Gestational Diabetes test, refuse it?? - Mothering Forums

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#1 of 69 Old 07-05-2011, 11:43 AM - Thread Starter
 
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So I had my 20 week check up today, everything went well, as usual, same as my last 2 pregnancies!

 

 This time around I am doing things way more natural/organic and am thinking of refusing the GD test, who has done this? Aren't there symptoms you can look for yourself if you have it? I've never had it in my last 2 pregnancies!

 

 My dr. today said I could eat my normal breakfast and a glass of orange juice and come in within the hour! Do I just try that or skip it all together?

 

Thanks!

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#2 of 69 Old 07-05-2011, 12:20 PM
 
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So, of course you can refuse it.  Here's my thoughts: there are not always symptoms the GDM, esp if it is not dramatically bad, although one way of looking for symptoms would be to check your own blood sugar at home with a glucometer a few times per day and see how it is with the food you eat- some providers see this as an alternative to the classic GDM test.  It is more likely as we get older, so you could have it in a 3rd pregnancy but not in earlier ones.  But it can lead to a baby that has a tough time transitioning to a lower-glucose life on the outside, or a baby that is bigger than your body would want to grow naturally, or a baby whose shoulders are disproportionatly large as compared to its head leading to an increased risk for shoulder dystocia.  I plan on doing the test because although I eat well, I know that what I eat is probably a bit more high-carb than would be best if i had GDM.  The treatment is typically really easy- just fine tuning your already healthy diet.  If it was the whole glucola test (essentially drinking concentrated soda), that does honestly seem a bit contrived to me, but it sounds like your provider is having you do the "breakfast" test which is pretty realistic.  

 

On the other hand, what are your consequences if you get the label of GDM?  Will you not be able to birth where you want, or with the provider you planned, or other consequences?  That would come into the decision making process.

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#3 of 69 Old 07-05-2011, 02:24 PM
 
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I refuse the test where you have to drink the orange soda, but I have done a random glucose test with pregnancy #2.   I didn't have to do anything special, they just tested by blood sugar when I went for my appointment.  I didn't see the harm in it and I'm so low risk that I don't worry about it.


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#4 of 69 Old 07-05-2011, 02:48 PM
 
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A lot of practices, especially birth centers, do not allow you to decline the test and stay in the practice.  Some will allow you to stay but will have to treat you as if you do have GD (not good).  So my advice would be to find out your practice's policy first.  Then ask if you can do an alternative to the traditional GTT (drinking the nasty soda) b/c it has a 15% false positive rate and then you'll have to take the 3 hour test.  Ughhhhh....  Some will allow you drink a glass of regular juice, take the jelly bean test, or eat a high sugar meal instead and come in an hour later for the blood test.  If you google it you'll find a lot of alternatives to the test.  You could come into your next appointment armed with information and ask what would be acceptable. 


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#5 of 69 Old 07-05-2011, 04:06 PM
 
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THE GD test has a lot of false positive and is really not an accurate way to test, diagnose, or treat. Proper nutrition is and Dr's fail to know about good nutrition, especially when it comes to pregnancy. If you have already decided this healthy path of life, good for you. I would decline if you feel comfortable with that. I have never had it and probably won't ever. I have no need to. I feel, personally, after lots of research from good, unbiased sources, that obstetrics is a one size fits all array of tests and systems to a group of people that are not one size fits all. You have the right to refuse anything you want to, for any reason you want to, and the right to take control of your health care without scrutiny! Good for you for looking into this!!!

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#6 of 69 Old 07-06-2011, 02:01 PM
 
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We have a family history of diabetes, so my midwives recommend taking the test. I'm kind of looking forward to it - an excuse to sit down and knit for a while, and have someone else chase my 2-year-old! I am going to look into alternatives to the orange grossness that they give, though. 

 

Interestingly, here in Vancouver, they have totally done away with the 1-hour/3-hour tests, in favour of just a diagnostic 2-hour test, which is a fasting test like the 3-hour. I'm NOT looking forward to the fasting, and the sitting and knitting on an empty stomach for 2 hours. If I could just opt for random blood sugar tests, I would, but my midwives don't offer that option. 


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#7 of 69 Old 07-13-2011, 08:55 PM
 
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I briefly debated refusing the test, but since I have several risk factors, that didn't seem smart.  I've done a bit of searching for alternatives to the orange drink (YUCK!) and didn't find a ton of information - I found lots of "there are alternatives, like drinking juice or eating jelly beans" but none that said exactly how much. When I was with the homebirth practice they let me eat a very specific meal as an alternative, but I no longer have what that is.  I would really like to have some specifics ready to present to my doctor at my next appointment.


