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declining the glucose tolerance test when pregnant


blondeviolin
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Tomorrow is my next OB appointment. I'm supposed to do the GTT, but I'm thinking about skipping it. I have symptoms of hypoglycemia when I'm pregnant, so the glucola really throws me for a loop. When I was pregnant last, I nearly passed out because of the low that came after drinking the drink. I don't want to feel so cruddy tomorrow. I have NO symptoms or history of gestation diabetes. With my last four babies my sugar level was always well below 100. My diet isn't pristine, but it's definitely not all cookies and candies and no veggies, y'know? (If I ate like that I'd feel like crud all day!) My last baby was "large" (9lbs10oz), but his sugars were all normal the three times he was checked after birth.

 

I'm not typically one to skip tests when I'm pregnant, so I'm not used to making waves about something. This isn't a dumb move, right?

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I always skip it because I crash also. However, I always have GD. Since I will be following the GD diet and testing anyway, it is easy for me to skip it.

 

Some OBs work with you on it, but for some it is not negotiable. I have read some good threads here about people being allowed to eat certain things or drink orange juice instead of the glucola. I will try to find one and post it.

 

If you do have to drink the glucola, try to get the lime flavor. It is so much better than the orange, IMO.

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I am totally supportive of patient's rights to refuse any medical care they don't want. But do be aware, your OB may drop you as a patient if you refuse. I wanted to skip it with my youi dngest. My OB was kind but firm that it was non-negotiable if I wanted to stay at the practice.

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I am totally supportive of patient's rights to refuse any medical care they don't want. But do be aware, your OB may drop you as a patient if you refuse. I wanted to skip it with my youi dngest. My OB was kind but firm that it was non-negotiable if I wanted to stay at the practice.

 

 

Most midwives won't drop you for choosing not to do a test. We don't tell you what to do. We offer testing, you choose it you want to do it or not.

 

So, if you have issues with an OB, maybe consider a midwife.

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I refused with my last pregnancy, as I had no symptoms, no history, and basically, I just really didn't think I needed to. Like you, I eat and ate well, though not perfectly, and just didn't think that nasty thing was going to give an accurate representation of how my body'd respond anyway. My midwife was fine with it, though I was a year past the recommended age, because she'd been seeing me for a long time and through enough pregnancies that she could judge that I didn't need to do it.

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I "failed" the one-hour test with my first two babies but "passed" the three-hour miserable torture test both times. My first baby was still nearly 9 pounds, and my second was nearly 10. So I figured either I had GD that the test didn't catch, or I didn't have it and just grow big babies, and I decided that I was never going to do the test again because it was so miserable. So I declined it with my third baby and just ate sensibly. Baby was only 5 ounces smaller than baby #2 (probably because he was gestationally three days earlier). None of them had their sugars checked after birth but none of them showed any problems.

 

So with my fourth baby, I again declined the test and ate sensibly. But since I am at higher risk for diabetes since my parents both have it, my midwife gave me a glucose tester and meter, and I spent a few weeks testing my own sugars in the morning and one and two hours after meals. I found that to be really helpful, because I could tell what spiked the sugars and what didn't, and I was able to correlate my meals to how I was feeling. Sometimes when I'm pregnant, I feel woozy and weird, but by testing, I was able to see that yes, I was feeling that way because of a particular meal. I did find that it was easy to keep my sugars in normal ranges if I observed a few simple rules (like, very limited carbs at breakfast), and it's carried over into how I eat when non-pregnant. So I would talk to the OB about doing something like that instead. (If I had not been able to keep my sugars in range, I'd have talked to the MW about official testing and treatment.)

 

Oh, and baby #4? He was exactly 8 pounds. But whereas all of my others were about 41-weekers, he decided to appear at 38w3d. He was on track to be the same size as his big brothers. (And he was healthy after birth too, no sugar issues.)

 

ETA: This is also what convinced me not to do the testing again. When I was waiting for the three-hour test with my first baby, the MWs told me to limit simple carbs, no juice, no bananas, no fruit in the morning etc. Three years later with my second baby, they told me to eat as many simple carbs in a day as I could, 300 grams, for three days before the test. So with completely different eating protocols, I passed the three-hour test both times, which convinced me that, for me, it's not a useful test.

