can i refuse the gestational diabetes test? - Mothering Forums

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Old 05-13-2008, 04:02 AM - Thread Starter
 
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So whats the big deal with the gestational diabetes test? My ob wants to test me in a month but i dont think i really need to be tested. I know blood sugar levels rise and fall naturally so im worried that if my blood sugar happens to be at a level that would have her diagnose gd, i will be stuck with an inaccurate diagnosis and a guilt trip. How accurate is this test anyways? And can i refuse it? I dont think theres anything wrong with me so i dont want to worry about it...
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Old 05-13-2008, 04:22 AM
 
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I'm sure others know more than I do about this test, but I think it's total BS. The amount of sugar they give you to ingest before the test is complete overkill. Lots and lots of women fail the test and then have to do the 3 hour challenge. Personally, I declined last time because I am positive I am not at risk for gd and I don't put junk into my body, ESPECIALLY when pg. If your doc says you really need to do it, find out why he thinks *you* are at risk for gd. Another option would be to monitor your blood sugar yourself for a few days and see what it does at fasting, after various kinds of meals, etc. so that you have some information to bring to the table if you decline the test.

Mama to two girls 12/05 and 8/09

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Old 05-13-2008, 09:59 AM
 
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I posted about this last week. I refused it at my appointment then. After reading Henci Goer's writings, I didn't see the reason for me. I had to explain why I was refusing it, but it was respected without any issues.

http://www.gentlebirth.org/archives/gdhgoer.html
http://parenting.ivillage.com/pregna...9z3m-p,00.html

Her book Obstetric Myths vs Research Realities has more elaboration too than online.

Good luck
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Old 05-13-2008, 11:08 AM
 
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It wasn't offered to me in the first pregnancy (they forgot) and I declined it in the second. Nobody even batted an eyelash when I declined it.
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Old 05-13-2008, 11:52 AM
 
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GD is silent, and dangerous for the newborn. If you choose to refuse the test, then my suggestion would go with MaClaire's suggestion, and moniter your sugars. Do you have a family member thats diabetic and might have an extra moniter you could use?

Truly, very few women actually develop TRUE GD, but a few do. Its worth watching and sometimes treating them.

"Listen, are you breathing just a little and calling it a life?"~Mary Oliver

RT knitting mama  to 3 (& 8 who didn't make it) wife working on 13 years to a silly man who drives me crazy.
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Old 05-13-2008, 12:29 PM
 
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I am not sure that GD even really exists as its own condition. You can refuse ANY and ALL testing.

Do a search for GD and Henci Goer to begin to understand the controversy.

-Angela
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Old 05-13-2008, 12:31 PM
 
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Of course you can decline any test (your doc may not be happy, but so what?). I personally feel that the GD test is valuable, though, because GD can have serious consequences - pregnancy complications, and it raises the risk that the baby will develop diabetes or pre-diabetes later in life. I have a diabetic family member so I know how difficult the disease is to live with, and want to do everything I can to reduce my kids' risk.

You don't have to do the disgusting sugary drink thing, though. In my last two pregnancies, I did a different version of the test that involved eating a specific breakfast and testing my blood sugar before and after. It was a little more complicated than the traditional test, but much more enjoyable - and no sugar rush. A lot of mws offer this version of the test; an ob may not be as familiar with it, but I would definitely talk to him/her about it if you are interested, or do it on your own if you can borrow a glucose monitor from someone - I'm sure you can find a description of how to do it somewhere online (probably somewhere on this forum).
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Old 05-13-2008, 01:56 PM
 
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I recently failed the 1 hr test by 18 points and was scheduled for the 3 hr challenge but cancelled it until I had enough time to read up on GD and start testing myself at home. From what I've read, the pregnancy hormones released in the 3rd trimester can make some moms more resistant to insulin which makes your blood sugars run higher than normal. Persistently high blood sugars during pregnancy cause the fetus to produce insulin to keep his/her blood sugar at a normal level even though yours isn't. This turns into a problem once the baby is born and is no longer being bombarded with glucose from the mother but the baby's pancreas is still producing the same amount of insulin as usual. This will make the infant hypoglycemic which means NICU time until he/she stabilizes. I've been doing my own readings at home and they've all be normal and actually a little low first thing in the morning after fasting. I think my experience has been a very valuable one because I now know how important it is to keep my blood sugar levels normal and also because I read up on how to combine foods so that I'm not bombarding my body or my baby with sugar all at once. My plan is to keep a log of my readings for my doctor and take it with me when I see him next week. I will be declining the 3 hr test based on the fact that my self tests have been quite normal. IMO, everyone should at least self test at least once during the 3rd tri to make sure its not going to be a problem. Borrow a meter from a friend or just have the 1 hr test done at the doc's office. It really wasn't a big deal to have the 1hr test done - I drank the orange stuff as soon as I got there, saw the doc for my check up then waited an extra 10 mins until it was time to have my finger stick. I believe my results were skewed because I ate a big breakfast with too many carbs right before my appt. Next time I'll know to eat more protein and maybe not eat right before the test. The only way you can be labeled GD from the 1 hr test is if your blood sugar is over 200. My mom had GD with 2 of her pregnancies and her blood sugar was like 300.
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Old 05-13-2008, 03:13 PM
 
