"the glucose test is not optional." - Mothering Forums

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Old 09-29-2006, 02:27 PM - Thread Starter
 
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Any mamas in MA ever been told this? I was at my 24 week apt this am and the nurse was giving me my orange cola for my 28 week GTT, going over instructions, etc. I asked, simply because I am curious, how many women pass (refuse) on this test. She looked at me like I had just said the dumbest thing she had heard all week and said, "They can't refuse it. It's NOT optional." I stammered something about knowing of people who had and I was just curious. She repeated herself and I let it go. I meant to ask my MW, but I got sidetracked on my VBAC questions (sigh). I got wondering about it and it seems utterly strange that it is "mandated." We are in MA and DP wondered if it was state regs or something.

I'm overweight to begin with and have a postive family history of GD and diabetes. So regardless, I am taking the test, but geesh, "mandatory??"
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Old 09-29-2006, 03:03 PM
 
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It's not mandatory. I'm in MA as well and just had my midwife appt this past Wed. I am in a normal, healthy weight range, eat an excellent diet and have only one case of diabetes in my family (my mother had GD when pregnant with my brother, but she was also close to 40 and didn't have a great diet herself back then). Anyway - both my husband and I don't feel I'm at risk and we shared all of these concerns with the midwife.
We also said that for peace of mind all around that we would test on our own (hubby is a pharmacist and has his own blood testing kit) and bring in the results and if they were abnormal then we might proceed to the Glucouse test. She seemed fine with that compromise and didn't seem shocked or bewildered that I would not want their test. She even admitted that they do more testing now then way back when b/c of needing to cover their asses just in case.
So, for the nurse to tell you it's mandatory is boloney!
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Old 09-29-2006, 04:36 PM
 
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That's bs, there is no such thing as a mandatory prenatal test. As a patient you have the right to refuse. Aside from some cases of women who refused c-sections when their babies lives were in danger, I don't recall ever hearing about a case where they got a court order or legally went after a mom for decisions she made regarding her unborn babies care. There are women who don't get any prenatal care at all. Also remember you always have the right to seek a second opinion.
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Old 09-29-2006, 04:53 PM - Thread Starter
 
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Thanks. This is really bugging me. I guess I just keep wondering about any women who have asked this nurse (only one in the office) about opting out of it, only to be told it's mandatory. Talk about potentially misleading and coercive (not that that is necessarily her intention at all). I feel I am a well-informed mama and she stopped me in my tracks with her whole response and affect. I'm going to f/u with the MW next time I am there.

Of courses my fate in all this will be that I WILL end up positive for GD!!
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Old 09-29-2006, 09:01 PM
 
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I would be really bugged also! I was jsut having a discussion with my MW about gluscose testing b.c I have read that with twins the incidence is higher and some physcians (Noble for one) believe that there may be a very good cause ot not limit blood sugars too much in a multiple pregnancy b/c it may be natures way of giving the babies more calories. But in a singleton i would be furious is I was not offered truely informmed consent! grrrr
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Old 09-30-2006, 12:46 AM
 
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that is insane.. she totally bullied you. that sux... I angry for you...I wish so badly I could go uc.... but I am a diabetic and thats not possible... but UGH!! I get so angry when docs and nurse push me around... sorry... I am venting my own frustrations.... :
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Old 09-30-2006, 10:52 AM
 
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Originally Posted by carrollmillins View Post
I'm going to f/u
I have no idea what this means, but when I first started to read it I thought you were going to say something about the nurse, like giving her a big "f/u". She deserves it, it sounds like. (I cannot stand bullies.)
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Old 09-30-2006, 05:51 PM - Thread Starter
 
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I have no idea what this means, but when I first started to read it I thought you were going to say something about the nurse, like giving her a big "f/u". She deserves it, it sounds like. (I cannot stand bullies.)

