blood sugar testing, without the routine GTTs

[llwr]

I'd like to do my 24-28 week sugar testing with a meter rather than the typical 1 hr glucose screen.  Is there any reason not to do this?  I failed the 1 hr screen in my previous pregnancy (3 hr GTT was ok) and found it to be rather stressful.  If this works just as well, I find it preferable.  Not to mention I'd be testing with food that I actually eat. 

The second part is how to pay for all the equipment.  Test strips are expensive, while the standard screen and GTT are free.  I'll check with my insurance company.   I should ask if and how they cover diabetic supplies, right?  I'm not sure if they'll go it without a diagnosis.  How many test strips would I need?

[babycatcher12]

I don't know about testing with a meter and paying for the equipment simply because I don't think it's terribly cost effective. I don't think an insurance company would pay for them without an official diagnosis of diabetes. 

I don't do the traditional glucose screen because it makes me so ill. Instead, I ask the doctor to draw a hemoglobin A1C. It gives them an overall picture of what my glucose control has been like over the previous 60-90 days. It gives a much better overall picture and for the most part I haven't ran in to much opposition when I've discussed it. 

[katelove]

Home testing is not sensitive enough for diagnosing GDM. If you intend to test 4 times a day and adjust you diet to meet the target levels from 26 weeks to birth it's fine but just doing it for a few days or randomly is not useful for diagnosis.

As the PP pointed out the Hba1c tells you what your sugars have been like for the previous two months. As GDM usually develops between 26-28 weeks an Hba1c won't be useful for diagnosis until 34 weeks at best. It will tell you if you had undiagnosed Type II diabetes prior to pregnancy though.

The one hour glucose challenge test is a screening tool not a diagnostic. It's not worth the trouble IMO and the hospital where I work and have my babies doesn't do it at all.

The two or three hour glucose tolerance test is not without faults but is the most reliable test we have at the moment.

[phathui5]

Have you talked to your midwife or OB about your preferences?

[myra1]

I decided to do this after skipping the gtt my first pregnancy and then having a large baby. With the next one, I tested 4x a day from about 26 weeks although the midwife said I could have even started later. My numbers jumped into diabetic range very quickly after eating a large meal or carbs/sugar, so I considered myself GD and ate very, very carefully small, high protein meals and adjusted as necessary based on my readings. I loved that it put me in control and taking responsibility for my health. I also did not want to expose my baby to the glucose solution, and foumd it irrelevant, since I would never eat that way while pregnant.

Also, I had a conservative cnm in an OB practice, so a diagnosis of GD would have made me high risk and made a natural birth more difficult. I did not feel I was high risk since, unlike many moms, I was willing and able to control w diet.

My insurances varied, sometimes paying for strips sometimes not. They are about a dollar apiece. Often a meter is available for free online since the strips are where the money is. Mine was insurance paid under Durable Medical Equipment, I went to a special pharmacy. A diabetic relative also had some about to expire extra strips and a free meter she passed along. Even paying for some it was worth it to have a healthy pregnancy without the label.

My widwife the first time was skeptical at my suggestion to self test but agreed, and on the subsequent pre gnancies a different CNM actually admitted she felt it was better but that most women don't want that many pokes. My babies also stayed almost the same weight as their oldest sibling instead of being larger as we thought they might be and were healthy, natural births. Blessings, hth

[llwr]

Thanks for the replies.  We haven't talked about preferences yet.  I have a couple more weeks before it's relevent and wanted to research myself a bit first. 

I was expecting to test 4x/day; but if my levels were fine, I thought maybe a week would be enough.

My midwives are pretty laid back.  I had considered not taking the screen the last pregnancy, since it was fine my 1st pregnancy and the only risk factor I had was age (and I was only 30).  We didn't talk about self-testing.  I decided on my own to do the screen, but she was fine either way.   I'm not concerned about the label issue with them if I did turn out to be positive. 

It makes sense (to me) to see how I react to real food, instead of a one-time test of something I don't normally eat.  However, I also realize that GTTs are respected diagnostic tools.  And I'm trying to save money, so a free test rather than I different one that I pay for is appealing. 

It kind of seems like if self-testing is done properly, it's mostly about preferences.  Self-testing isn't diagnostic, of course, but you can find the same end of keeping the levels in check.