3 hr GTT I need info! UPDATED post #22

[aslmere]

I tried to do a search but it brought up EVERY post that had the word test in it.
TOO MANY!

So I get a form letter today from the OB office saying my one hour test came back a little elevated. It said that I needed to follow a HIGH carb diet for 3 days and then fast for 12 hours and then go to the lab where they will give me more crap and draw levels at 1,2 and 3 hours.

There were no numbers or anything about why I needed to have this done.... no personal contact... just the stupid letter.

I have never failed the one hour before. So this is all new to me.

It seems really weird to me that they want me to carb up for three days and then go do a glucose test.... wouldn't that mess with the results?
Not to mention my body isn't going to be able to handle fasting for 12 hours and then drinking that drink.

I am not in a position to outright refuse this testing...not to mention I am really unsure of the ramifications of GD (other than a big baby...which doesn't worry me as much as other things could)

So do I just go ahead and take the test as outlined?
Do I eat my normal diet and then fast for 12 hours and take the test?
Do I call and refuse to take the test until I have actual numbers from the one hour?
I was supposed to have an appt on tues, but rescheduled for the next week so that my next us results (cervical length) would be known before I see anyone.
Feeling like maybe that was a bad move........

Tell me about this test and then tell me about GD.

Thanks

Nina

[Dea]

From what I understand regarding GD and babies is that there are far more ramifications than a large baby. That baby can be at more risk for diabetes, obesity and other insulin and sugar issues.
I do think though that your care provider should give you more information. After all it's your baby and your body, you have every right to be informed and make a choice based on that. I hate how some doctors and providers have the "pat you on the head" mentality where you're just supposed to trust them, and they almost belittle you for trying to learn something.
I would absolutely call your doctor/ midwife/ care provider and ask questions. You deserve to know! I think you're right to question the results and why they want you to carb load.
Good luck! I hope you pass with flying colours!

[aslmere]

Originally Posted by Dea

From what I understand regarding GD and babies is that there are far more ramifications than a large baby. That baby can be at more risk for diabetes, obesity and other insulin and sugar issues.

And those ramifications are exactly what I want to know about.
The only thing I have ever really heard is the big baby thing.. and honestly that doesn't scare me.

If I DO have GD I want to know.
I understand that it is important to keep it under control. And I am at the point where I need to realize exactly why.

BUT I don't want to give into panic now. I want to know what "a little elevated" means. And why I wasn't told my numbers......
I will be calling on monday and asking my questions and NOT be satisfied with a pat on my head.... I got that when I questioned why they needed 5 vials of blood for the 1 hr test.
Noone told me that they were testing for a bunch of other things too and I didn't like that. Not to mention some of the tests were redundant..having been run at my first appt.

Thanks so much

Nina

[sarahn4639]

I think doing the carb loading and fasting for so long is very hard on your body and does not provide accurate results. I would talk with your doc at your next appt and tell them you will not do the 3 hour GTT but will use a glucometer at home for the next 3 days or what ever. Do waking (fasting) readings and before and after meals however they want. This will atleast give you actual real life data and won't cause a strain on your body. I would also recommend just following a diabetic diet, low carb (low sugar and simple carb atleast) and high protein. It's a pretty good way to eat for most people anyway. That's what I would do, I hope it goes well for you!

[elizaMM]

you definitely deserve more information, sorry I can't provide it.

you said:
It seems really weird to me that they want me to carb up for three days and then go do a glucose test.... wouldn't that mess with the results?

Maybe they want to put a load on your pancreas etc. and then see how it responds under stress. (When they don't tell me why, I make something up-- I can't help it-- until I can find the truth.)

My understanding is that those initial tests aren't very accurate. They are just a starting point.

Good luck!

[BJSkolnik]

I just had a slightly elevated 1hr test and had to do the 3 hr but they said nothing about high carb. I generally follow a lowish carb diet anyway so I stuck with that and then did the 12 hour fasting and did just fine on the 3 hour. I hope you find out more info!!

[the elyse]

i would see about the glucometer test like the pp said...

i had a client that had a "slightly elevated" number as well... she ended up with a whopping 7lb baby.

if you want more info on the testing, see if you can get a copy of a thinking woman's guide to a better birth, i'm pretty sure she covers the topic really well.

good luck and bravo for being a concerned mommy.

[flapjack]

OK: first of all, did you take this test because that's what your OB told you to do and you didn't feel like arguing, or did you take this test because you were spilling sugar in your urine?
In your shoes, if the answer to that question is a) my OB told me, I would ask for a repeat 1 hour and consider using foods instead of the glucose drink if my numbers were more than 5-10% above where they should be. Cross-reference where they should be with other posters here to make sure all the doctors are giving the same information about desirable numbers.
OTOH, if the answer is b) then I'd get a blood glucose monitor, check sugar levels for a couple of weeks and then get the 3 hour test done. Having the information on your average levels before the test means that you're in a better position to make an informed decision about whether you will be accepting any treatment. You're already planning a hospital birth, it is possible to keep baby under close obs whilst rooming in (and it IS. Suspected GD is not automatic SCBU, they can transfer baby quickly enough if needed), so an indefinite diagnosis will not make a huge difference to your care unless treatment is offered.
Are you eating differently now than you were before you had the others? Women who routinely eat low-carb seem to find it harder to pass this test. It could be worth carb-loading for a week or more.