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#8 of 69 Old 07-14-2011, 01:03 AM
 
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I am declining the test. I don't think it's healthy and I suspect it leads to misdiagnoses. I took the 3 hour test ages ago when I wasn't pregnant but had borderline blood sugars, and it was horrible on all the pregnant women around me who weren't allowed to eat even though they were starving. One of them just ate anyway. Also the sugar water tasted terrible. These days I have excellent blood sugar from exercise, low stress and nutrition, and my midwife doesn't insist on the test.

 

Here is what we're doing instead: at week 28 I monitor my fasting blood sugar every morning and then postprandially (1-2 hours after starting breakfast). The tests are only there to make sure your body is not exposing the baby to high glucose levels. If you are at normal levels while eating normally, who really cares what happens when you drink sugar water? I never normally drink juice or sugar water with this pregnancy, so it doesn't make sense to me to have that be my test. I already know that when I eat a normal meal even with real dessert, my blood sugar still doesn't go outside of normal. To me, that's all that we need to know.

 

btw, the store brand home glucose monitors at target aren't really that expensive, so you can keep an eye on your bg anytime you want. I do it about every 10 days now.


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#9 of 69 Old 07-14-2011, 02:01 AM
 
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I refused entirely with my 1st, did random glucose with my 2nd, and at today's prenatal my MW asked me what I wanted to do for it since the next visit is "the one". Going with the random glucose again. She's already sticking me to get an iron test, so why not, eh? If I had a provider who really wanted me to do a "real" test, I wouldn't oppose a modified one (glucola, though, would be a deal breaker. ick) like I know some people do a specific breakfast (denny's grand slam w/ OJ or something similar?) and the jelly bean test has been well tested and proven. I believe its 18 Brach's Jelly Beans. 


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#10 of 69 Old 07-14-2011, 12:26 PM
 
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Quote:
Originally Posted by Jennifer B View Post

 I would really like to have some specifics ready to present to my doctor at my next appointment.

You need 50g of sugar.  So you can look at how many grams are in the serving size and multiply.  So if 8 oz of your favorite juice has 20g of sugar then you'll need to drink 2.5 servings (2.5x8=20 oz) of that juice.   Here's a link to one of the jelly bean studies: http://www.ncbi.nlm.nih.gov/pubmed/10561636.  This one required 28 jelly beans. 

 

The meal I ate was a PB&J sandwich with 2-4 TBS of jam (depending on the jam), a glass of milk, and an apple.
 

 


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#11 of 69 Old 07-21-2011, 08:07 PM
 
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I decline the GTT. My midwife has no problem with that.


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#12 of 69 Old 07-22-2011, 05:21 AM
 
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Gah! I am scheduled to take the GD test in 3 weeks and I don't want to. greensad.gif In order for my CPM to maintain her licensure and practice home births, her clients have to have coordinated care for at least two visits with an ob/gyn or midwife in a clinical setting, and I have one appointment left with that person so I had scheduled to just do the GD test with her. But then my midwife showed me what they'll be having me drink at that appointment, and it started me thinking about whether or not I really want to do this. irked.gif She said I'll have a choice between a clear, orange, or red flavored soda drink. She said to drink the orange because they all taste nasty but that one is the least disgusting. I don't drink soda and stay away from food dyes as a personal choice, so I hate the idea of ingesting pure sugar like that while pregnant. I wish I'd feel more comforted by the idea that most women take this test so it MUST be okay and necessary, right? But most women also do a lot of stuff in the medical model of healthcare that isn't necessarily healthy or safe but is advised by their healthcare professionals, so I don't put a lot of faith in anything regarding pregnancy testing these days. Yes, I'm cynical! lol

 

I suppose I should just suck it up and do the test, though. My blood sugar tends to be on the low side in everyday life, so I don't know how that would translate to a decreased or increased risk for GD during pregnancy. There is a lot of diabetes in my family too. duh.gif


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#13 of 69 Old 07-22-2011, 06:13 AM
 
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BirdHappy... why don't you reschedule for a later appointment with the OB?  Maybe your 32 week appointment where nothing happens?  Your mw would likely allow you to do one of the alternative tests... way better and less chance of false positive.


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#14 of 69 Old 07-22-2011, 07:19 AM
 
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The last OB appt I will have will be the GD test. After that, I will have an unassisted pregnancy, unless something comes up.

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#15 of 69 Old 07-22-2011, 08:03 PM
 
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Other then a false positive on the test are there really any health risks to you or the baby by takeing the nasty sugar drink test?...general treatment seems to be w/ diet/nutrition.  Takeing this test monday and didn't really think to question my OB on it ( so far she's been very thorough with my health care along with my babies).  I was told I get to chug a nasty flat soda concoction and get blood drawn. my sister in law had GD so I got some info as to how dangerous it can be, left un-treated.  diabetes runs in both sides of my family so the question isn't weather to be tested for me.. but are there health risks I'm yet unaware of in the traditional nasty orange drink?

