WWYD: Glucose Test during Pregnancy

[Canadianmumof5]

So I am at that point in my pregnancy where one would do those glucose tests. I don't want to do it. My midwife is encouraging me to go. I don't want to do it. Did I mention that I don't want to do it?

 

FTR, a few things you should know;

• We have big babies - 2 were 9lbs 7oz, and 2 were 9lbs 10oz (yep, we are consistent). That is just how we make them.
  
• None of the babies had issues with sugar, etc at birth or in the days following. Yes, they were tested and only because apparently that is the protocol with babies over a certain weight at a certain gestation.
  
• I had gestational diabetes with my last pregnancy only. It was borderline - as in perfect for fasting, and just 1 point over the upper limit for both the 1 hour & 2 hour readings.
  
• I was testing my sugar 2-3X a day - NEVER had an abnormal measurement. Even when I ate like carp. Sometimes I exercised.
  
• I've been testing at various points during this pregnancy and so far, not a single reading outside of the normal range.
  
• I am otherwise healthy. I have low blood pressure normally and it is lower now (87/60 @ my last appt). No other issues.
  

Here is my rationale: I don't want to waste 3 hours at a lab. They are always jam packed with people (50+ people), many of them are sick, and I won't be able to leave. That is a lot of time just sitting there. Yes, I could bring a book; no, they don't allow you to use cell phones in the lab waiting rooms, and yes, I would need to get a friend to watch the other four kids for that time.

 

So - knowing all of that, if this were you, would you;

 

A. Just skip it and continue to test at home and exercise and eat healthy.

 

B. Suck it up and go do the test.

[Dory]

My mom lost my little brother when we was 6 months along due to gestational diabetes that she hadn't been concerned about and hadn't gone in for glucose testing. I don't remember all the ins and outs of what all went on, but the heartache over having a stillborn baby that far along and holding that little one when I was 5 years old has stuck with me enough that I did every blood test they suggested.

[jewellsmommy]

:grouphug: Suck it up and do the test :D.

 

I did 6 while pregnant! The doc just could not accept that I was not going to develop any issues. I have pcos and he was convinced that I was going to develop GD (never did). I still can't drink orange soda to this day (10 yrs later :lol:) but I don't regret doing what I had to do. And trust me a nurse had to stand over me and threaten me to get me to drink that c*ap fast enough. I soooo understand where you are coming from. :001_smile:

 

ETA: I ate low carb my entire pregnancy. OK, I went over on a couple days. It was all the chili cheese dogs I kept craving, I had to have the bun too.:)

Edited July 4, 2012 by jewellsmommy

[wapiti]

So, you had GD with your last pregnancy. What I would do: assume you have GD again, eat accordingly and continue testing 4x per day and reporting all your numbers to your health care provider (as I did during my last pregnancy on a weekly basis). If you assume a diagnosis of GD and according diligence going forward, then you don't need the test. If you might fail to be diligent with diet and testing, then I would not avoid the test.

 

That's what happened during my last pregnancy, when I was already taking metformin due to PCOS. I passed the 1 hour test, and rather than have me take the 3 hour (in spite of the negative result on the 1 hr), my OB had me assume GD, see the nutritionist, and test blood sugar with the glucometer 4x per day. Sure enough, as I got further along in the third trimester, I began to blow through the limits. (hint: don't eat pancakes. ever.) My OB, very experienced and very cautious, demanded tight control.

 

Eta, when I say assume the diagnosis, I mean literally in your chart.

Edited July 4, 2012 by wapiti

[raceNzanesmom]

I'm not a believer in the glucose testing for all women. My concern, however, would be if you birth at a hospital they'll want intervention since you didn't test. If you're birthing at home, I'd keep watching your levels, eat right, plenty of water, walk when you can.

 

Congrats on your new babe!!

[ssavings]

I'd either do the test, or assume its positive and act accordingly.

[wapiti]

A. Just skip it and continue to test at home and exercise and eat healthy.

 

By "eat healthy," I am assuming you mean a carb-counting, GD diet.

[Forget-Me-Not]

I'm not a believer in the glucose testing for all women. My concern, however, would be if you birth at a hospital they'll want intervention since you didn't test. If you're birthing at home, I'd keep watching your levels, eat right, plenty of water, walk when you can.

 

Congrats on your new babe!!

 

 

:iagree::iagree: The Intervention Factory, I mean hospital, in my town practically insists on a scheduled c-section for GD moms. At the very least, they like to induce them.

