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Glucose tolerance test in pregnancy--I failed again!!


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With my last 2 pregnancies, I've failed the 1 hour test and passed EVERY hour of the 3 hour test. I had the 1 hour test today and (shock!!) failed. When I mentioned this to the tech. doing the blood draw, she said that that is very common. Harumph. I don't have 3 hours to sit at the hospital with 3 kids and I hate making DH watch them. I know I'm fine. Should I put my foot down and refuse to take the 3 hour test?

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Well, depending on your practice, they may assume you to be a gestational diabetic and treat you as high risk if you do not take the test to disprove this. We have lots of doctors around here who will assume this and pressure women for c-sections for suspected macrosomia, even if mom's pass a 3-hour test. Yikes.

 

I would talk about this to the doctor before scheduling the test. Discuss your past history and ask what the ramifications would be if you did not take the 3 hour test. Good luck (or should I have not said that:).)

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I had 7 babies and failed the 1 hour 5 times! I hated the 3 hour test and "failed" once b/c I threw up and couldn't keep the glucola down. Another time the glucola gave me such a bad migraine I had to call my husband to drive me home. My Dr. understood and did not make me do the 1 hour or 3 hour for my last pregancy. He prescribed a glucose monitor and let me test at home. I tested at home for a week doing fasting and 1hour after meals. The blood sugars were fine, and I didn't have to go through that horrible test again!:tongue_smilie:

 

HTH,

Leanna

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Ask your care provider what their policies are? If you aren't happy with them, you can always change.

 

I know some midwives will test blood sugar after a balanced normal meal rather than using the glucose drink. Maybe you can monitor your blood sugar at home as if you were diabetic for a few days/week and if that is consistently good, they'll accept that.

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I had 7 babies and failed the 1 hour 5 times! I hated the 3 hour test and "failed" once b/c I threw up and couldn't keep the glucola down. Another time the glucola gave me such a bad migraine I had to call my husband to drive me home. My Dr. understood and did not make me do the 1 hour or 3 hour for my last pregancy. He prescribed a glucose monitor and let me test at home. I tested at home for a week doing fasting and 1hour after meals. The blood sugars were fine, and I didn't have to go through that horrible test again!:tongue_smilie:

 

HTH,

Leanna

 

 

Glad you didn't have to do it again! That sounds horrible. My previous midwives always tested after a balanced meal and I was always REALLY low. With my first child, the midwife was quite worried at the results. This pregnancy was my first real test. I only did it because I want to use the birth center and they require it; they won't accept a test after a meal. I discussed my 1 hour results with my midwife and we concluded that I wouldn't be able to do a fasting or 3 hour test had I needed it. My blood sugar drops too low too fast and both tests could potentially put me in a coma.

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I would talk to your dr. about it and see if you can work something out. Around here, it's almost impossible to get out of it b/c of super-strict malpractice laws. And the insurance companies are quick to label you as non-compliant and start refusing to cover things. I tried to go in for the 1 hour test without fasting and got lectured and sent home to come back another day. Ugh. I hate all the regulation.

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Refuse it. I refused with the last pregnancy to even take the 1 hour. Instead, I opted for the "diet" I just said I won't. I fail them pregnant, I fail them not pregnant, I fail them. I don't know why. I've never had diabetes. I've never had large babies. In fact I did the diet so well with #3 that she was only 5 lbs and 12 oz. :glare: But I'm preg with #4 and I am sure I will have fight with this dr (newbie - fresh and eager from training) I'm just not going to be available to drink the stuff that week or the next week or the next until it is too late to worry with it. NOt great plan but I'm going to fail it and then spend a miserable 3 hours being stuck with bloody bruises everywhere just to be told everything is fine just keep a eye out for all the warning signs. I figure they keep an eye out for all the warning signs without having to do the test. But I'm stubborn. ;) A quickie sonogram can keep tabs on the baby size.