LOL! Sorry!! It was short hand for "follow up."
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Old 09-30-2006, 07:29 PM
 
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Popping over from November

If you want to take the test, there are other options than just chugging the glucola. That test made me very ill with my son's pregnancy, so this time I did the test by eating a meal with a minimum of X gms of carbs 2 hours before having my blood drawn. There's also a test that can be done by eating a specified number of jelly beans. You can opt to get your fasting blood sugar taken and then taken again 1-2 hours after eating breakfast... or you can borrow someone glucometer and test yourself with finger pricks 3-5 times a day for a week.

But like others have said, no prenatal test is mandatory. It may be mandatory for that practice (meaning, if you refuse it, they can drop you), but that shouldn't scare you into taking it - you're still early enough along that you can find another care provider should they try bullying you further. Hopefully this isn't a sign as to how much they'll respect your wishes during labor and after birth.
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Old 10-02-2006, 05:47 PM
 
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Don't do the Glucose Tolerance test. Demand to do the Alpha - 1 test instead, no drinking garbage and no fasting required.
Just my 2 cents... Of course I was "terminated" from care in my last pregnancy for "reasons of non-compliance" which I was told on the phone was the "glucola test".

I'm such a rebell...
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Old 10-02-2006, 08:17 PM
 
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Hi: not from your due date club but my mw and I just had this conversation this morning. I told her I would not be drinking the nasty orange thing and she said two things: fine, no one can make you do any prenatal tests and then that I could do the glucose test by eating whole wheat toast before hand and she would look into how to make that happen..
What by the way is the Alpha 1 test mentioned by previous poster?
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Old 10-02-2006, 09:16 PM
 
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Sounds like that chicky had a bug up her bum. Mandatory? My patooty!
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Old 10-04-2006, 12:24 AM
 
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Eeeew! Icky poo!

Nothing, as we all know is mandatory when it comes to your own body, but it might be mandatory in thier office and they might send you walking, in which case, that could be a blessing.
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Old 10-04-2006, 02:16 PM
 
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Hi there,

I agree with many posters...I'm not taking the "formal" test (blech, I'm not drinking that garbage).
My midwife just offered to lend me a glucometer and told me to test in the morning before eating, log the reading and then to have breakfast and test every 1-2 hours afterward. She asked me to also log what I eat through the day.
So I already started doing that today.
I logged the fasting reading and then had breakfast. I'll test in an hour and then have another snack...wait another hour and test again....
And so on...and pretty much do that until this evening. I am not diverting from my normal eating routine.
She also asked me to log what I am eating throughout the day.
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Old 10-04-2006, 03:32 PM
 
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Originally Posted by Electra375 View Post
Don't do the Glucose Tolerance test. Demand to do the Alpha - 1 test instead, no drinking garbage and no fasting required.
Personally, I don't really understand what the big deal is about the glucose tolerance test, having taken it 3 times with my fourth time coming up in a couple of weeks. Yes, it made me a little nauseous at 20 weeks with this pregnancy, but it wasn't exactly a horrible experience. At my doctor's office, you drink the stuff ahead of time, come in half an hour later, and tell them when you drank it. They then draw the blood at the appropriate time, and off you go -- doesn't seem like a big deal.

As for the A1c test, since that measures blood sugar levels over the preceeding 3 months, I'm not sure that really meets the same purpose, since the point of taking the glucose tolerance test is to measure your body's response to glucose right at that time, not over the last 3 months. (This time around, they gave me the A1c earlier on in the pregnancy, to test for pre-existing, non-pregnancy-related blood sugar problems.)

Sonja , 40, married to DH (42) since 5-29-93, DD born 11-3-2004, DS born 1-18-2007.
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Old 10-05-2006, 09:14 PM
 
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I never had any problems with the glucola either - no bad reactions or anything. I had GD with my first pregnancy (a pretty significant case of it too, despite being a VERY healthy eater, and at a healthy weight...please don't insinuate that it's just a bunch of fat cheeseburger eating girls that *give themselves* GD....)

