GTT and diabetes

[Taradactyl3]

I had GD with my first. This time they tested me at 12 weeks and I scored 137. They said last year the cut off was 140 but it was moved to 135 this year in order to catch any borderline cases, so now I'm ordered by the MW to go take the 3 hour test. I was told I was border line on both 1 hour and 3 hour tests with my last preg and I'm disappointed and frustrated that I can't get a few points lower. This time I'm taking Juice+ since some research shows it has a lower percentage of women on it diagnosed with GD. I am thin, excersize regularly, and have no family history but I do have a sweet tooth. I don't eat much meat and I can't eat peanuts so I find it difficult to get extra protein in my diet w/o feeling hungry all the time (and I'm only 108lbs at 15 weeks). Is there any help or hope for me passing this 3 hour test?

Thanks,
T

[Reha]

Why struggle to pass a test that is meaningless and shown to be worthless in terms of outcome? Why not just decline?

70% of those who test positive on the OGTT will have normal results if retested at a later time. I could go on and on about the GTT and

Gestational diabetics’ babies are not at any additional risk for anything other than being slightly larger (and only a small percentage of the time).

It has been said (can't remember who) that GD is a diagnosis still looking for a disease. : While there are a small number of women who may have undiagnosed TRUE diabetes during pregnancy (and there are lots of possible risks with true diabetes), these women will be feeling bad, and be having symptoms of blood sugar issues anyways.

The threshold values used today to diagnose gestational diabetes are actually LOWER than those used to diagnose true diabetes in non-pregnant people, in spite of the fact that during pregnancy, one of our bodies adaptations is to make more glucose circulate in our blood (so that it is available to our baby). Pregnancy is a diabetogenic state.....and that is perfectly normal.

Do you mean that you feel hungry all the time? or just when you are trying to get enough protein? There are lots of protein sources aside from meat and peanuts. Beans, whole grains (like 100% whole wheat bread), dairy (eggs, milk, cheese, ice cream, yoghurt), etc. I think that if you are eating regularly (at least every 2 hours in the daytime) and try to always eat something with protein and eat to appetite, you should be fine.

I'm sorry that I don't have advice for how to pass the OGTT, as I think it is a test with no value. Do you have any actual symptoms of blood sugar problems (hyperglycemia or hypoglycemia)?

[Taradactyl3]

I do have some symptoms. I have blurry vision this pregnancy and I'm extra thirsty. I wake up around 3am very thirsty for cranberry juice and could just guzzle it. I'm super tired all the time, but really in pregnancy, who isn't tired, right?

I was talking about being hungry all the time when on the diabetes diet. It's esentially atkins diet and it just doesn't fill me up.

I have to agree with you about a lot of this stuff but I do like my MW and she is a stickler for this test apparently.

Thanks,
T

[Reha]

It isn't uncommon to be super thristy in pregnancy, as well as to have fuzzy vision (mainly due to the extra fluid volume circulating through your body).

The diet most providers put you on for GD does way more harm than good, and hasn't been shown to improve outcome.

Perhaps approaching your midwife and asking her what her major concerns are about GD. IS she worried about a big baby? Why does she insist on it so? Is it going to risk you out of her care?

I'm sorry that I am so down on GD screening. I would bet that if you approached it with research and information, she may not agree with you, but she may respect your choice to decline testing, or to decline following the GD diet.

[courtenay_e]

Anne Fry has a great chapter about this in her book "Understanding Diagnostic Tests in the Childbearing Year" She explains the history of the GTT and the diagnosis if GD. She talks about the fact that very few providers actually give you all of the test, which most often makes for inaccurate results. You see, you are supposed to carb load with healthy carbs for at least three days before the test. Either test. Did your midwife tell you to do this? Did she give you a list of the kind of carbs you should be eating to get the most accurate numbers off of the GTT? If not, let me know and I'll see if I have the sections I copied for a friend in my computer's memory and I'll send it to you or post it here. Let me know.

[chandasz]

Originally Posted by Lennon

Gestational diabetics’ babies are not at any additional risk for anything other than being slightly larger (and only a small percentage of the time).

