is glucose test mandatory? - Mothering Forums

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#1 of 28 Old 06-09-2011, 07:01 AM - Thread Starter
 
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My midwife didnt make me go through it last time - she said it wasnt necessary since i had no warning signs at all.  My current midwife was sick at yesterday's appt and the intern i met with was pretty clueless on many things so I didnt even ask.  I left with a slip to do it next week (28 weeks) but really dont want to :(

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#2 of 28 Old 06-09-2011, 07:26 AM
 
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No, you don't have to do anything----you don't have to submit to any test or procedure that you don't want to.  You're an adult, it's your body, and you have the ability to refuse. However, because you're only 28 weeks pregnant, it is possible that your providers could 'dump' you if you refuse to comply with their policies.  They cannot, however, refuse to treat you once you are beyond a certain number weeks' gestation. . . and my pregnant brain for the life of me can't remember if it's 36 or 37 or what.  Anyone?  

This might help, but I don't have time to weed through the whole website:
Emergency Medical Treatment and Active Labor Act  FAQ
 


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#3 of 28 Old 06-09-2011, 07:46 AM - Thread Starter
 
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that was my take on it as well - I guess part of me wants to make sure Im not saying 'no" to something necessary- i will chat more with them in 2 weeks when Im hopefully not talking to a 20 yr old who tells me "nap when she naps" when I say my 4 yr old can be challenging - she hasnt napped since infancy!! - Or asks me "Oh my, what's WRONG with her?!?!!?" when I say I get bummed out at times by my 4 yr old's behavior.  Oh jeez, I could go on and on - it was a waste of an appt.

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#4 of 28 Old 06-09-2011, 08:19 AM
 
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I just had to sign a form saying I declined it.


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#5 of 28 Old 06-09-2011, 08:36 AM
 
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That's the thing.  Dont decline it just for the sake of declining it.  Read up on what the test does a little more and see if you're at risk for developing it.  I took the test, I tend to gain a lot of weight with pregnancy and I have a sweet tooth.  If I need to watch my sugar to make sure this LO is ok (and that I'm ok) then I want to know.

 

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that was my take on it as well - I guess part of me wants to make sure Im not saying 'no" to something necessary.


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#6 of 28 Old 06-09-2011, 08:41 AM
 
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You an decline any test you want. Of course, a provider has right to fire you and refuse to treat you (there are limits as far as EMTALA).

 

On the other hand, it is not a diffiucult test to have and not everyone had obvious sings of diabetes early on..

 

 

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#7 of 28 Old 06-09-2011, 09:01 AM
 
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My mws did a finger prick test, though, and my blood sugar was great.  I dunno if that's something they would consider doing.  I had no risk factors (not even over 25), so I didn't want to subject myself to it, and my mws said they aren't big on GD anyway.

 

The form I signed, explained the test and risk factors, as well as what declining meant.


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#8 of 28 Old 06-09-2011, 09:58 AM
 
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I've always had the test done but this time my OB didn't even mention it. No idea why but I wasn't about to look a gift horse in the mouth.


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#9 of 28 Old 06-09-2011, 11:15 AM - Thread Starter
 
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I tend to NOT gain a lot of weight, eat really well,  exercise daily, low blood pressure and have had no symptoms/concerns.  I think my fear is that it'll test inaccurately and ill end up being treated for something that wasnt a problem in the first place.

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#10 of 28 Old 06-09-2011, 11:19 AM
 
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I always had the first glucose test, but after the first pregnancy, declined the 3hr glucose test.  I offered to treat myself as if I had gd and went to nutritional counseling and did blood sugar testing on myself.   That actually gave me a lot of useful information.  The first time, I gained 65lbs and I always have big babies, plus my mother had GD, so I felt like they missed my gd and sure enough, when I started using the gd diet and testing my blood sugar, there was definitely something going on. 


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#11 of 28 Old 06-09-2011, 11:26 AM - Thread Starter
 
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Curious- what was your reason for declining?

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#12 of 28 Old 06-09-2011, 12:13 PM
 
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Quote:
Originally Posted by nald1 View Post

Curious- what was your reason for declining?



me?  I declined because the 3hr test felt like torture to me and in the end they found nothing, where I felt like there actually was something.  I asked the dr. to let me skip the 3 hour and just assume I was positive and they were fine with that.


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#13 of 28 Old 06-09-2011, 02:08 PM
 
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I think for some people, they choose to decline because of how your care providers will treat you if you come up positive (pushing for early induction, c sect, etc). If you are going to ask questions at your next appointment, you might want to ask, what happens during the rest of your pregnancy and during birth if you test positive?