My blood sugars went immediately back to normal after my first pregnancy, and I was screened for Type II one year after the birth, with no problem.

I did the glucola a couple of weeks ago for this pregnancy. I failed the one hour test so miserably, there was no need to do the three hour. Once again, I have been eating healthily (though I will admit I started this pregnancy heavier than the first, but I am not obese or anything.) I have now had a battery of tests with my endocrinologist, and though we are "calling" it GD for now, he thinks I likely have developed Type II. Disappointing, but I for one am grateful to know (I am already on insulin), in hopes of reducing the effect on my sweet son in utero. (My first son was born at a nice healthy weight of 7 lbs 7 oz, and I was also on insulin during that pregnancy, after first trying to control the sugars with diet - as I said, I had already been eating very healthy meals, so the few changes I made in my diet had little effect, unfortunately.)

My point is only that for me, it was nice to know, and MOST mothers with GD are able to control it with diet.

But, I still don't believe that such prenatal tests should be mandatory.
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Old 10-05-2006, 09:22 PM
 
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But, I still don't believe that such prenatal tests should be mandatory.
Oh, neither do I -- obviously, I think it should be a personal choice which tests, if any, to have done during pregnancy.

What I was wondering about was why people object to the glucose tolerance test -- it's non-invasive, has no negative effect on the baby, and tests for something that can have negative repercussions for both mother and baby. So why does it get such a bad rap?

Sonja , 40, married to DH (42) since 5-29-93, DD born 11-3-2004, DS born 1-18-2007.
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Old 10-05-2006, 09:22 PM
 
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I did not have a problem with the test in my first pregnancy either.
But I guess I'm adverse to it now for a few reasons. One is that I tend to think that many of these "mandatory" tests assume that a pregnant woman is a sick one...and they test everyone "just to be sure"...kind of the same philosophy that justifies a lot of interventive practices in medicalized labor/birth.
I do realize that these tests/interventions are there for some moms who do need them....but not for the bulk of normal/healthy pregnancies.
Also, I remember drinking lots of that "glucola" for the test and frankly, that is something I would never do in real life. I eat a very balanced diet and think that if my blood sugar is to be tested, the results would be realistic if the testing took place under normal circumstances.
And the third reason is that (call it silly), all of that glucola sugar going into my body/baby just makes me feel a bit grossed out.

Mel.
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Old 10-07-2006, 12:49 PM
 
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I DID have a problem with the test my first pregnancy. I tested high during the screening, so I had to do the 3-hour test, I had to fast for 12 hours prior to the test, then drink a high sugar drink, my b/s went up and up ,and then crashed down to 70, I left feeling a bit ill and was driving home when I started feeling really weird and then began shaking, I had to pull over and get a soda. I could have gone into convulsions, and crashed!

Not only that, but I've said before on another thread, that many many people feel that gestational diabetes is a
'diagnosis in search of a disease'
google that quote if you want all the details. My m.w. reccommends against the test, but will do it if I want to, which I don't.

BTW, I was diagnosed last time with G/D and after my ds was born they had to poke him all the time to keep checking his b/s....what a terrible experience for nothing!!
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Old 10-07-2006, 03:07 PM
 
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Personally, I don't really understand what the big deal is about the glucose tolerance test, having taken it 3 times with my fourth time coming up in a couple of weeks. Yes, it made me a little nauseous at 20 weeks with this pregnancy, but it wasn't exactly a horrible experience. At my doctor's office, you drink the stuff ahead of time, come in half an hour later, and tell them when you drank it. They then draw the blood at the appropriate time, and off you go -- doesn't seem like a big deal.

As for the A1c test, since that measures blood sugar levels over the preceeding 3 months, I'm not sure that really meets the same purpose, since the point of taking the glucose tolerance test is to measure your body's response to glucose right at that time, not over the last 3 months. (This time around, they gave me the A1c earlier on in the pregnancy, to test for pre-existing, non-pregnancy-related blood sugar problems.)

