Do I really have GD? Need help!

[Luvbnmama2alex]

I've failed two 1-hr glucose tests - the first was random and my bs was 158, the second was fasting and my bs was 194. My dr. has referred me to the Sweet Success program at the hospital without giving me the 3-hr GTT. Has this happened to anyone else? I'm finding it hard to believe I have GD since my only risk factor is age (42). I eat well, although I probably don't eat the same amount each day, or at the same time which I know can effect bs levels. I also don't exercise.

I don't know what to do. Does anyone know of alternative treatments for GD? I'm wondering if accupuncture would help. I've already started trying to eat more regularly and more often.

I'm afraid if I accept this diagnosis it's going to lead to a lot of interventions at the birth and post-partum. I'm already having a vbac so I don't need any other complications.

Tia for your help and suggestions.

Cynthia

[slightly crunchy]

It sounds like you are asking for some advice, so...

If it were me, I would insist on having the 3 hour test. That is the only real way to diagnose GD. The one hour is only supposed to be for screening. And like you, I wouldn't want to be labelled with GD unless I really met the criteria.

That said, if it were me, and I had those numbers on the one hour, *even if I ended up passing the 3 hour*, I would follow a GD diet, and maybe go ahead and see the nutritionist and all of that anyway. And maybe not just because it will help with glucose levels, but because it seems like your doctor is already concerned, so if you do pass a 3 hour, is it going to be enough for him? A GD diet is not all that hard to follow once you get the hang of it, but it is more than just eating healthy foods. It is more about how you balance your foods. Like you said, eating very regular meals and snacks, but also limiting starches, and counting your carbohydrates for each meal and snack, while making sure you have a certain amount of protein each time you eat. Exercise is also a very good idea. It helps to stabilize blood sugars.

I have read a lot about GD because it runs in my family, and my first child weighed over 10 pounds. I really did not want that diagnosis with this pregnancy, so I proactively started eating a GD diet plan early on in pregnancy (though I have cheated quite a bit at different times). I passed the one hour test, but not by as much as I would have liked. I know there is a LOT of controversy over GD as a diagnosis anyway, and I don't know the answer. But like you, I am planning a VBAC, and I worried about anything else that would put obstacles in my way.

[peaceful herbivore]

Let me preface this in saying I am not a medical professional and this is just my opinion!

There are different schools of thought on the traditional GD test. I took the traditional test before switching to my midwife and passed thankfully, but my midwife, and many midwives think that the traditional glucose test is kind of crap and here is why.

It is not natural or normal to fast for 12 hours, then drink 8 ounces of artificial sugar in less than 5 minutes in a few big gulps. It pretty much shocks your system, and for people who are sensitive to sugar, as many people are, even people without diabetes---it can produce a negative effect or high number which is often misdiagnosed as GD.
My midwife performs a test where you fast for 8-10 hours, where you would normally be sleeping, then eat a specific breakfast that is formulated to a specific glycemic index...I don't know exactly what it is but just for example it would be something along the lines of:

2 eggs
2 slices of whole wheat toast
half a banana
4 ounces of orange juice

something like that, then she will test your blood sugar in an hour to see where you are. I personally think logically that makes more sense, and there is medical research to back that up as well. I think much of it can be controlled with diet, unless your sugar level is ridiculously high.

I would get a second opinion if I were you, or change your diet and get a personal tester to test for a couple of days at different intervals while on a specific food comination type diet. To me that would seem more accurate, but as I said, I am not a medical professional!

Take care!

[fireflies~for~me]

Read Henci Goer's research in The Thinking Woman's Guide...she clearly lays out why there is much question as to the validity of the GTT... 1 hour or 3 hour. Finally, many docs and midwives are not using it as the standard anymore. A post-prandial test should do the trick as above posters mentioned.

I can't recall my levels, but they were only borderline....failed both tests and immediately was on my OBs hot list for nonstress tests and ultrasounds and ...who knows what. I switched providers at 33 weeks-to a family doc who let it go if I did finger sticks (I agreed) and I found exercise really helped. DS was born on his due date and 8 pounds 3 ounces.

With this preganancy, I have an incredible CNM who is not even requiring me to do the post prandial or finger sticks. I do not have the risk factors and so it is not an issue.

All pregnant women should eat right and exercise, so why create stress for mama over something that may not be an issue?

[CathToria]

I have GD. I've had it with all 3 pregnancies, and I started having high blood sugar reedings at 5 weeks this pg. I take insulin to keep my blood sugars controlled. My 1st pg was diet controlled alone.