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#16 of 69 Old 07-23-2011, 07:14 AM
 
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Blayzes Mommy- I don't believe there are major health risks associated with the GTT drink.  I do think there are common adverse effects like nausea, dizziness, vomiting, etc.and less common allergic reactions to the dye.  If you vomit it up you'll just have to take it again.  This was one of my major concerns with my first b/c I still had pretty terrible morning sickness at 28 weeks.  I figured I might have to attempt to down it several times.  Not pleasant.  The alternative tests are gentler on your system b/c they include other nutrients along with the sugar instead of just straight glucose, which is not natural for your system to handle.  The results are more accurate b/c of this as well.  It's not too late to ask to take an alternative form of the test if you're interested! 


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#17 of 69 Old 07-23-2011, 10:04 AM
 
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Jaimee - Thanks for the information!  I've been lucky to be one of those horrible preganant women to have no morning sickness what so ever.. just have higher aversions then normal to foods I disliked in the past.  I doubt I'll have an allergic reaction to the dye.. I've never had any issues w/ allergies much.  But it's very good to know.  I think I'll give it a try, if it works I'll muddle threw it.. if not.. then my doctor is likely to be more apt to go with an alternative.

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#18 of 69 Old 07-23-2011, 10:10 PM
 
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I did the test this morning. I can see now why you would want to refuse it. Where I live, the test (and many other medical tests) is administered by a private laboratory, with very strict and streamlined practices, which did not allow for any substitutions. There is no such thing as having it done at your doctor's office. Because of our family history, I wanted to take the test, so it was the bottle of orange yuck for me. I did the 12 hours of fasting, which was awful (I was hungry 2 hours into my fast) and was so cranky as I was made to wait 40 minutes in the waiting room before even being able to begin the process of the test.  At least they had a comfortable chair in a semi-private corner for me to wait out my two hours. I knit and read a book, and that part was nice, though I was so hungry, and felt quite dizzy partway through. I was a dazed wreck when it was finally done and I was allowed to eat again, a full 15 hours after the last time I ate. Plus I have ugly bruises on my arms from the three needle pricks. I have not felt myself all day, and feel like I needed to recover from the test. It did not feel healthy. I realize that some of my experience is due to where I live and the type of care I receive, but I do wish I had pushed harder to be given other options. 

 

 


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#19 of 69 Old 07-24-2011, 05:07 AM
 
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Hmm. The clinic where I'm having my GD test done told me I didn't have to prepare for the test in any way. I specifically asked if I need to fast, and they told me no... Is that typical for this test? They suggested maybe I don't eat a lot of carbs in the prior day, stick to protein-rich foods, but that was about it.


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Quote:
Originally Posted by birdhappy85 View Post

Hmm. The clinic where I'm having my GD test done told me I didn't have to prepare for the test in any way. I specifically asked if I need to fast, and they told me no... Is that typical for this test? They suggested maybe I don't eat a lot of carbs in the prior day, stick to protein-rich foods, but that was about it.


Yes, the typical 28 week test in the US does not require fasting.  If you fail this test and are asked to take the 3 hour test, then you will need to fast.  http://www.americanpregnancy.org/prenataltesting/glucosetest.html.  Because of the high rate of false positives on the first test (15%) some places have adopted a different version of the test to begin with.  It sounds like that is the case where Kirsten lives.  The test she took is more accurate, but obviously much less pleasant as well.

 


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#21 of 69 Old 07-24-2011, 06:18 AM
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There are two test commonly administered to screen for GD and one is fasting while the other is not. It does not matter which test is used, though most doctors in the US prefer the nonfasting for reasons of patient comfort.

The test is non-invasive and carries no known risks.

I have a healthy BMI of 19, and have never been overweight. My family is 100% organic, macrobiotic and vegan. I work out six times a week, and I cycle semi-professionally. At 22 weeks, I was given a routine GTT, and failed. Badly. Anything over 140 is a "fail," and my numbers? 460. I had no symptoms. I went in for the three hour test (because everyone, midwife included, was sure the first test was in error), and I failed that, too. I was referred to a doctor specializing in gestational diabetes, who coordinated care with my midwife. They quickly discovered I was in the early stages of a type of diabetes known as Latent Autoimmune Diabetes of Adults. The onset is so gradual, that many people only know they have LADA after going into DKA (a type of serious diabetic complication wherein the body shuts down due to high blood glucose). Obviously, during pregnancy, this can be all the more serious, and most infants would not survive the long term elevation in blood sugar, or would experience serious child-birth related complications. In short, that routine test saved my life. I would NEVER advise a woman, no matter her lifestyle or health habits, to forgo that test. My friend, actually, counseled me not to have it, saying it was just another way of turning pregnancy into a medical condition requiring management, and that I did not need it being so low risk for GD. Thank God I didn't listen!