 

Personally, because I have a family history of diabetes and I'm overweight, I wanted to test. But since I didn't want to drink the nasty orange drink, my care provider gave me the option of eating jelly beans instead. Others eat a very carb-heavy breakfast, and others just get a glucose monitor and self-monitor for a couple of weeks. You could bring these things up to your provider and see what they say.


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#14 of 28 Old 06-09-2011, 07:36 PM
 
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The only risk factor I have for GD is my age (a few years over 25).  I am super healthy, slender, I eat very healthfully, I have no family history of practically any disease, let alone diabetes.  I declined the 1-hour GTT, because I don't think it's a very accurate test.  I think a lot of people "fail" who don't actually have GD.  I also wonder how many people pass who do go on to have trouble with maintaining sugar levels.

 

To be certain that all is well, I got a glucose monitor like diabetics use to test my sugar levels at home.  I am very grateful I did, because it turns out that my body is having trouble keeping my blood sugar levels in a safe range.  I have altered my diet pretty seriously in the last 10 days, which has made a big difference in my ability to keep my levels under control (though my fasting level is still in the GD range most mornings.)  My homebirth midwife knows about all of this. My back up care does not, because I want more time to try to control my sugars with diet changes before I allow them to label me diabetic.  However, if another week of careful meal planning does not help me get my fasting levels on track, it would be in my best interest (and my baby's best interest), to pursue further care.

 

I write this to encourage you to find an alternate means of seeing how well your body is coping with maintaining sugar levels should you skip the 1-hour test.  I really would not have guessed that would have trouble!  I'm one of the healthiest people I know!  I had no symptoms, no warning signals of any kind.


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#15 of 28 Old 06-09-2011, 08:02 PM
 
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I skipped it during my first three pregnancies.  They can get pissy or annoyed all they want to...it's not mandatory.  If you don't want to do it...then don't!

 

I only agreed to it this time because I had some concerning symptoms.  Otherwise I would have had no trouble saying "no thanks" to it again.

 

I also always refuse the GBS.  That is harder to get out of, but certainly not impossible.


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#16 of 28 Old 06-09-2011, 11:47 PM
 
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Quote:
Originally Posted by cat13 View Post

If you are going to ask questions at your next appointment, you might want to ask, what happens during the rest of your pregnancy and during birth if you test positive?


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If the worst that will happen is just an "oh, we'll have you change your diet," then you probably don't have much to lose (although if you're already eating especially healthily, you don't have much to gain either).  I think for a lot of women, a diagnosis of GD can lead to more pressure for early induction, C-section, or can risk them out of a home/birthcenter birth.  It can be used as ammunition for extra monitoring, and can add a lot of stress to an already VERY stressful time.  Those are all pretty big issues.

 

For me, the test sounded like a pain in the ass, and I didn't really have much to gain by taking it.  I eat as healthily as I can, GD or not.  Since I would be paying out of pocket for the test (insurance doesn't kick in until next month... sigh), it seemed like a waste of money, and that I'd have to go through a huge ordeal.  I already get so faint with needles anyway, and I figure if I show signs later of needing it (excessive thirst, excessive weight gain, measuring markedly further ahead, easy bruising, etc.), then I'll revisit the test with my midwives then.

 


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#17 of 28 Old 06-10-2011, 08:58 AM
 
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I'm not sure why there seems to be so much resistance to taking this test. GD is nothing to play around with. Of course I wanted to know if I had GD and it turns out I do. Diet alone was not enough to keep my blood sugars in check so I'm now on insulin. Also, there can be no warning signs. In my diabetes class, there were 12 women, half of which were in good physical shape, ate well, and had no history of diabetes in the family. It can happen to anyone.


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#18 of 28 Old 06-10-2011, 09:41 AM
 
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For myself, I am not sure I believe GD exists.  At the very least, labeling it as 'diabetes' is very misleading.  Like someone said above, if all they did was change your diet and keep a close eye on you, I imagine more people would take it.  Instead, you open yourself up to a whole host of needless, dangerous interventions!

 

I am going to a mw at a birth center, I have no risk factors, and they said they saw no reason for me to do it.  


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#19 of 28 Old 06-10-2011, 09:51 AM
 
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Quote:
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For myself, I am not sure I believe GD exists.  At the very least, labeling it as 'diabetes' is very misleading.  Like someone said above, if all they did was change your diet and keep a close eye on you, I imagine more people would take it.  Instead, you open yourself up to a whole host of needless, dangerous interventions!

 

I am going to a mw at a birth center, I have no risk factors, and they said they saw no reason for me to do it.  