[Canadianmumof5]

By "eat healthy," I am assuming you mean a carb-counting, GD diet.

 

100%

[Canadianmumof5]

:iagree::iagree: The Intervention Factory, I mean hospital, in my town practically insists on a scheduled c-section for GD moms. At the very least, they like to induce them.

 

:confused1: A c-section??? Sheesh, I thought it was bad enough that they want to induce me at 39 weeks since I am of "advanced maternal age" (40). DH will not agree to a homebirth so hospital it is. I am OK with that - our midwives have great relationships with the OBGYNs so I don't think there would be any interventions unless it was seriously required.

[Canadianmumof5]

My mom lost my little brother when we was 6 months along due to gestational diabetes that she hadn't been concerned about and hadn't gone in for glucose testing. I don't remember all the ins and outs of what all went on, but the heartache over having a stillborn baby that far along and holding that little one when I was 5 years old has stuck with me enough that I did every blood test they suggested.

 

Oh gosh, I am so sorry about your brother :grouphug:

[Forget-Me-Not]

:confused1: A c-section??? Sheesh, I thought it was bad enough that they want to induce me at 39 weeks since I am of "advanced maternal age" (40). DH will not agree to a homebirth so hospital it is. I am OK with that - our midwives have great relationships with the OBGYNs so I don't think there would be any interventions unless it was seriously required.

 

Yeah, I may be exaggerating, but only slightly. Don't get me started on the birth climate around here. There's at least one (male) OB in town who thinks that ALL women should deliver by c-section "to preserve their pelvic floor". :ack2:

[Annie]

Would you consider doing your own glucose tolerance test at home using jelly beans?

 

I did it once, and while it wasn't pleasant, it was tolerable.

[Dory]

Yeah, I may be exaggerating, but only slightly. Don't get me started on the birth climate around here. There's at least one (male) OB in town who thinks that ALL women should deliver by c-section "to preserve their pelvic floor". :ack2:

 

Oh my goodness!!! I've never heard anything like that before! We have the opposite problem around here. The doctors like to push things as far as possible because they don't want to have to do a c-section. Which is good unless your pelvis is too small or you've been in labor for 2 days and the baby is showing signs of distress.

[knittingmomof3]

Just wanted to chime in. I had GD with all 3 pregnancies. With my second and third pregnancies, I began testing 4-5 times/day as soon as I had the positive HPT. It was obvious that the GD had returned so I refused the glucose tests and continued to do finger sticks and follow the diet. As long as you are doing what you are supposed to do and verifying success with finger sticks, you will be fine. I was adamant that I didn't want to unnecessarily expose my babies to 3 hours of high blood sugars when I already knew from home testing that the GD had returned. Eat the way you know you should and TEST TEST TEST!

[Chocolate Rose]

I refused to do the glucose test. My doctor agreed to my decision as long as I got a meter and strips and tested every day. I never had any blood sugar issues.

[Forget-Me-Not]

Oh my goodness!!! I've never heard anything like that before! We have the opposite problem around here. The doctors like to push things as far as possible because they don't want to have to do a c-section. Which is good unless your pelvis is too small or you've been in labor for 2 days and the baby is showing signs of distress.

 

Yes, he's one of only five OB/GYNs in town and they're all in the same call group and they're ALL c-section lovers. I hate this area. I really want to VBAC this time around and I'm going to have to fight or travel for it because of crappy OB coverage and stupid hospital policies :glare:

 

Anyway, didn't mean to hijack. Sorry!

[Canadianmumof5]

Thanks for the replies.

 

For those of you who have had GD before and tested, can you tell me when exactly you were testing?

 

With my last pregnancy, they told me to test first thing in the morning (fasting) every day and then test 2 hours post-meals; but just to choose 1 meal at random each day. So test after breakfast on Day #1, lunch on Day #2 and Dinner on Day #3. They didn't suggest testing after each meal, or even after 2.

 

If I decide to pass on the test, should I increase the testing to after every meal? Any other important times of the day?

[Canadianmumof5]

Yes, he's one of only five OB/GYNs in town and they're all in the same call group and they're ALL c-section lovers. I hate this area. I really want to VBAC this time around and I'm going to have to fight or travel for it because of crappy OB coverage and stupid hospital policies :glare:

 

Anyway, didn't mean to hijack. Sorry!

 

That is awful!!!

But congratulations on your pregnancy :001_smile: I hope you can find a more supportive group close to home.

