Ugggggg!! the dreaded Glucose Test - Mothering Forums

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#1 of 8 Old 08-09-2012, 08:08 PM - Thread Starter
 
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Hey everyone!

I'm almost 17 weeks pregnant with my 3rd baby and my midwife had me do the 3 hour GTT last week. I passed it just fine, it only went up to 85, my final draw dropped pretty low and during the test and after I felt like I wanted to die.  She told me today that even though the test was fine I have to do it again around 24 weeks, which makes no sense to me nor do I want to put the baby through this again.  I eat well, walking 3 miles every other night and swim the opposite days.  So my question is if diabetes is not in my family, I've never had GD and the first test was good, why do I have to do this again!  At my next appt I think I'm going to explain how I feel and see if I can refuse or offer to check my blood sugar for a week or something similar. Any thoughts/advice is appreciated!

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#2 of 8 Old 08-09-2012, 09:41 PM
 
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Ask her if she would draw a hemoglobin A 1C. It tells you how well your glucose has been in control over the last 3 months and gives a better indication of long term control. No one naturally ingests as much glucose in one sitting as they have you ingest for the glucose tests. I don't understand why if it was fine she would want to repeat it and you can absolutely refuse. My midwife does the HgbA1C instead and only the glucose challenge if that value is abnormal. Hopefully if you explain your point of view she'll be understanding. 


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#3 of 8 Old 08-09-2012, 11:02 PM
 
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The reason you need to do it again is that 17 weeks is *way* to early to do it in the first place. Gestational Diabetes typically doesn't appear until 24-28 weeks. Do you know why she wanted you to do it so early? Even 24 weeks seems early to me. Where I am it is typically done between 26 and 28 weeks.

Unfortunately there is no alternative which is diagnostic for GDM. As the PP mentiones, the Hba1c will give you a picture of the last couple of months. Unfortunately, if you develop GDM at about the usual time the Hba1c would only show that at about term: too late to do anything about.

Home glucose monitoring for a week is not sensitive enough to detect GDM in the early stages. GDM is a progressive condition so your sugars are likely to be quite close to normal initially. That's why the GTT uses a glucose load to detect subtle changes in your body's ability to manage glucose. The whole point is that it is more glucose that people normally ingest. That is precisely why it works.

However there is still no international concensus on whether testing everyone is necessary or whether peOple can be screened in and out based on risk factors so you could opt out if you have no risk factors.

Another alternative is to behave as though you have GDM, follow the diet and monitor your BSLs 4 times a day for the rest of your pregnancy. It won't tell you if you have it but it will help to prevent some of the complications if you do. What it won't do is help you determine your future risk, as women with GDM have an almost 50% chance of developing GM Type2 in later life.

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#4 of 8 Old 08-10-2012, 05:07 AM - Thread Starter
 
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I think she had me take the test that early because she thought I had gained too much weight at my 12 week check up. I gained at total of 4 lbs and she told me that is too much. The only risk factor I have for GD is when I became pregnant my BMI is 30.  My BMI is on higher side but I am very active, running (before pregnancy), walking, biking, swimming, etc.  and for the most part I eat a well balanced diet but I am not perfect.  DH and I both have higher BMI's but are not out of shape people we both have a lot of muscle and are in good health.  I'm not going to obsess about this my other pregnancies were healthy and this one seems to be going along great!

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#5 of 8 Old 08-10-2012, 09:42 AM
 
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My midwife tried to push the test on me many, many times but I just flat out refused. Is taking the test a condition of her providing care? If not, just refuse and take care of yourself (sounds like you are anyway).


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#6 of 8 Old 08-10-2012, 10:13 AM
 
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I was sent to a high-risk appointment in the first tri due to my BMI and borderline high blood pressure. They ordered the GTT and an a1c. ??? I was maybe 13w! I could see the a1c to check if I had undiagnosed Type 2 or something, but the GTT just seemed unnecessary in conjunction with it. All it did was make me anxious. The a1c, early GTT, and the subsequent one I took at 28w were all fine.

 

Bottom line, in my personal opinion it's a good idea to take the test, but it was pointless for them to make you take it at 17w. If they were worried about preexisting diabetes for some reason, they could have ordered other tests or had you self-monitor your BG. IMO they should have held off and just had you take the GTT once at 26-28w so you wouldn't have to drink that stuff twice.


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#7 of 8 Old 08-12-2012, 08:00 AM
 
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Interesting.  I was told by my midwife that I tested positive for GDM with an AIC of 5.7.  They are having me see a dietician and change midwifes to a special "diabetes midwife". From what I have heard, it is pretty ridiculous given that I am only 13 WEEKS!!  I guess the extra care will not hurt, and less sugar is prob good for everyone but to tell me I've tested positive for GDM and worry me!!!  That was really unnecessary.  I am not overweight and fit.  No history or family history.
 


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#8 of 8 Old 08-12-2012, 10:27 AM
 
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Hey, I'm a CNM and probably on the conservative side. Doing an early test for DM if a woman is obese; a member of a higher risk ethnic group; family history of DM; personal history of GDM; history of a macrosomic baby, I think it can be a good idea. But the 3hr GTT is a b!tch of a test. It seems much kinder, and clinically acceptable, to start with a 1hr, nonfasting, glucose challenge test, then move to a 3hr GTT if it's positive. Doing all that before 28ish weeks is just looking for preexisting insulin resistance, though; gestational DM doesn't develop that early. I can understand your reluctance to go through that crap again. I really really do; I had a pre-pregnant BMI of 20, am white, no family history of DM, had gained less than 10 lbs at 28 weeks due to nausea and vomiting, and I failed the 1hr GCT and had to do the 3hr GTT TWICE, because I threw up the glucose at 2hrs into the test the first time. And naturally I passed it well within normal values. No waffles and syrup right before taking that 1hr test is a good rule of thumb duh.gif  

 

But unfortunately, GDM really does happen to people without much risk for it, and the test you had doesn't tell you whether you're developing it or not. Like katelove said though, 24 weeks is too early. 26-28 weeks is the recommended time frame.


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