The whole point of the test is to give your body a load of sugar that is higher than what you would normally eat to see how it responds. It does have a high false positive, but it's meant to be a screening tool, not diagnostic. That's why we only have to do the three hour test if we fail, that gives a more complete picture of how the body is responding to sugar, and many who fail the one hour pass the three hour.
My issues with the test have to do with the sugar - what makes GD dangerous is if you aren't able to control it with diet. We all become a little insulin resistant and people eating a more SAD diet are usually eating a lot of sugar, which will mess with blood sugars and could cause problems for the baby. So it would be important to test so that those people could better control their diets. And sometimes someone eating a healthy diet can have high insulin resistance that could cause problems. But again, if levels can be controlled by diet, then most problems can be avoided and Mom can go on to have a totally normal birth and baby will be totally fine. So, I will talk to my MW on Tuesday about doing the A1c blood test, which tests blood sugar levels over several months, with the intention of having a record of blood sugar levels being under control. If they aren't then we can go from there. I eat minimal sugar and a very healthy diet, better than the "diabetic' type diets I see recommended. So If I do end up with GD, it wouldn't really be able to be better controlled by diet (I could probably make some small adjustments, but not extensive). I would probably need insulin...and I really, really don't think that's the case. The other "SMH" moment that I have is that the 1 hour test that is supposed to test a "huge" load of sugar, is less sugar than a bottle of soda that you see tons of people drinking all the time, so in many cases isn't actually a huge load of sugar in their case. My MW said that I could do a "real food alternative" but i would still need to ingest 50g of sugar in a short amount of time...which is seriously ridiculous for me. And there is a lot of variation with what people are and aren't allowed to do (what types of sugar, with fat/protein or sugar alone, fasting, not fasting, etc) which tells me that the test is pretty goofy to begin with. I would be a lot more open to it if I had a discussion with my provider that indicated a risk for my particular pregnancy, but so far she's talking like it's just "protocol" and "of course you eat more sugar than you *think* you do" and that bugs me. I guess I am also using this as a litmus test to see how hard I have to push to not have unnecessary tests and interventions in general.
ETA: the other thing that is weird, is that if you look at what a person's blood sugar should be 2 hours after a meal, it is 140. but they test pregnant women, who are known to be somewhat insulin resistant, with a large load of sugar, and it should be down to 140 withing 1 hour instead of 2....
Follow Mothering