 

My pregnant mother had a mini-stroke due to her non-existent GD.  It may be mislabeled (I'm not saying that it is), but it's a very real thing that can cause serious issues.  She also had an 11.5 lb baby. I had a 10.5 lb one myself.  Try doing that in a tub...not so easy.  It's real.  I learned a lot from testing my blood sugar.  I always thought I felt fine before, but once I figured out what high blood sugar felt like, I realized how uncomfortable it really felt.  I also started out with no risk factors except a family history of it.  


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#20 of 28 Old 06-10-2011, 10:19 AM
 
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I def think woman can have blood sugar issues in pregnancy, I just think they way it is handled makes things worse for most women.  Which I think is why so many of us decide to just skip it.  You have to weigh the risks of what will be done to you if it is positive, with any risks that come from possible blood sugar issues.


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#21 of 28 Old 06-10-2011, 11:31 AM
 
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Possible complications from undiagnosed Gestational Diabetes:

 

C-section due to very large baby

Hypoglycemia in baby after birth

Jaundice in baby

Shoulder dystocia

increased risk of pre-eclampsia for mother

diabetic ketoacidosis for mother


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#22 of 28 Old 06-10-2011, 02:13 PM
 
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I am following the information presented in "Creating Your Birth Plan" By Marsden Wagner MD, MS.  I forgot how mainstream MDC had gotten, or I would not have brought it up!  My mw doesn't really believe in GD either. *shrug*

 

Like I said, in the end, you have to research and work with your CP to decide what is best.


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#23 of 28 Old 06-10-2011, 03:07 PM
 
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Quote:
Originally Posted by greencarnation View Post

I am following the information presented in "Creating Your Birth Plan" By Marsden Wagner MD, MS.  I forgot how mainstream MDC had gotten, or I would not have brought it up!  My mw doesn't really believe in GD either. *shrug*

 

Like I said, in the end, you have to research and work with your CP to decide what is best.


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#24 of 28 Old 06-10-2011, 03:54 PM
 
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Good grief I thought I was reading a thread on a mainstream parenting board there for a bit.  Everyone does what they feel is best for them.  Years ago, declining the glucose test would have been the norm for a MDC mama.  There is a lot of controversy surrounding the whole process/screening and it's not terribly unusual to deny the test.  If you feel the test is important for you...then definitely get it done!  I did the gd test for the first time this pregnancy based on my symptoms, normally I decline it.  That's the beauty of making an informed decision.  Scolding and lecturing other moms who don't feel exactly the way you do about a topic isn't going to accomplish anything other than putting people on the defensive.  Which imo no one should have to be in their own DDC.


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#25 of 28 Old 06-10-2011, 05:11 PM
 
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http://www.childbirthconnection.org/article.asp?ck=10025

This is an excellent resource - compilation of studies and facts on birthing and pregnancy.


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#26 of 28 Old 06-10-2011, 06:11 PM
 
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I wasn't lecturing the OP.  I saw this on the main forum and decided to reply since I declined the test in 3 of my 4 pregnancies.  I hadn't heard anyone say that they didn't think it exists before though, so I'd be interesting in hearing the logic behind that argument.  I feel pretty strongly that GD does exist based on what I've seen, but I'm pretty open to other ideas.  The test for it, however, I haven't found to be very useful.   I got more information from self-testing my blood sugar and from GD nutritional counseling.


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#27 of 28 Old 06-11-2011, 05:41 AM
 
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It's not mandatory, and I, for one, wish I hadn't taken it this pregnancy. I've been diagnosed with GD even though my numbers were barely over, my glucose meter continues to show my sugars as being fabulous, day after day, and my recent A1C came back as superb. Nevertheless, my doctor is already talking about interventions and non-stress tests and induction. That kind of freak-out to one test (that is then not supported by any other of their tests) is why I am skeptical about the GD diagnosis. Next pregnancy I'm going to refuse the test. I will agree to test blood sugars (that stuff is interesting!) but I'm not going to risk a GD diagnosis off the glucose tolerance testing. No way.

 

We all have to decide for ourselves.

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#28 of 28 Old 06-13-2011, 07:42 AM
 
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LOL, I guess I am too "mainstream" for this forum then. I do a lot of research on my own as I believe many of you do but I do trust my doctor and also the numbers on my glucose meter. If I don't control my blood sugars, too much sugar reaches my baby causing his/her pancreas to work overtime and then I have to worry about hypoglycemia in my baby when they are born. I don't want that to happen.

 

In the end, I think we all just want what is best for our babies.


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