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I wouldn't necessarily skip it, but I would refuse to use the glucola. Last time I had this done I was able to eat half a banana and a glass of orange juice. Not the best choice to feel great in the morning, but better than a slug of straight glucose. There was no way I was drinking that stuff. I would be passed out in bed for days afterward--that can't be healthy!

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If you do have gestational diabetes, it can be devastating to your baby. The hard reality is that you might feel fine, but your body may be not functioning properly in terms of feeding your baby. If the test is hard for you, see if there are other ways to test or monitor you. There are other ways of doing it. Ages ago they let me do a certain number of jelly beans. Some OB's will let you skip the test if you agree to more frequent blood sugar tests and/or late term sonograms, but that isn't that common.

 

Locally a midwife agreed to let an at-risk mom skip testing for gestational diabetes and being weighed. Another midwife had actually refused the case because of that. They also didn't do any sonograms at all. The mom came through it fine, but baby did not . There was a big invesigation, and the midwife was suspended from practicing for a year.

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Most midwives won't drop you for choosing not to do a test. We don't tell you what to do. We offer testing, you choose it you want to do it or not.

 

So, if you have issues with an OB, maybe consider a midwife.

 

 

 

If I had it to do over, I'd have gone with a midwife instead of an OB both times.

 

I've had a pediatrician refuse to keep us on as patients for our decisions regarding vaccinations, too.

 

Good luck OP, whatever you decide to do. Remember that your health care is YOURS. It does not belong to anyone else, including the health care providers you choose to assist you. THEY work for YOU, not the other way around.

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FWIW, this last pregnancy the drink they serve had changed. It was like drinking a glass of pop. You might want to check around and see if you can get a different drink than you have had before.

 

I understand disliking the sugar crash. I'd talk with your doctor about considering postponing the GTT until there is one positive indicator for GD, or something like that.

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I understand. That stuff upsets my stomach. I always ended up throwing up and then they'd have to make me drink it again, and then I'd throw up, and then...eventually laying down on my side in an examination room to keep the nasty stuff down and usually, they'd barely get the blood out before I'd be vomitting again anyway. I don't know what they put in there, for all I know it's high fructose corn syrup, batery acid, and formeldehyde :D , but my stomach will not take it. Of course, outside of semi-sweet and dark chocolate, I actually do not partake of sweet things very much because I just do not like overly sweet items anyway.

 

I ended up by the third pregnancy saying, NO Way, but since I knew it was important to at least have a baseline on sugar levels, I agreed to the blood test they do for diabetics - H1 something...can't remember exactly. It's more accurate anyway because it can tell not just today's sugar level, but back several weeks. The insurance company balked because labs charge more for that test than the glucose tolerance test. However, I argued and eventually consigned myself to paying out of pocket for it if necessary. In the end, my midwives wrote up convincing arguments about my vomitting experiences making the other test vitally important, and the insurance company agreed to pay for it.

 

Faith

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My midwife says that that test is designed to make you fail. What person should drink a bottle of sugar on an empty stomach, pregnant or not? She said if I wanted to do it, to eat a high protein meal beforehand to prevent crashing. I skipped the test for both of my pregnancies and never had any problems.

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I refused it, and the OB had me do an alternate test where they tested my blood sugar levels before and after breakfast. She said that the pre- and post-breakfast test was actually a much better test, but that it's not often used because patients don't want to hang around and have to go to the office twice in a morning. She didn't say that they also fear non-compliance with the no-eating-before the first blood draw part, but I suspect that's also part of it. To get an accurate test, I had to not eat that morning before the first blood draw.

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I declined it for this pregnancy.....I've failed the one hour test with all three previous pregnancies, and passed the three hour 2 out of 3 times. But I have a meter and test frequently at home. For awhile my midwife asked me about my numbers, but she hasn't lately--I don't know if she forgot all about my history or if she just stopped because the numbers were always fine when she asked and because I haven't had any sugar in my urine, low weight gain, etc. At any rate, I'm actually eating much lower carb now than I did during my pregnancy where I officially had GD.

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