAVE NOTHING TO WORRY ABOUT - let me just put that out there to you. I treat many diabetics in my practice as an NP and my father is a diabetic so I have a lot of knowledge and experience with diabetics.  I just have to ask - did your provider TELL you that you have GDM or did you just get a copy of your test results and see the 5.7 reading? There are so many reasons why you absolutely CANNOT use your A1C test to diagnose Gestational Diabetes. Here are SEVERAL reasons why:

 

1) All major endocrine societies, diabetic associations and expert medical guidelines specifically state that a diagnosis of Gestational Diabetes (GDM) can ONLY be made using the Oral Glucose Tolerance Test (OGTT) done at about 20 weeks. The reason this is NOT done until 20 weeks or so is because there are many changes that occur in early pregnancy that affect glucose and carbohydrate metabolism. Think about it - GDM is considered such a serious condition, that ALL pregnant women are tested for it. Don't you think if there was a way to diagnose it earlier, they would be doing testing at 8 weeks, 12 weeks, 14 weeks etc? They don't test earlier because it is simply not accurate.

 

2) Pregnancy causes changes to red blood cells and other blood parameters that renders the A1C practically useless. Many, many studies have shown that abnormal A1C results in pregnant woman DO NOT correlate with other widely accepted, well-known glucose tests. And it goes both ways - woman with low A1Cs who turn out to actually have GDM and woman with high A1Cs who turn out to NOT have GDM.

 

3) Unless you have a history of GDM with other pregnancies OR you had an elevated A1C prior to being pregnant, the A1C should not even be tested. All of the major diabetes experts and associations recommend against it. A1C testing in pregnant women and even in women who have given birth in the past 12 weeks is notoriously inaccurate. 

 

4) An A1C can be abnormally elevated in a person who has any type of iron deficiency or anemia, which is VERY COMMON in pregnant women. Was your iron level tested?

 

5) The A1C reading alone CANNOT be used to diagnose diabetes in any asymptomatic individuals - pregnant or not. It must ALWAYS be confirmed be further testing  like the Oral Glucose Tolerance Test (OGTT). Medical guidelines are adamant about this!

 

6 ) A reading of 5.7 is BARELY abnormal in the NON-pregnant person, let alone a pregnant woman. 5.7-6.5 is considered "pre-diabetic" which ONLY means that a person is "at-risk" for diabetes, NOT that they have diabetes or will even get diabetes in their lifetime. It is a screening test, not a diagnostic test (if that makes sense?). An A1C in the 5.7-6.5 means "you are heading down the wrong path" in a non-pregnant person. Many people within this range are able to decrease risk by losing weight or modifying diet. Still, this does NOT apply to pregnant woman. 

 

I can literally go on and on about this, but my post is pretty long right now. Momma41, feel free to PM me if you need further information or if you'd like me to give you a list of the dozen or so sources I have to support these points. (You could show them to your provider- sounds like they may not know all of the facts re: A1C in pregnant women). 

what she said.  i'm floored at this reaction this early too.  i am not a tested celiac, but have a strong family history and reversed infertility by being gluten-free for 11 years.  DON'T PANIC.  I definitely found that i drink a lot more juice when pregnant (first trimester i crave citrus juice), but try to focus more on adding in plenty of protein and good fats b/c they're harder for me to keep in the diet.  i don't do the glucose test (did the fasting test for 2 pregnancies, and my blood sugar was always between 72-75) and didn't do the test for the last 2 pregnancies b/c i was basically on a diabetic diet.  also, had friends w/ gestational diabetes totally address it w/ diet and have no complications or problems once they got the diet figured out, which was actually pretty gluten-free, and based on meats and veggies with whole grain brown rice.  Jess seems like a great resource and encouragement!!!

post #9 of 10

So glad I can help! This is what I've dedicated my life to as a nurse and an NP - educating others and empowering patients to take an active role in their care. Also, this is an issue that is really close to my heart. My dad was diagnosed with diabetes in his 50s - and he was never overweight, very fit & trim, exercises regularly, eats healthy. I did a ton of research into it in order to maximize his health. Now that I am pregnant with serious risk factors, I did a ton of research into GDM. 

 

Momma41 - I am really disappointed (although not surprised) in the behavior of your MW group. They....actually called a pregnant woman, who has already suffered from 8 losses, on the phone and left a voice mail...not saying "please call us back to discuss your results" but...to literally say...you tested positive for GDM. I realize that I am a little hormonal myself right now, but THAT INFURIATES me. But...I digress......I'll refocus...

 

In medicine, all practitioners and providers rely on "clinical guidelines" to make decisions on what tests to order and what medications to prescribe for ANY condition. These clinical guidelines are established using scientific evidence, results of highly reliable research studies and the input of experts in their fields. Guidelines for GDM come from two main groups (and many smaller groups chime in). These are the ADA (American Diabetic Assoc) and ACOG (American Congress of Obstetricians and Gynecologists). Here our links to the official guidelines for both: http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Obstetric_Practice/Screening_and_Diagnosis_of_Gestational_Diabetes_Mellitus

and

http://care.diabetesjournals.org/content/34/Supplement_1/S11.full

 

They are written for providers, so I apologize that they are not an easy read. There are other groups that have some input. They are summarized nicely in these two articles (again, written for providers):

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153423/?tool=pmcentrez

and

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943351/pdf/hippokratia-14-151.pdf

 

 

The only group that mentions screening with A1C in early pregnancy is the International Association of Diabetes and Pregnancy Groups (IADPSG). They consider an abnormal A1C as anything >6.5 (NOT 5.7). I'm just not sure where you're MW group is coming from. I applaud them for taking an active role in your care, but I worry that they may be causing you undue stress and anxiety. It's possible (but this is pure speculation) that they have just hired a diabetes midwife and they are trying to fill up her patient load. (Again, pure speculation, but something that does occur frequently in medicine). 

 

On a positive note, let them monitor you more closely. You HAVE been through a lot and you want this pregnancy to go as smoothly as possible. Learn what you can from their dietician (she can counsel you on ANY diet concerns you have like constipation, heartburn, etc - not just GDM), take the free monitor and use it to check your sugars (BTW- LOW sugars can be very bad too), but DON'T let it stress you out at all - please! You have not done any harm to your unborn baby! If you do go on to test positive for GDM at 20 or 24 weeks (which I highly doubt) you will be knowledgeable, ready, and fully armed to deal with it. 

 

Sorry so long! Again, this is what I do -  I love to help people and glad I can provide some knowledge and comfort. Knowledge is power! read.gif

 

 

 

post #10 of 10
Thread Starter 

Yay!  Thanks so much all!!  grouphug.gif  I am really taking to heart everything you said. I feel incredible!  I love this group!! joy.gif

 

Jess, we are so lucky to have you as a resource of knowledge....as well as caring and support.hug2.gif

  Return Home
  Back to Forum: February 2013 Due Date Club
Mothering › Groups › February 2013 Due Date Club › Discussions › Anyone else been diagnosed with gestational diabetes-13 weeks?