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I don't think it is worthless but then again I have a family member with diabetes and I know what ugly effects it can have. I choose to do it every-time and I have always passed with no problems. Your blood sugar should not be all over the place when you test it unless you go nuts on carbs or sugar which they advise you against. I always eat some eggs for bfast and never have an issue. To me it brings peace of mind.
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Old 05-13-2008, 03:20 PM
 
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You can refuse any test. However, I think you should do so only after evaluating all relevant information for yourself.

One reason why gestational diabetes screening has become universal is that GD can be completely silent- you can feel fine even with abnormally high blood sugar. The other reason that GD screening has become so common is that it can increase the baby's risk for complications that can, at times, be severe. These complications include neonatal hypoglycemia due to overproduction of insulin by the baby and higher incidence of macrosomia or extreme large size which can make birth more difficult. Some new research has also found that babies born to GD moms are more likely to become diabetic themselves.

The 1-hour test for GD is sensitive but not diagnostic. The 1-hour test is a screening test, and screening tests are designed to catch all possible cases of a problem (a.k.a. sensitive) but not to identify actual cases (a.k.a. diagnostic). The high rate of false positives on a screening test is a natural outcome of the design of the test: the goal is to catch everyone with GD, even though that means that some women who do not have GD will "fail" the 1-hour test and therefore be subjected to the 3-hour test. Most women pass the 1-hour test. Of those who do not, 70% (if I remember correctly) will go on to "pass" the more accurate 3-hour test.

You do not have to fear being labeled "gestationally diabetic" merely by failing the 1-hour screening test. If you fail the 3-hour diagnostic test, however, you will probably get the GD label. Women who fail the 3-hour test who are mistakenly labeled will go on to do self-testing which will reveal their non-GD status.

Who should be tested for GD? IMHO, anyone who has significant risk factors for impaired glucose tolerance during pregnancy should consider taking the test, or at least self-monitoring on a regular basis. This includes:
- Women with a family history of diabetes
- Women with PCOS (Polycystic Ovarian Syndrome)
- Women who are significantly overweight
- Women who are older
- Women who are spilling sugar in their urine

If you do decide to take the test, and do discover that you have GD, ask yourself, and your OB this question: how will having GD change my treatment? If your OB says "Well, we'll want you to monitor your diet, and get more exercise, and do some self-testing with a home blood glucose meter, but that's about it" then you have nothing to fear. If you hear "Well, I don't let my GD patients go past their due dates and I do a lot of inductions to prevent babies from growing too large," then it's time to run.

Preferably to a midwife!
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Old 05-13-2008, 05:05 PM
 
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The "treatment" that a woman should be given if she fails the 3 hour test is no different than what every pregnant woman should be doing anyway -- getting exercise, eating low simple carbs, high protein. The problem is that we live in this wonderful culture that loves white bread and HFCS and all kinds of horrible processed junk and has no concept of what taking it easy on those things means. No, eating 2 pieces of white bread toast for breakfast, a sandwich on white bread for lunch, spaghetti and meatballs for dinner, and a bowl of ice cream for dessert is NOT a balanced diet. Off soapbox.

There is also the fact that many OBs like to treat anyone who fails the 1 hour, or anyone who comes anywhere near the cutoff for the 3 hour, as if they're raging diabetics. And they may give you nutritional advice or a home monitor, but their favorite thing to do is induce/section you at 38 weeks, and then torture your newborn with multiple sticks, sugar water, and possibly NICU monitoring.

And there is also the irony that if you have a decent diet typically, you're more likely to fail because your body is going to be completely blown away by the fasting and then onslaught of sugar.
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Old 05-13-2008, 05:12 PM
 
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Yes I agree.

Well first I couldn't take the test because I was way too sick. Then I researched it more. Now I will always refuse this test.

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Old 05-13-2008, 07:21 PM
 
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Quote:
Originally Posted by coyotemist View Post
GD is silent, and dangerous for the newborn. If you choose to refuse the test, then my suggestion would go with MaClaire's suggestion, and moniter your sugars. Do you have a family member thats diabetic and might have an extra moniter you could use?

Truly, very few women actually develop TRUE GD, but a few do. Its worth watching and sometimes treating them.
I agree--it's important to at least check your blood sugar levels once in a while if you decline the test. You can buy a cheap generic testing set at major pharmacies.

