freaking out - failed one hour glucose...

[paranoidprego]

Pardon the background: I am 27 weeks pregnant. I have 3 healthy children at home. We are pretty healthy people - my hubby is a chiropractor so diet is important. I have had 3 easy, healthy pregnancies easy labor and deliveries. With my fourth pregnancy, I had a normal, easy healthy pregnancy (passed the 2 hour glucose test), but at 39 weeks(this past February) I had a placental abruption that resulted in the death of my daughter and almost my own death. So, this pregnancy, they have been watching me like a hawk (for which i am grateful). Oh, and they have no idea why i had a placental abruption (no risk factors, nothing) so I am considered high risk though i have no other reason other than a traumatic fluke of nature thing that happened to me and baby. 

with all these appointments, i have had to find childcare for my 3 little ones which is not easy. my friends have been wonderful, but i feel awful to ask. when it came time for my 2 hour glucose, my midwife told me i could opt out of it and just do the one hour, so that is what i did. she said i did not have any risk factors (no family history, I'm skinny, active, good diet). My only risk factor is that i am 35 years old. i am 137 pounds at 27 weeks (which is about a 17 pound weight gain so far, but I hadn't lost all the baby weight from my last pregnancy - I am usually 108 pounds).

my blood sugar was 165 after the one hour test (and i did fast). i felt like crap after drinking that drink too. i know that gestational diabetes is not considered as big of a deal as other things (especially in light of my recent loss), but i am freaking out because i am a healthy person. i guess i must admit that i have not taken the greatest care of myself - with 3 little kids, i don't eat breakfast, just coffee. i skip meals and don't drink much water throughout the day. here is my question: do you think my lack of good habits has affected the blood glucose? would taking care of myself for the next week help my chance of doing better on the two hour tes next wednesday or is my body just shot and there is no hope for me. i know nothing about gestational diabetes but plan on reading more about it.

any information is greatly appreciated. advice on what/how to eat would be welcomed too. thank you!

[dayiscoming2006]

You drank the nasty drink? If so, that can throw things off. I would go for the regular glucose test where you take your blood, go eat a meal and come back and take your blood. 

[katelove]

Under the circumstances I think your midwife didn't give you the best advice. The one hour test is a screening test not a diagnostic test. If she was trying to save you a visit she would have been better off advising you to go straight to the diagnostic. There is still a good chance you don't have GDM but, unfortunately the only way to know for sure is to do the diagnostic 2 or 3hr test. But, just because you failed the one hour does not mean you will fail the 2 hour.

I'm afraid I disagree with the PP regarding just eating normal food and testing as well. The glucose drink is a known dose of glucose with known absorption and bioavailability. Food is variable so will produce less reliable results. IMO if you're going to test you may as well use the most reliable one available.

I don't think the eating habits you described in your OP have contributed. GDM is the result of your body's response to placental hormones which increase insulin resistance. We don't know why some people are more responsive to them than others, especially when they have no obvious risk factors. I have GDM this pregnancy. I didn't last time and the only change, that I know of, is that I am 2 years older.

All the best, whatever you decide.

[paranoidprego]

thank you for your responses. i know i shouldn't freak out. When i had the placental abruption, already knew my baby was gone, and I was bleeding out, I just felt like my body completely betrayed me. its hard not to think that way while pregnant again - will my body fail me in some way again, etc.? Thinking that my body is betraying me again with a possible GDM, just adds more to my plate than I have room for.

thank you again. i will probably be back posting for diet advice if i fail the next test:)

[Therese's Mommy]

Didn't read the other responses, but wanted to share my story.  I failed the 1 hr GTT with a 177 this time.  Everyone was freaking out, thought it was so bad, etc.  Instead of doing the 3 hr GTT I opted to monitor my blood sugars for a week.  I checked 4 times a day, fasting in the AM, and then 2 hrs after each meal.  Um, yeah, my blood sugars were beyond perfect.  My fasting numbers were usually in the 70s, rarely in the 80s and a couple of times in the 60s (they need to be <110).  My 2 hrs were most often in the 80s, a couple times in the 70s or 90s and in that week only above 100 3 times with the highest being 114 (they need to be <140).  So, there is no reason to freak out.  The 1 hr test is totally flawed.  Being <140 after 2 hrs is considered fine, why a pregnant woman needs to be <140 after 1 hr is absurd.  I talked at length with my mw about it.  She had never thought much about it and was going to bring it up with the OBs, but said nothing will likely change since they are just following ACOG.  But the whole thing really makes me MAD!  Women are given so much stress and for what?  It is stupid.  FTR, my regular doc, did not bat an eye at the 177, his response was that it is only important to know what it is after 2 hours.  Also, I see you are worrying about your habits affecting things.  I failed worse than you and I took really good care of myself this pregnancy.  It is the test not you.  See if you can get a meter and check your blood sugars.  What your blood sugars are on your normal diet is what is relevant, not what happens on this stupid test.

[katelove]

Originally Posted by paranoidprego 

thank you for your responses. i know i shouldn't freak out. When i had the placental abruption, already knew my baby was gone, and I was bleeding out, I just felt like my body completely betrayed me. its hard not to think that way while pregnant again - will my body fail me in some way again, etc.? Thinking that my body is betraying me again with a possible GDM, just adds more to my plate than I have room for.
thank you again. i will probably be back posting for diet advice if i fail the next test:)

I think, given your history, you have every right to freak out whenever and about whatever you want. You've been through something dreadful and I wish I could wave my magic wand and make this pregnancy completely stress-free.

More than happy to offer you more info on what I've learned over the last couple of months if it turns out that you need it.

The other thing to bear in mind is that a person with well-diet controlled GDM has similar risk factors to someone who doesn't have GDM so, even if you do have it, it doesn't mean everything has to change.