[smokeylo]

If you think GD is a serious problem, ask to monitor your blood sugar levels with a regular monitor, not do that BS test. That test is designed for failure! Don't take it.

[flapjack]

To clarify, if your numbers were only slightly elevated, I would take no action. If they were up by more than 5-10% on normal, I'd repeat the test, more than that I'd go to the 3 hour.
BUT (this is going to sound like a dig, I can't help it) you need to know that this test is only routinely carried out in countries without socialised healthcare. Whenever costs of maternity care are an issue, routine GTTs are considered a waste of time and a bad resource.

[cocoschmoco]

Here's Henci Goer's take on GD testing:

http://parenting.ivillage.com/pregna...,,9z3m,00.html

It's a good article, and she also talks about carb-laoding for 3 days beforehand to get your body used to the extra carbs, I think? Basically, the only risk is a bigger baby, but studies haven't shown the majority of big babies are from GD moms, even.

I would definitely insist on knowing what exactly your levels were - so shady they didn't tell you outright! I think Goer talks about how different places consider different levels passing or failing, so it's sort of arbitrary.

Oh, and Goer goes into how GD became a diagnosis in "Obstetric Myths vs. Research Realities", but not Thinking Woman's Guide...hth!

[firecat]

hey there, if you're into doing a lot of reading this site has a ton of links and info...

http://www.gentlebirth.org/archives/gestdiab.html

Let us know what happens!

[AlwaysByMySide]

With my second pregnancy, I failed the one hour and threw up the three hour, and refused to do another three hour. They had me do three separate blood draws, but by the time we got to that point after scheduling everything else, I was very late into my pregnancy.

I ended up being on insulin for about two weeks at the end of my pregnancy, which I think was completely ridiculous. (I was never able to get my sugars really under control, even with food and insulin.)

So, I would ask to move straight to blood sugar monitoring, if it were me. But that's because I had the unpleasant experience of dealing with insulin for what was probably no good reason last time.

[flapjack]

I LOVE the article cocoschmoco posted.

[operamommy]

Don't panic; chances are everything's fine. I just did a 3-hour test on Friday because my 1-hr test levels were elevated. It was the first time in all my pregnancies that I'd ever failed. Thankfully, I ended up passing my 3-hour. I *did* "fail" one of the blood pricks, but you only "fail" the entire test if you fail 2 blood pricks. As my doc said, I just made it.

I think it's really weird they didn't give you your levels, though, and I'd definately ask what they were.

[True Blue]

The carb-loading is actually a good idea, especially if you normally follow a healthy, low carb, or more complex-carb diet and avoid simple sugars. When you eat this way, drinking that nasty sugar drink sends your body into a sugar shock, and it overcompensates...giving you a false high reading.

Also, it's interesting to note they are planning on changing the levels at which they diagnose GD, making them LOWER...meaning more women would be diagnosed. I find it hard to believe that a very large percentage of the population gets GD and that it is actually dangerous.

Do a search for diabetes, or GD, or GTT...not "gd test" or something like that...you'll get search results that are more honed in.

[weeirishlass]

I'm not a fan of the gd screening, so I'd decline it, but if you feel you can't do that, I'd at least wait until after your next appointment to schedule it and talk to the doc/np/mw at your appointment. They will most likely urge you to take it, but some won't. I see a mw, but saw an ob the appt. they would have sent me for the gtt and told him I didn't want it, and he agreed with me that it is not really that necessary. In his words, they throw out a huge net and hope to catch one or two cases of gd. If you didn't develop it with previous pregnancies, you are probably safe this time. Also, the course of action taken to treat gd is a low carb, high protein, low sugar diet, so if you already follow some variation of that, there's not really any need for the test.

[aslmere]

Thanks everyone for the information!

The office is closed today, but tomorrow I will be calling and questioning.
I want to know the exact numbers. I know that the nurse will tell me I just have to do it and you never get to talk to the doc on the phone unless it is an emergency.

DH says I need to just go and get it done no matter what the numbers were :

Thanks for links too.. very helpful.
I do have an actual appt with the OB next week and he tends to be someone who likes to give options and let you choose. He has been at births for my last 3 appts though and so I am starting to think I am never going to see him!
If he and I could come up with a good option that would be great.. however if he says I need to do it then I need to... I don't have the option of refusing... long story.

I have been really sick this weekend and so I am putting of DH by telling him that I need to be all they way better for at least 3 days before I take the test
But I won't just go and do it until I talk to the OB.

I am not so nervous about the actual possibilities of having GD anymore...

Thanks
Nina

[lovetobemama]

Hope things go well with the Dr's visit. I like the "3 healthy days" rule for your dh and taking the test!

[Nikki Christina]

i failed my 1 hour last pregnacy & did the 3 hour. at the time i didnt question it..but then i found out my 1 hour had only been a teeny bit elevated.
& the 3 hour made me sooooooooooooooooooo sick. i seriously got scared that last hour i felt so awful. it cant be too good for a baby

i wont do it this time unless really really necessary
id ask to repeat the 1 hour & if i failed again id request the sugar monitoring as suggested above