I just wanted to post this article I found, and I plan to use it this time around when I refuse the test.....
The American College of Obstetrics and Gynecologists (ACOG) said in a recent statement to the media that there is not one certain method to be used to effectively screen the pregnant population for gestational diabetes. They do not, however, know what screening is best or agree on when the screening should take place.
One of the most intriguing recommendations is that a woman may not need laboratory testing to screen for GDM if she meets all of the following criteria:
less than 25 years old
not a member of a racial or ethnic group with a high prevalence of diabetes (eg, Hispanic, African, Native American, South or East Asian, or Pacific Islands ancestry)
a body mass index (BMI) 25
no history of abnormal glucose tolerance
no previous history of adverse pregnancy outcomes usually associated with GDM
no known diabetes in first-degree relative
Women who are at a higher risk for GDM usually have one of the following risk factors:
family history of diabetes
past obstetric history
While diet and exercise are the mainstays of treating GDM, there are not a lot of concrete studies indicating that one way is best for anyone. While it has been popular in the past to place women with GDM on restrictive diets, particularly caloric intake, ACOG now advises that this may not be desirable. In fact, they state quite clearly that even if one chooses to restrict caloric intake no more than 33% of the calories should be removed from the woman's diet. Though the focus should definitely be on proper nutrition and eating habits. When conventional therapies involving diet do not bring about the desired changes in glucose levels insulin should be considered.
Other things that were long held in popular belief for women with GDM includes routine early induction simply because they had GDM. "When glucose levels are under control, and no other complications arise, there is no strong evidence to support routine delivery before 40 weeks of gestation," says the report issued on August 31, 2001. They gone on to report, "Although cesarean delivery rates are higher in women with GDM, ACOG notes that there are no data to support a policy of cesarean delivery purely on the basis of GDM."
by Robin Elise Weiss, ICCE-CPE, CD(DONA), CLDhttp://pregnancy.about.com/cs/testin.../bl100101a.htm