Personally, if I were you, I would rather test my own bs levels at home after eating regular, normal meals than tto take that 3 hour glucola test.... You probably will get a glucometer and a meal plan at the class that they signed you up for.

You will probably be able to control it through diet (think 6 small meals a day, with balanced protein, fat and low Gi carbs in each meal) and exercise. Exercise is a natural blood sugar lower-er.

As long as your blood sugar levels on paper look controlled, your pg should be treated the same as a non-GD woman.. and definitley the same as someone who took or didn;t take the 3 hr test.

HTH and good luck!

[savdoc2]

I can relate to what you are going through. When I was pg with my first DD, the OB said that I failed the 1 hour test and refused to allow me to do the 3 hour test. She told me it would be dangerous - I didn't believe her, but she refused to order it. She immediately sent me to the diabetes center for counseling (FYI, I knew more about nutrition than the counselor). So I was given a glucometer (finger stick style) and told to keep a log of everything I ate and do all the testing. BTW, I rarely eat any sugar, so any amount of added glucose is going to cause my blood sugar to rise. I never changed how I ate, but did the finger sticks as directed. When I returned to the daibeter center & Dr 2 weeks later, they looked at my meals and glucose levels and they were surprised - not one high level. At this visit, I explained to the diabetes center that finger sticks were making it impossible for me to work (I am a chiropractor and finger sensitivity is paramount to me) so she gave me an alternative site glucometer. It was at this visit to the OB, that we decided to change providers - she refused to allow me to repeat the 1 hr test, to do the 3 hr test, she immediately labeled me as GD requiring more invasive testing and procedures at the end of the pregnancy and she refused to follow any of my birth plan stating the we were "just going to have to trust her to make all the decisions".

I found a midwife about an hour drive away. She immediately ordered the 3 hr test. I did not have a single high level and the label was removed from my chart. I still continued to follow a high protein/low carb diet - as I had been doing this long before the 1 hr test, but I did not stress if I occasionally had pasta or ice cream.

Personally, I would insist on the 3 hour test or find another provider. Finding another provider was the best option for me.

[Cutie Patootie]

hope I don't get flamed here, but...I think there are very few real cases of gd. I think that everyones body needs something different at different times. Pregnancy changes your body heaps and heaps, but I rarely think that drugs are necessary to regulate what your body needs. That said I was diagnosed with severe "gd" with my first pregnancy. I was sent to a very prestigious womens hospital to be evaluated at their diabetes clinic. We ask questions, more questions, and more questions. They did not want to do any further testing besides the one hour. We insisted. I ended up doing a week of testing my blood sugars 3 times a day eating what and how I normally ate. My numbers came up high. I had an appt. the next week with the diabetes clinic but my dh and I decided not to go. The doctors there were furious. They called us and harrassed us 3 times that morning stating that had I come in they would have had me on insulin immediatly and that my case was severe. They were already talking about how my baby was big and that I would probably need a cs. We continually told them that we would manage my sugars with diet change, and that we were not comfortable doing the insulin. They said it wasn't possible. We did it and it worked. I ate little to no processed foods, I kept my carb levels low(no where near Atkins low ) and my protein levels high, ate 3 meals a day and 2 snacks. I was unable to exercise(a big factor in keeping your sugars down naturally) because I was on bed rest for other complications. I lost 25 lbs eating tons of food and super healthy...on bed rest!...eating more food than I have ever eaten in my life including ice cream on most nights :LOL and my sugars were well under control. My baby was not big at all...6 lbs 12 oz.
It is amazing what your body can do with your help and without drugs. I will add though that anytime I ate processed foods my numbers soared. Processed meaning frozen foods, frozen dinners, soda, high carb breads with lots of ingredients, etc. I wish my brain was as smart as my body. :LOL If it was I would have kept it up after I had ds.
I also ran screaming from that miserable hospital and my ob at 7 months pregnant. When I gave birth to ds, my new ob said, "it's a good thing you avoided insulin, it can cause low birth weight and breathing complications". Do you think the diabetes clinic would have ever copped to that?

[CathToria]

I just wanted to add... I HATE having to take insulin. I take as little as possible to keep my numbers just within range. At 5 weeks... no matter what I did diet wise, i could not keep my am fasting bs levels under 110 or 120. I understand that high bs/diabetes in early pregnancy is teh "real" serious time, and can cause birth defects.

My endocronologist early on gave me a scrpit for quick acting insulin.. saying, "this way, if you want to eat something, just take more insulin".... that is so not me, as I pretty much eat a very healthy diet full of whole foods. I went round and round with him, explaining that i would rather just avoid the "bad" foods instead of taking insulin.

