Was going to refuse 3hour glucose test but now not sure??

[Love2learn]

I was 10 points high on the one hour.
I've been testing my blood sugar. In the mornings it is around 105. Once it got up to 111 but that only happened once.
1 hour after a meal it is usually 140 or slightly above. It is also borderline 2 hours after a meal.
I ate meatloaf for dinner (lots of ketchup) and it was 160 1 hour after and 130 2 hours after! That has me a little worried.
Does this look like I am gestational diabetic??
I REALLY don't want the diagnosis if I can manage it on my own. My dr is sure to give me lots of ultrasounds at the end and a csection.
Is it possible to manage this on my own? Or am I probably already GD? I am 20 weeks.

[chaoticzenmom]

I refused the 3 hr, but I did go see a nutritionist and test my blood on a regular basis. It was the best decision ever. I have had the 3 hour and it's not fun. I passed the 3 hr with my first pregnancy, but I learned so much when I just told the dr. to pretend that I was diabetic and send me straight to the nutritionist.

Good luck with your decision. I'm not sure about your numbers though, it depends on other factors. There's sugar hidden everywhere!

Lisa

[Love2learn]

Thanks
That's what I was wanting to do- go see the nutritionist, do the diet, check levels. But in order to do that I would have to take the GD diagnosis which labels you as high risk. They won't let you go over and you'll be induced if you have GD.
I am really wanting a natural birth. They also do lots of ultrasounds which can be inaccurate and lead to a csection.
This is all so stressful and frustrating!

[Pastrydemon]

I would for sure see a nutritionist. The guidelines my perinatolgist uses are under 95 for fasting and under 120 at 2 hours post-meal. He says the 1 hour-post meals are useless for pregnant women as your stomach empties more slowly during pregnancy. Tweaking my diet helped my numbers a lot. I had been eating a protein snack right before bed and my numbers were in the low 100's/high 90's for fasting. I switched to a carb/protein snack an hour or two before bed and they're way lower now. You can play around and find out what works for you.

Also -- I skipped the 3 hour. I was 2 points over my 1 hour but I'd been testing at home and knew there was a problem. My OB referred me to the perinatologist (mostly so I could get my inurance to cover the dietician) on the basis of my home-testing alone.

[Pastrydemon]

Originally Posted by Love2learn

Thanks
That's what I was wanting to do- go see the nutritionist, do the diet, check levels. But in order to do that I would have to take the GD diagnosis which labels you as high risk. They won't let you go over and you'll be induced if you have GD.
I am really wanting a natural birth. They also do lots of ultrasounds which can be inaccurate and lead to a csection.
This is all so stressful and frustrating!

Didn't see your last post.....I had GD with my last pg and had a totally natural birth attended by midwives. I had to fight a bit (they had to refer me to a perinatologist) to avoid some excess ultrasounds though. This time, I have a good OB (insurance issues) who is pretty hands off and willing to let me go to almost 42 weeks (well, I have to have NSTs) but is pretty relaxed about the GD in general. She's not pushing a c-section at all -- and this baby is estimated to be almost 10lbs already. DD was 10lbs8oz.

Just wanted to let you know that you can still have a natural birth, even if you have to fight the "high-risk" label some.

Best of luck!

[danotoyou2]

I had both tests with first pregnancy. Barely passed the 3 hour test, and switched to a midwife who had me drastically later my diet. It made a huge difference.

In my second pregnancy, I knew I had a problem, so I refused both tests and adjusted my diet from the beginning. I knew the feeling when my glucose was too high, and I'd be careful to not get that feeling. It meant eating eggs for breakfast for 9 months. Eck. But hey, I managed it with diet, so it can be done.

I did not want the label, because I knew it would lead to more interventions (or attempts at intervention). I think as long as you test at home and are careful, get a nutritionalists advice, etc., you can not do the 'official tests.'

[Mommal]

Hi! From the numbers you have posted, it looks like you would be diagnosed with GD at almost any practice you went to. (Sorry! )

105 is considered to be a high fasting number. Most guidelines suggest that fasting numbers of 70-85 are optimal. A lot of practitioners recommend starting insulin or a medication like Metformin or Glucophage at fastings above 95.

Generally, post-prandial (after meal) numbers are supposed to be below 140 one hour after the end of a meal, and below 120 two hours after the start of a meal. So, again, you are a bit high.

This does not have to mean the end of a healthy, happy pregnancy, and it does not rule out having a good birth! Talk to your practitioner about this. Ask what their approach to GD is. If you hear "Women with GD usually need to be induced" or "GD makes it highly likely that you will have a huge baby" or "GD mothers should never be allowed to go past 40 weeks gestation" or "GD mothers need more monitoring during birth" or anything that sounds wrong, consider finding another practitioner! I left my original practice around 20 weeks, and found a midwife who helped me have a terrific birth experience!

Do you need the 3-hour test? No. It's nasty, and if you're willing to do daily sugar testing anyway, it's irrelevant. The daily monitoring is much more informative than the test. But it's not like you will escape your practice's attention just because you didn't take the test. They've probably already flagged your chart due to the high one-hour test result. So I would be upfront about it, and get the full scoop on how you will be treated if you have GD.