I see a lot of women on this board making the argument that because they don't "feel" diabetic or because they have no risk factors, or because they eat a healthy diet, they couldn't possibly have GD. I had a very persistent case of true GD with my first pregnancy, and it came as a complete surprise. I had none of the risk factors (except being over 30), and I was exercising a lot during my pregnancy (running 3 miles 4 times/week) and eating a very healthy, lowish carb diet. My GD could not be controlled with diet and exercise and was increasingly out of control as the weeks went by. I was put on an insulin-like drug, and eventually after they moved me up to the highest dose I started to get control of my sugars. I find it puzzling that women on this board argue that GD doesn't exist, when my own experience (uncontrolled fasting levels near 200, etc. etc.) shows me otherwise. I mean, no one would argue that a true diabetic refuse treatment during pregnancy, and my numbers looked exactly like a true diabetic's, if not worse.

Anyway, I just wanted to offer another perspective. At least check your sugars once in a while if you refuse the test, because uncontrolled sugars really aren't great for the baby.

lady.gif mama to H. 4/05 and A. 9/08 and baby C. 10/11

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Old 05-13-2008, 08:37 PM
 
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I monitored blood sugar relatively closely while pregnant, but only because both my mother and sister were diagnosed with true diabetes during or immediately following a pregnancy.
Otherwise, I might have checked it once or twice at some point, but I would never do the glucose tolerance test. It just does not make sense.
The only way I would accept a diagnosis of GD would be if I fit the criteria for true diabetes during pregnancy.
The main thing with those tests that make you drink insane amounts of sugar is that they cannot be repeated. You could do it 3 days in a row and get 3 completely different results.

Single mom to E (2004) and D (2010)
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Old 05-13-2008, 09:11 PM
 
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You can refuse whatever you like, as you know. I don't mind this test, but I will do the menu, NOT the sugar drink.

fambedsingle2.gifnovaxnocirc.gifHappy to be a mommy and teacher to D fencing.gif, born 1-17-06 via waterbirth.jpg  and A  blahblah.gif, born 10-6-08 with a homebirth.jpghomeschool.gif

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Old 05-13-2008, 10:57 PM
 
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Quote:
Originally Posted by paquerette View Post
The "treatment" that a woman should be given if she fails the 3 hour test is no different than what every pregnant woman should be doing anyway -- getting exercise, eating low simple carbs, high protein. The problem is that we live in this wonderful culture that loves white bread and HFCS and all kinds of horrible processed junk and has no concept of what taking it easy on those things means. No, eating 2 pieces of white bread toast for breakfast, a sandwich on white bread for lunch, spaghetti and meatballs for dinner, and a bowl of ice cream for dessert is NOT a balanced diet. Off soapbox.

There is also the fact that many OBs like to treat anyone who fails the 1 hour, or anyone who comes anywhere near the cutoff for the 3 hour, as if they're raging diabetics. And they may give you nutritional advice or a home monitor, but their favorite thing to do is induce/section you at 38 weeks, and then torture your newborn with multiple sticks, sugar water, and possibly NICU monitoring.

And there is also the irony that if you have a decent diet typically, you're more likely to fail because your body is going to be completely blown away by the fasting and then onslaught of sugar.
Couldn't agree more with this post--well said!

Mama to two girls 12/05 and 8/09

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Old 05-14-2008, 12:05 AM
 
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According to Williams Obstetrics, "Gestational diabetes is a diagnosis looking for a disease."
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Old 05-14-2008, 01:29 AM
 
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My feelings on GD go back and forth. I took the one hour test and almost refused the three hour test. But then I knew I'd be worried the whole time about whether or not my blood sugar levels were a problem. So I took the three hour test and I failed. Now I check my blood four times a day.

The thing is I'm 95% sure I had a misdiagnosis. Even the three hour test results indicate the test wasn't all that accurate.

It takes a lot for my blood sugar levels to be above "normal" when I test it. BUT the good thing is that I can control and monitor it all myself. So now, if I ever worry about my blood sugar *I* am the one checking myself. In the end, having the ability to check my own blood has been a great thing - because now my anxiety about it all is way way down and I can track it any time I want to.
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Old 05-14-2008, 02:41 AM
 
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like many pps said...it is important to maintain healthy blood glucose levels throughout pregnancy, for the health of both the mother and the child. hyperglycemia and insulin resistance (whether you choose to call it GD or not) can be both silent and cause significant complications. the only way is NOT with the 1 hour glucose challange test and the sugar water. i would encourage you to find a way that works for both your and your care provider. they should be looking for glucose in your urine with every visit/sample. a challange test following a high carb/sugar meal FOR YOU (might be pancakes, for instance) is a great method. consistent and periodic blood glucose measurements are also a great way for you to ensure your levels are great.

and of course...you NEVER HAVE to do anytihng.

amanda... lovin' my dh since 2004 and mama to dd (3), ds (18 months) and expecting someone new Oct 2010.
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