But as my pg has progressed, I need more and more insulin, even when I eat very low GI foods. I really hate taking it, but i feel like my body just must be sensitive to teh pg hormones making my own insulin factory not work. I get over it in my mind by assuming that taking the shot is just like supplementing my body teh way a "normal" pg woman's body would just naturally put out more insulin.

I really wish I didn;t have to take it, but my numbers just seem too high not too....... So I'm not just taking teh "easy" way out.

[seren]

I have GD with this pregnancy. I did the one hour and failed horribly. That was after eating a very high protien breakfast. Then did the 3 hour fasting and failed it misserably. Even my fasting was super high. So I do finger sticks four times a day and have a strict diet. It's not as bad as I thought it would be. I eat lots of veggies, lots of protien, and even more carbs than I thought I would be able to. It's hard to learn what will and won't affect your sugars. But I finally have them under great control. I was scared for a while I would need insulin, but so far have been blessed. I don't want insulin because then I have to deliver in the hospital. But my midwife is great and she works with me. And if I do what I need to for my baby then I don't need a c-section. What caused me some stress at first was that when my sugars are high my body makes more insulin, which Madalyn gets. But she doesn't recongnise it as insulin, but as growth hormone. I had an u/s almost 9 weeks ago and she was 3 lbs, instead of the 1.5 she should have been closer to. But I have things under control now. I have met with a nutritionist 3 times and have my diet all set up. We have a certian number of carbs and protiens at each meal, plus 3 snacks. If you would like I can give you that info, if you would like to try it. It's just eating more healthily. And I am losing an average of 1.5 lbs a week. I am very overweight, so I have it to lose. Anyways, it's not as bad as I thought it would be.

[Luvbnmama2alex]

I really appreciate everyone who has taken the time to reply to my post. It's great to hear different perspectives and opinions.

I don't know what to think about GD at this point, though. It does seem to me that too many women are diagnosed for it not to be a normal response to pregnancy, but then I think that some responses may be more "normal" than others. Kind of like jaundice in a newborn?

My big concern about ignoring this, is possibly creating a situation in which I will be considered and treated as high risk, not to mention uncooperative. Fortunately, there are 4 drs in the practice and I really like one of them and we are going to see him this Monday. He was the back-up for the homebirth midwife I had with dd which is why I chose this practice this time. He created the menu for the post-prandial test my midwife used with her clients. He's very respectful and will give me the facts and let me decide what to do for myself. I really need my drs. on my side if I'm going to have a successful vbac and this is the most vbac supportive practice in town. Of course, my baby has somersaulted and is now breech, but that's a topic for another thread.

My appt. to see a counselor at the Diabetes Center isn't until this Friday which has given me a lot of time to learn about GD. I've also written down everything I've eaten for almost two weeks now so I won't have to remember off the top of my head. I've been pretty good about eating 3 meals and 3 snacks a day and it's really cut down the desire for chocolate covered cranberries and Jelly Bellys. I've also increased my protein intake and cut my carb intake - it's hard to find a balance, though, when I don't know what the counselor will recommend. What seems to be a common combination?

I did talk to my naturopathic dr. and she said to have a protein in each meal and snack. Kind of tricky as a vegetarian, but I'm eating cheese, beans, eggs, Quorn products, rice protein powder, and cashews (I don't eat peanuts and soy while preg. or nursing). Today, I bought low-carb bread and tortillas, ricotta cheese, cottage cheese (ick), and a high-fiber, no sugar (artificial or otherwise) cereal. I checked out many of the low-carb food options, but most had artificial sweeteners which I don't eat. I have been using xylitol in my oatmeal. My naturopathic dr. also mentioned a study showing that cinnamon lowers bs levels. I bought a cinnamon supplement today but it says it takes 40 days to achieve best results so I don't know if it will be valuable. Anyone taking cinnamon?

Also, I will begin exercising soon. I'm waiting for the rain to stop and it to warm up some. Plus, I'm trying to figure out how to walk everyday with a spirited 3-yr old who won't stay by my side. Any suggestions will be welcome.

Would someone mind telling me what my appt. with the counselor might be like? Also, is the glucometer she gives me all I need to check my blood or will I need to get test strips and lancets? Does she charge me for the glucometer? Is it usually a good one or could I get a better one on my own. My insurance is supposed to pay for diabetes supplies, after the deductable, of course.

I also plan to read what Goer's says about GD before bed tonight. Then, I'll see the counselor on Friday, and the dr. on Monday and try to put it all together.

Cynthia