Should you try to manage GD on your own? You can definitely give it a try and see what your levels are! Going on the GD diet is not hard, and getting more exercise is a great idea regardless of your GD status.

Here are the guidelines I followed, with meal examples:
-Breakfast: 15-30 g complex carbohydrates plus some protein (think half a cup of oatmeal with plain soy milk and a hard-boiled egg)
-Walk at least 10 minutes (I was actually walking 30-45 mins)
-Snack: 15 g complex carbohydrates plus some protein (nuts and raisins)
-Lunch: 30-45 complex carbohydrates plus some protein (think turkey sandwich on whole wheat)
-Walk again
-Snack: complex carbohydrates plus some protein (nuts and raisins again)
-Dinner: 45 g complex carbohydrates plus some protein (1/2 cup couscous with grilled chicken breast)
-Walk again
-Bedtime snack: 15 g complex carbohydrates plus some protein (cheese and crackers)

I hope that a little work on your diet and exercise regimen will bring your numbers under tight control. Good luck!

[Mommal]

Hi! From the numbers you have posted, it looks like you would be diagnosed with GD at almost any practice you went to. (Sorry! )

105 is considered to be a high fasting number. Most guidelines suggest that fasting numbers of 70-85 are optimal. A lot of practitioners recommend starting insulin or a medication like Metformin or Glucophage at fastings above 95.

Generally, post-prandial (after meal) numbers are supposed to be below 140 one hour after the end of a meal, and below 120 two hours after the start of a meal. So, again, you are a bit high.

This does not have to mean the end of a healthy, happy pregnancy, and it does not rule out having a good birth! Talk to your practitioner about this. Ask what their approach to GD is. If you hear "Women with GD usually need to be induced" or "GD makes it highly likely that you will have a huge baby" or "GD mothers should never be allowed to go past 40 weeks gestation" or "GD mothers need more monitoring during birth" or anything that sounds wrong, consider finding another practitioner! I left my original practice around 20 weeks, and found a midwife who helped me have a terrific birth experience!

Should you try to manage GD on your own? You can definitely give it a try and see what your levels are! Going on the GD diet is not hard, and getting more exercise is a great idea regardless of your GD status.

Here are the guidelines I followed, with meal examples:
-Breakfast: 15-30 g complex carbohydrates plus some protein (think half a cup of oatmeal with plain soy milk and a hard-boiled egg)
-Walk at least 10 minutes (I was actually walking 30-45 mins)
-Snack: 15 g complex carbohydrates plus some protein (nuts and raisins)
-Lunch: 30-45 complex carbohydrates plus some protein (think turkey sandwich on whole wheat)
-Walk again
-Snack: complex carbohydrates plus some protein (nuts and raisins again)
-Dinner: 45 g complex carbohydrates plus some protein (1/2 cup couscous with grilled chicken breast)
-Walk again
-Bedtime snack: 15 g complex carbohydrates plus some protein (cheese and crackers)

I hope that a little work on your diet and exercise regimen will bring your numbers under tight control. Good luck!

[applejuice]

Originally Posted by Love2learn

This is all so stressful and frustrating!

Which in itself can lead to high glucose levels and gestational diabetes.

Relax, and go see a nutritionist on your own, that is, out of pocket. It is worth it.

My DH and I were given an appointment to see a nutritionist only after he was determined to be terminal through our health plan; so much for "health". So do not wait for someone to "O.K." your appointment to see a nutritionist. Do it yourself as it is worth it.

[savithny]

Originally Posted by Mommal

105 is considered to be a high fasting number. Most guidelines suggest that fasting numbers of 70-85 are optimal. A lot of practitioners recommend starting insulin or a medication like Metformin or Glucophage at fastings above 95.

Can I ask if those numbers have been changed or depend on the lab?

I did the 1-hour glucose test 2x with my first pregnancy (suggested becuase I started overweight) and 1x with my 2nd.

Each time, my results came back right around 95-99.

The results slip told me that for the test, the "normal" range was something like 80-120 -- it was centered around my score, whatever that was.. Midwife was always pleased with my results and said they were "Perfectly normal."

Is the one-hour not a "fasting" test, because you fast and then drink the sugary syrup?

[Mommal]

Originally Posted by savithny

Can I ask if those numbers have been changed or depend on the lab?

The one-hour test is totally different from the fasting number. On the one-hour test, you come in fasting (although this isn't strictly necessary), drink the glucose solution, and then get your blood drawn 1 hour later. A normal result for the one-hour test is any number above 60ish (below 60 or so is hypoglycemia. a.k.a. low blood sugar) and below 140 or 130, depending on the scale your practitioner prefers. So a result of 95-99 is EXCELLENT! That's extremely good blood sugar control.

The fasting number is the number you get if you test first thing in the morning before eating anything or drinking the sugar solution. It's a number you only know if you take the three-hour test or if you are self-testing. It should be between 70-85, optimally.

[Birth&Bunnies]

GD is a problematic diagnosis at best, some practitioners think it's a load of crap. Henci Goer has two good articles about it, the way it's managed and the outcomes...bottom line. Watching your carbs and refined sugar is important for all pregnant women, but the tests a flawed and the numbers do not take into account the normal way blood sugar behaves during pregnancy.

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

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