First of all, those of us committed to keeping organic and chemicals out of our bodies find the "sugary drink" to be offensive. I don't drink soda or anything with "sugar" in it (on a rare occassion maybe lemonade - homemade). I find the ingredients of the "sugary drink" for the glucose intolerance test are really against what I consider healthy or what I want to expose my baby too even briefly. I also feel it is dangerous to fast and to drink that on an empty stomach to SEE if you react. As someone posted, they did react and it was scary. Pregnant women do not need to be put into a position that makes them feel lightheaded, dizzy, or sick left to drive home on their own, care for other kids, etc.

Also, since most women have the glucose test at about 28 weeks (not 20 that is early for "routine"), the ac1 which test over the last 3 months would be indicative of a problem, if one exisit. It is a more accurate test and since you have had the ac1 and the glucose I would assume that would mean you have researched them in full prior to consenting, but not everyone does.

For every test or procedure routine or not, informed consent is the best way to make a decision. And by informed consent I don't mean listening to what your doctor says and then feeling pressured, I mean researching it at home not under pressure and coming to a conclusion you can live with.

GD is a medical mystery, sometimes diet helps, sometimes it doesn't, sometimes insulin helps, sometimes it doesn't, it's a hit or miss "game" b/c the condition is completely misunderstood.
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Old 10-07-2006, 09:59 PM
 
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I find the ingredients of the "sugary drink" for the glucose intolerance test are really against what I consider healthy or what I want to expose my baby too even briefly.
I can see that -- I certainly agree that it's not something I would ordinarly choose to drink.

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I also feel it is dangerous to fast and to drink that on an empty stomach to SEE if you react.
I do agree that the test is unnatural, in that fasting for 12 hours and then consuming straight sugar isn't something people normally do. I'm personally comfortable with this approach, as I like the idea of measuring my body's response to an exactly measured dose of sugar.

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Also, since most women have the glucose test at about 28 weeks (not 20 that is early for "routine"), the ac1 which test over the last 3 months would be indicative of a problem, if one exisit.
Actually, my understanding is that most women who develop gestational diabetes develop it between the 24th and 28th weeks of pregnancy, which is why the standard screening test is done at 28 weeks -- and why an A1c test performed at 28 weeks might not show anything unusual, even if the woman had developed gestational diabetes.

I'm not actually sure whether my doctor prefers to test all women over the age of 35 for gestational diabetes at both 20 and 28 weeks; I do know that since I have a family history of type 2 diabetes, I'm happy to undergo such testing, and have chosen in the past to be tested for blood sugar problems when I wasn't pregnant.

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For every test or procedure routine or not, informed consent is the best way to make a decision. And by informed consent I don't mean listening to what your doctor says and then feeling pressured, I mean researching it at home not under pressure and coming to a conclusion you can live with.
And that, I can certainly agree with.

Sonja , 40, married to DH (42) since 5-29-93, DD born 11-3-2004, DS born 1-18-2007.
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Old 10-07-2006, 10:04 PM
 
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I've had all 3 of my pregnancies and births in MA and there was never a mention of getting the GT test from my midwife.

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Old 10-11-2006, 02:27 PM
 
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I wish I'd known an alternative way to do this test. Since I am super healthy and have no warning indicators of needing a 'glucose' test, I was not particularly enthused, but thought it was no big deal. Later that morning, after feeling sick and nauseous the entire way to the appmt, I threw up in front of my physician a total of 5 times, in the sink. Needless to say it was the highlight of my prenatal care. (Well,not really.) What the heck do they put in that stuff? I thought it was just like orange soda or smthg.
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Old 10-11-2006, 02:32 PM
 
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It might be "mandatory" at their office- which means that women have a choice between taking the glucose test or finding another care provider.

It also could mean that the nurse has never encountered anybody who declined the test and "assumed" it was mandatory- the head OB or MW might be willing to work with a woman who chose not to do the test, but the nurse is unfamiliar with that.

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