Incidentally, I continued care with my midwife, and gave birth at an area birthing center with no internal monitoring, and no other interventions of any kind. It was a beautiful birth. I was able to walk around, lay in the jacuzzi tub, and then delivered naturally in a short, easy labor. My baby was perfectly healthy. Her sugars were a bit low after delivery but, after nursing immediately after birth, she was just fine. Getting diagnosed did not change my birth plan or care. In fact, if I had not gotten diagnosed, I would have certianly required a ton of monitoring and probably a c-section due to diabetes-related complications!

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#22 of 69 Old 07-24-2011, 06:25 AM
 
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Oh okay, great to know! Thanks, Jaimee!

 

NatureMom2Two - Your story is a great example of why even when we might be doing everything right and feel like we have no reason to worry about something being wrong, we still should exercise caution. I'm glad you were able to find out you had LADA before any complications developed!

 

I'm still on the fence about taking the test, lol. I'll talk to my midwife about it soon. I see her a week before I'm scheduled at the clinic for the test.


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#23 of 69 Old 07-24-2011, 08:21 PM
 
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Quote:
Originally Posted by birdhappy85 View Post

Hmm. The clinic where I'm having my GD test done told me I didn't have to prepare for the test in any way. I specifically asked if I need to fast, and they told me no... Is that typical for this test? They suggested maybe I don't eat a lot of carbs in the prior day, stick to protein-rich foods, but that was about it.



That's how it was when I had the GTT last time around (2.5 years ago) but, like Jaimee said, my midwives told me that here in BC Canada they are phasing out the screening test (the one-hour, non-fasting one) because of it's high rate of false positives. They also phased out the three-hour test, in favour of this single test, the 2-hour diagnostic GTT. 

 

Hopefully you'll get a negative with your one-hour test and that will be that! Good luck!

 

 


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#24 of 69 Old 07-24-2011, 11:22 PM
 
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Yes, the typical 28 week test in the US does not require fasting.  If you fail this test and are asked to take the 3 hour test, then you will need to fast.  http://www.americanpregnancy.org/prenataltesting/glucosetest.html.  Because of the high rate of false positives on the first test (15%) some places have adopted a different version of the test to begin with.  It sounds like that is the case where Kirsten lives.  The test she took is more accurate, but obviously much less pleasant as well.

 



I beg to differ. The two times I took the test for my babies (two different OB offices, two different towns) they required that I fast an hour before taking the drink and not to eat until after the appointment, which is an hour after taking the drink. So, that is a two hour fast. Maybe not an all day fast or 12 hour fast, but still, not able to eat or drink anything 2 hours before the appointment.

 

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#25 of 69 Old 07-25-2011, 03:54 AM
 
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How accurate is this test if the instructions going into it aren't even standardized? ROTFLMAO.gif Ay ay ay!

 

Just kidding. redface.gif Totally kidding!


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#26 of 69 Old 07-25-2011, 07:14 AM
 
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Becky, that's why I said the "typical" 28 week test.  It does differ place to place.  And yes, you drink and then wait an hour without eating before getting your blood drawn, but I wouldn't really consider that fasting.  At any rate, I have to agree with BirdHappy... it's not standardized and it's not very accurate.  Again probably why Canada opts for the fasting, 2 hour GTT instead. 


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#27 of 69 Old 07-25-2011, 08:53 AM
 
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Sheepish.gifAlright..........

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#28 of 69 Old 07-25-2011, 09:00 AM
 
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lol.gif  Becky... sorry if my post sounded a bit harsh... I didn't mean it to!


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#29 of 69 Old 07-25-2011, 11:22 AM
 
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Originally Posted by Jaimee View Post

lol.gif  Becky... sorry if my post sounded a bit harsh... I didn't mean it to!



lol Not at all. I just felt a little foolish.

 

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#30 of 69 Old 07-26-2011, 06:09 PM
 
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My midwife doesn't require the GD test to be done, so I opted out of it. I have owned a blood glucose meter for a couple years, now, so I have been keeping an eye on my sugars the whole time I've been pregnant and I haven't had any issues. My fasting numbers (in the morning) are usually around 80-85 and my 1 hr post meal numbers are usually 90-100 for a meal without any carbs and 100-110 if there are carbs in there. We are for the most part grain free in our house, so perhaps that has helped. I am overweight, which is a 'risk factor' but I eat super healthy. I abused my body pretty bad for about ten years with eating disorders and my weight management has never been the same - regardless of what I eat. I have only gained about 10 pounds in this pregnancy (now at 25.5 weeks) so that feels pretty good :)

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