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I always fail (and just did so again) the one hour finger prick test. However, with this baby they sent me straight to a lab for a vial of blood. It came back fine & I avoided the 3 hour torture!

 

they want me to take another 1 hour test next month b/c of my weight & age.Ugh. I told them I didn't want it, but they said it was really needed. Shoot.

 

I may not eat for 2 days to avoid the vial... b/c I always fail the finger prick.

 

You can atleast try to resist. Actually, legally, I don't see how they can make you. It is your body & your test. But they make you really feel like you should.

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This was a hot topic for me during my last pregnancy, during which I discovered Henci Goer. Check out her site http://www.hencigoer.com and especially this page: http://www.lamaze.org/Forums/AskHenci/tabid/363/view/topics/forumid/12/Default.aspx

 

I must say though that my drs were very pressuring about my views and would not give up. They finally pushed the issue by forcing me to come in for weekly NSTs and then saying my baby looked abnormal on a sonogram, which meant i had to see a specialist. He did not think there was a thing wrong with the baby and acted very casual about it. Our baby was perfectly normal. They tried to tell me I HAD to induce early because they suspected dwarfism, even though the specialist disagreed with this.

 

I did not induce early and my baby was perfectly normal.

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Gestational diabetes is serious, as I'm sure you know. If you don't want to do the test to find out if you are or not, do you intend to ignore the issue or eat as though you are diabetic? To keep off insulin last time I had to cut all grains from my diet and get my carbs from legumes. I don't recommend that unless you have to! If you have a meter, you can test at home and monitor yourself, but I don't imagine you would want to fork out for a meter just to avoid a three hour test.

 

Rosie

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Actually, Rosie, using the meter makes a lot more sense than the Glucose Tolerance Test. The research I have done into this issue has highlighted that the testing has not made a difference in perinatal outcome. There is a lot of debate within the obstetric community as to what numbers should be used as a cut off. It is all very unscientific. With a meter, you can test real life situations - fasting and post-prandial.

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Actually, Rosie, using the meter makes a lot more sense than the Glucose Tolerance Test. The research I have done into this issue has highlighted that the testing has not made a difference in perinatal outcome. There is a lot of debate within the obstetric community as to what numbers should be used as a cut off. It is all very unscientific. With a meter, you can test real life situations - fasting and post-prandial.

 

You can also get huge variation using the meters as well, so I don't put a heck of a lot of faith in them either. Still they're the best we have, so that's what we use. None of that makes gestational diabetes any less serious so it is important to know whether or not you have it so you can treat it appropriately.

When you said "testing has not made a difference in perinatal outcome," what sort of outcomes are you talking about. Someone else here seemed to be suggesting that a test wasn't necessary because either you or the docs would notice if you had diabetic symptoms. I can assure anyone that isn't true!

 

You lot are lucky to get the meters for free! I was able to borrow from the hospital for the first pregnancy, but so few were returned they stopped lending and I had to fork out $60 for one for my second pregnancy. Kind of wish I'd kept the first one. Now I have a meter I don't need. :glare: Not that I want to need it!!

 

Rosie

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According the book "A Guide to Effective Care in Pregnancy and Childbirth"

"There is no convincing evidence that treatment of women with an abnormal glucose-tolerance test will reduce perinatal mortality or morbidity. Trials of dietary regulation for "gestational diabetes" do not demonstrate a significant effect on outcome, with the possible exception of macrosomia. Trials comparing the use of insulin plus diet with diet alone, show a decrease in macrosomia, but no significant effect on other outcomes, such as use of cesarean section, the incidence of shoulder dystocia, or perinatal morality. There is no evidence that such treatment reduces the incidence of neonatal jaundice or hypoglycemia. "

 

"The diagnosis of "gestational diabetes," as currently defined, is based on an abnormal glucose-tolerance test. This test is not reproducible at least 50 - 70% of the time, and the increased risk of perinatal mortality and morbidity said to be associated with this 'condition' has been considerably overemphasized. "

 

"An abnormal glucose-tolerance test is associated with a two or threefold increase in the incidence of macrosomia, but the majority of macrosomic infants will be born to mothers with a normal glucose-tolerance test.