[Soror]

Fwiw I don't do the test. I don't think it should be routine without checking risk factors. I homebirth but see an ob for backup and he is fine with me skipping . In your case I would assume positive and follow the diet with testing since you've previously had it.

Edited July 4, 2012 by soror

[wapiti]

If I decide to pass on the test, should I increase the testing to after every meal?

 

Yes. Fasting as soon as you wake up, and then 2 hours after breakfast, lunch and dinner. That's one way to force you to space out your snack until right after you've done your test :D.

 

Record it on a chart or spreadsheet. If the meter remembers the numbers, write them all down once a day or something.

 

I would not skip testing at home with the glucometer, religiously.

[ktgrok]

Will she let you substitute a different test? My midwife just does a post prandial (post meal) test instead. She says she doesn't care what my glucose is after drinking that crud, as I'm not supposed to eat/drink stuff like that anyway in pregnancy.

 

That said, if you are delivering at a hospital, how will they treat the baby differently if you don't have the test? My fear would be that with no negative test on record they would want to constantly test the baby, keep them in the nursery, give sugar water, etc. I'd test to avoid that. Oh, and pace around/walk during the waiting time to burn some of the sugar off.

 

Again though, I am lucky in that my midwife does the alternate test. I think if you are testing at home there is no point to the lab version, other than to pacify the hospital.

[Canadianmumof5]

Yes. Fasting as soon as you wake up, and then 2 hours after breakfast, lunch and dinner. That's one way to force you to space out your snack until right after you've done your test :D.

 

Record it on a chart or spreadsheet. If the meter remembers the numbers, write them all down once a day or something.

 

I would not skip testing at home with the glucometer, religiously.

 

You just read my mind.....half the time I am already snacking before the 2 hours is up :lol: How the heck would I be able to test after every meal with that kind of snack schedule??!!

[WiseOwlKnits]

I got so sick after the test with DD1 (that I passed with flying colors) that I refused with DS and DD2. I offered to test, go on a GD diet, whatever they wanted to make them happy as long as I didn't have to take the test. I was fine with both of them. DD2 was actually my smallest baby at 8 lbs., 7 oz.

 

:confused1: A c-section??? Sheesh, I thought it was bad enough that they want to induce me at 39 weeks since I am of "advanced maternal age" (40). DH will not agree to a homebirth so hospital it is. I am OK with that - our midwives have great relationships with the OBGYNs so I don't think there would be any interventions unless it was seriously required.

 

OK, I probably shouldn't mention this...but you do realize that a mandatory induction at 39 weeks IS an intervention, right? And a mandatory induction for maternal age is a terrible reason to induce if the pregnancy is otherwise healthy. Please look up your Bishop's Score before you consent to an induction. Please, please, please.

[Truscifi]

If you pass on the test, yes I would increase to testing after every meal. That way you will definitely catch it if it starts running high.

 

ETA: I would suck it up and have the test. In fact, I had my 2nd yesterday, but my numbers at home have been running somewhat high as well. I had GD with ds8 and there were some complications during labor, and he was severely jaundiced (bilirubens over 20) and needed a week of light therapy. The ped said it was related to the GD and she would have preferred me to be induced early as he would have had less risk of jaundice. FTR, I was induced anyway, as ds didn't want to come out, but it was a few days after my due date.

Edited July 4, 2012 by Truscifi

[AK_Mom4]

I had GD with DD11. I failed the one hour test miserably and so there was no need to do the 3 hour test. I tested 4 times a day - fasting first thing in the morning, then 2 hours after each meal. I had a very severe case that could not be controlled with diet and exercise alone. But, thanks to all the testing, we caught on to it very quickly. I was on insulin for the last 3 months and DD was a healthy and happy full-term 8 pound baby. She was SUPPOSED to be a VBAC, but apparently didn't get the memo and decided to be transverse and show up via c-section.

 

If you are going to follow a GD diet and test regularly anyway, I don't see the value doing the tolerance tests.

[kricau]

Yeah I always thought that was weird. They make you drink that junk just to fiond out if you have a bad reaction to it. There has got to be a better way. I don't think you need to do the test, as long as you are checking your blood sugar levels daily and are eating (or rather not eating) things you know to eat. I too had GD and it was a pain. They made me go into the hospital 3 times a week for fetal monitering. Then at 37 weeks they freaked out and took her out via emergency c-section. I was NOT happy with it. But we do have a healthy girl :) So it was all worth it. I wouldn't risk anything, just to save myself 3 hours of annoyance. So if you think you need to know if you are to control it, you better go. But if you assume you are and know what to do, then your safe :) Does that make any sense?