While i agree with much of what the pp says... this is just not true. True diabetes also shows a higher risk for stillbirth and needs to be taken seriously.

I think the tests are bunk though. You are putting your body into a very unnatural position. When else do you consume that much sugar in a short time and when else do you starve yourself?

Thirst and blurry vision CAN be normal in pregnancy. I know I experienced this.

I would say that with a "borderline" diagnosis-- I'd feel comfortable with skipping the 2nd test. I would just pay good attention to my diet and get an appropriate amount of exercise.

These numbers they use are so freaking arbitrary. One day they say 140, the next 135... next year they'll decide 125 just in case.

Pay attention to your body. If you don't feel well- then make other decisions.

You get labeled as GD, you will be facing a limitation of choices available. They will start considering you high risk. They will start pushing induction if you are not early. They will start deciding that they can tell this baby is big and telling you that you need to have it early or face c-section-- then likely give birth to a perfectly normal-sized baby.

Do some reading about this. GD is VERY contraversial

[Reha]

Originally Posted by chandasz

While i agree with much of what the pp says... this is just not true. True diabetes also shows a higher risk for stillbirth and needs to be taken seriously.

YES, stillbirth is a risk of TRUE diabetes (type 1 and 2), NOT of gestational diabetes. They are very different, and it is a fact that stillbirth is not associated with gestational diabetes, but only with type 1 and 2 diabetes.

So many people refer to GD as a form of true diabetes, and it simply is not.

[Reha]

Originally Posted by courtenay_e

Anne Fry has a great chapter about this in her book "Understanding Diagnostic Tests in the Childbearing Year" She explains the history of the GTT and the diagnosis if GD. She talks about the fact that very few providers actually give you all of the test, which most often makes for inaccurate results. You see, you are supposed to carb load with healthy carbs for at least three days before the test. Either test. Did your midwife tell you to do this? Did she give you a list of the kind of carbs you should be eating to get the most accurate numbers off of the GTT? If not, let me know and I'll see if I have the sections I copied for a friend in my computer's memory and I'll send it to you or post it here. Let me know.

I recently read that carb loading has been recently shown to not have much difference on results. The most recent copy of 'Diagnostic Tests' is almost 10 years old, I believe (though it is still VERY valuable!).
It is still worth a try, though, if you are going to consent to the test.

[Taradactyl3]

Originally Posted by courtenay_e

Anne Fry has a great chapter about this in her book "Understanding Diagnostic Tests in the Childbearing Year" She explains the history of the GTT and the diagnosis if GD. She talks about the fact that very few providers actually give you all of the test, which most often makes for inaccurate results. You see, you are supposed to carb load with healthy carbs for at least three days before the test. Either test. Did your midwife tell you to do this? Did she give you a list of the kind of carbs you should be eating to get the most accurate numbers off of the GTT? If not, let me know and I'll see if I have the sections I copied for a friend in my computer's memory and I'll send it to you or post it here. Let me know.

She did give me a three day diet for before the test.

I'm super overwhelmed now. I was hoping to feel better about this but all the conflicting info is making it worse. I had GD with my first and was on the diet and was 4 days "overdue" and birthed a slightly above average 8lb 5oz baby in perfect health. I'm just going to follow my gut and try to limit the indulgences in my diet (I do have a sweet tooth) and believe that this babe will have a similar birth and health.

T

[Reha]

Here is a good article by Henci Goer on the topic, full of referenced studies.

From that article:
"We now know that GD doesn’t increase the risk of stillbirth or congenital malformations (4). A couple of modern studies have concluded otherwise, but they didn’t take into account that women with high blood sugar are more likely to have other risk factors for poor outcome, or that some women had undiagnosed diabetes prior to pregnancy (17,24). Indeed, the fact that these studies were of women whose blood sugar had been normalized by treatment proves that GD is not the culprit. Besides, GD testing and treatment could not affect the incidence of congenital malformations under any circumstances, because testing isn’t done until the third trimester. By that time, the baby is long since fully formed."

[Reha]

Originally Posted by Taradactyl3

I'm just going to follow my gut and try to limit the indulgences in my diet (I do have a sweet tooth) and believe that this babe will have a similar birth and health.

Good plan.