 

There is, in addition, a great potential for doing more harm than good by performing a glucose-tolerance test. A positive result labels the women as having a form of diabetes. Her pregnancy is likely to be considered as "high-risk", invoking an extensive and expensive program of tests and interventions of unproven benefit. A negative glucose-tolerance test, on the other hand, also has a potential for harm by falsely reassuring the physician and the woman that the risk, engendered by the indication for the test, has been removed. "

 

It did go on to say that, for moms suspected of diabetes, testing blood sugars regularly in a fasting state and 2 hours after a meal are much better at improving outcomes.

 

This book is published every year an overview of the results of the best available research about maternal practices. It uses the Cochrane Database, which is highly regarded as a source of good research. It is available at childbirthconnection.org. I think you have to register to read the book online, but it is free.

Edited by dirty ethel rackham
fixing the hyperlink
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I never had much luck passing the 1 hour either - and hated the 3 hour test (but passed it each time). When I asked my midwife if I could just skip the 3 hour, she was very much against it and reminded me that your risk for gestational diabetes does increase with age. So, I found a good babysitter and brought a lot of reading to do. :001_smile:

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I skip the test and refuse to take it because I have a life long history of failing the 1 hour test. It's what I do and I do it well. :) Shakes, vomiting, normally can't even drive because I am so looney. I've passed out more than once and have done that stupid thing since I was a pre teen. With the first couple of babies I followed the advise, went thru hell, and then hell again for the 3 hour. But imagine my disgust to find out that all of my obs (I've had 3 different ones) all had the same approach. If you failed the 1 hour, you are considered a diabetic and they insist on you doing the diet regardless of the outcome of the 3 hour test. Just to be on the safe side.:glare: While I understand the reasoning and appreciate the concern, it irritates the fire out of me that I go thru the test, do the follow up and still have to be monitored and treated like I have diabetes to cover their behinds in case the test was wrong. So now, we make an agreement. We know I'm going to fail the first test (past history makes it highly unlikely I will magically pass) and we know you are going to monitor me regardless of the outcome of the 3 hour test as a diabetic and have me follow the diet, so lets just skip Points A and B and go straight to C. So that's why I said I would refuse to take the test. Plus, they have all said they would do the diet first before giving insulin to see if it would be controlled that way, so it's not like I am taking any kind of risk by refusing the test. I'm just skipping the test that cause me great grief and issues and just following the treatment plan. I don't have to make arrangements for the kids and for a driver to babysit me and the drs know they will catch any issues because I've agreed to be monitored.

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I skip the test and refuse to take it because I have a life long history of failing the 1 hour test. It's what I do and I do it well. :) Shakes, vomiting, normally can't even drive because I am so looney. I've passed out more than once and have done that stupid thing since I was a pre teen. With the first couple of babies I followed the advise, went thru hell, and then hell again for the 3 hour. But imagine my disgust to find out that all of my obs (I've had 3 different ones) all had the same approach. ..... I'm just skipping the test that cause me great grief and issues and just following the treatment plan. I don't have to make arrangements for the kids and for a driver to babysit me and the drs know they will catch any issues because I've agreed to be monitored.

 

I am so glad to know I am not the only one.:tongue_smilie:

My Dr. asked me to follow the diet too, even when I did pass the 3 hour. (That didn't include the time I threw up and couldn't finish the test, so I automatically failed!) One thing that always got me is that most of my babies were in the 6-7lb range at 40 weeks. I never had a high blood sugar on my home glucometer (with 5 babies). What was high risk about that? I wonder if some women are just overly sensitive to the glucola?

 

~

Leanna

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