 

Will she let you substitute a different test? My midwife just does a post prandial (post meal) test instead. She says she doesn't care what my glucose is after drinking that crud, as I'm not supposed to eat/drink stuff like that anyway in pregnancy.

 

That said, if you are delivering at a hospital, how will they treat the baby differently if you don't have the test? My fear would be that with no negative test on record they would want to constantly test the baby, keep them in the nursery, give sugar water, etc. I'd test to avoid that. Oh, and pace around/walk during the waiting time to burn some of the sugar off.

 

Again though, I am lucky in that my midwife does the alternate test. I think if you are testing at home there is no point to the lab version, other than to pacify the hospital.

[AK_Mom4]

You just read my mind.....half the time I am already snacking before the 2 hours is up :lol: How the heck would I be able to test after every meal with that kind of snack schedule??!!

 

Make sure that if you snack before the 2 hours is up, that you limit your snack to proteins. Keep the snack 10g of carbs or less. A handful of nuts or a cheese stick will generally hold you until the 2 hours are up and have little effect on the blood sugar readings. If you are still hungry when the 2 hours is up, then have a second snack.

[kitten18]

*I* would suck it up and do the test. But, I'm compliant like that. :D

[FaithManor]

Personally, I'd test at home which is more accurate anyway.

 

I never had GD and by the third pregnancy couldn't keep that awful stuff down...seriously, I'd just start vomitting and could.not.stop...it set off my pregnancy nausea in the worst way. I eventually made the naysayers do the A1C which is a FAR more accurate test anyway. It was normal.

 

But, just to make them happy because I didn't follow the standard protocol, I made sure I ate just about zero simple carbs and I tested with a glucose monitor twice per day for about four weeks at which time they finally conceded everything was fine. During the last pregnancy they were absolutely certain I had GD despite the fact that every single home test and A1C was normal. GRRRRR....ds was born on his due date and weighed 8 lbs. 1 oz.

 

I do not believe in ignoring blood sugar issues during pregnancy or being naive about them. However, standard 28 week testing isn't all that reliable...it gives a fair number of false positives and negatives (at least according to my endocrinologist who hates the fasting blood sugar, drink the crap test and believes that fasting is actually bad for the baby when followed then by a truck load of sugar). So, I believe in checking for it, but with much more accurate methods.

 

Faith

[alpidarkomama]

So, you had GD with your last pregnancy. What I would do: assume you have GD again, eat accordingly and continue testing 4x per day and reporting all your numbers to your health care provider (as I did during my last pregnancy on a weekly basis).

 

:iagree:

 

There's no risk at all in just assuming you have it and eating and testing accordingly.

[JennyD]

I had GD with my second but not with my first and third babies. I am surprised to hear about the problems it can cause at some places -- I delivered at a big not-especially-crunchy urban hospital and even there diet-controlled GD did not risk you out of the in-house birth center. (Low blood platelets, which I also have, does risk one out, alas.)

 

In your situation, OP, I would -- like others -- either do the test or simply assume that I had GD and proceed accordingly. However, I personally would find the 3-hour test *infinitely* less annoying than three months of the GD diet and testing rigamarole, so I would definitely do the test just on the off chance that you don't have it and therefore do not need to stick yourself multiple times a day for the next 12 weeks.

[jennsmile]

Which scale are they using? (10 years ago there were 3) I had a doc that used the lowest scale and I was a point too high he wanted to hospitalize me 24 to monitor me. I switched doc's and got a second opinion. Thankfully he used a different scale but he did make me retest.

 

I would avoid the test but that is me. It makes me sick, literally and that can't be healthy for me or my baby. I don't get sick when I eat food just the nasty glucose drink.

 

Good luck.

 

Can you do the jelly bean test or even eat a real meal?

[Coffeetime]

I have never had GD, but I have never passed a 1 hour GD test, and have only passed a 3 hour test a few times. ;) My last couple of pregnancies my doctor, instead of having me do a pointless test, gave me a glucose monitor and had me test my fasting sugar in the am, and 2-3x during the day. Never once had an abnormal reading. We did this for a month and then called it good. :)

I would see if your midwife would be willing to take this route, instead.

[Impish]

B/c your last was indicative, I'd suck it up and test.