Help/WWYD? 3-hour glucose test AGAIN

[mariposa]

I'm 30 weeks pregnant and "failed" the 1-hour glucose for the 5th pregnancy in a row. My # was 154 (if anyone has any insight into how bad that is, I'd love to know what that actually means). According to the American Diabetes Assn. 180 is the number to "beat" but my drs. office says 130. :confused:

 

So the nurse called today to tell me that I have to take the 3 hour test. Every time I have passed the 3-hour test with no problem. In fact, they made me test early with my last pregnancy and then again later on, so I've had this done 5 times and it always results in nothing. My blood pressure is low, I feel great, weight gain is normal. I REALLY REALLY don't want to spend half a day taking this test yet again, arranging child care for the day, you get the picture. My last baby was 8 lbs. even, so not huge ( I had one that was 9.5 but 1 week late). The other 2 were 8.6 and 7.15 respectively.

 

Anyway, the nurse was actually sympathetic and I have a tele-appointment next week to discuss this with my doctor. If anyone has any further help/support/arguments that I could use to convince her that I don't need to do this I would be so thankful! OR tell me that I'm crazy and I should just do the test (I can take it!).

Thanks,

Sarah

[Bluegoat]

I refused these tests with my last pregnancy. My reasoning was that they aren't considered to be really great tests for gestational diabetes anyway, giving a lot of false positives, they don't really give a realistic challenge to the body, and in fact most countries don't use them for those reasons. As well, if you have an issue and fail them, what they do is make diet reccomendations, and people really ought to be eating well already if they are pregnant.

 

It would be one thing if failing had no repercussions, but it can be used as an excuse for things like inducing early so the baby won't get too big.

 

I am not sure about the numbers myself, but I would be suspicious if the doctor is giving you a different level to fail than is generally recommended. I would tend to think they were looking for some sort of leverage.

[learningmama]

:grouphug: I hate the glucose test (but don't mind the drink actually). I failed the 1-hr twice with ds. My number was either 129 or 139 and the office's cutoff was either 130 or 140 (which I have read is not that bad at all). I passed the 3-hr. Not much advice here. Either just do it or fight not too. Eat healthy and exercise regardless. If you have a big baby, so what. Lots of women do.

[PiCO]

I'm 30 weeks pregnant and "failed" the 1-hour glucose for the 5th pregnancy in a row. My # was 154 (if anyone has any insight into how bad that is, I'd love to know what that actually means). According to the American Diabetes Assn. 180 is the number to "beat" but my drs. office says 130. :confused:

 

So the nurse called today to tell me that I have to take the 3 hour test. Every time I have passed the 3-hour test with no problem. In fact, they made me test early with my last pregnancy and then again later on, so I've had this done 5 times and it always results in nothing. My blood pressure is low, I feel great, weight gain is normal. I REALLY REALLY don't want to spend half a day taking this test yet again, arranging child care for the day, you get the picture. My last baby was 8 lbs. even, so not huge ( I had one that was 9.5 but 1 week late). The other 2 were 8.6 and 7.15 respectively.

 

Anyway, the nurse was actually sympathetic and I have a tele-appointment next week to discuss this with my doctor. If anyone has any further help/support/arguments that I could use to convince her that I don't need to do this I would be so thankful! OR tell me that I'm crazy and I should just do the test (I can take it!).

Thanks,

Sarah

 

I would refuse the test. I would tell them to do an HbA1-c if they want to see how your actual glucose is. Or get a glucose monitor and check yourself after a normal meal (as opposed to after a huge dose of sugar.)

 

I wish I had know I could turn these tests down when I was pregnant...

[Leanna Tomlinson]

I have had gestational diabetes with several pregnancies. I do know that over the past few years the numbers have been lowered that are considered "failing". Most doctors would say anything above 140 is failing for the 1 hour test.

 

If you want to make sure everything is OK, but you don't want to do the 3hr test ask your Dr. to write a prescription for a glucose monitor and test strips. Offer to test yourself after some high carb meals. If your numbers are below 140 1hr after or under 120 at 2 hours after a meal, you are probably fine. They also want your fasting blood sugar to be under 95. A fasting blood sugar is taken before eating in the morning. If these numbers run high, you can still skip the three hour test and just follow the gestational diabetic diet and monitor your blood sugars at home.

 

I refused all testing during my current pregnancy because I've failed so many times before. I just started following the diet and monitoring my blood sugars by mid pregnancy.

 

The glucose tolerance test should be endured by all Dr.s on an annual basis just so they can learn compassion. It's miserable. :tongue_smilie:

[JoLuRu]

They recently changed the "number to beat" to 130 for gestational diabetes.

 

I had one borderline reading this pregnancy and refused all other tests for the reasons bluegoat gave. I tested myself with MIL's kit and had no other problem with high or even moderate readings, and I didn't want to get childcare and give up a morning to the lab.

 

I already eat healthy in general but had hyperemesis (severe throwing up) and wasn't willing to make changes to what actually stayed down! The baby was growing perfectly fine, and I might have been more compliant had she been a giant or too small. She was born on her due date at 8 lb. 2 oz.; I gained exactly 10 lb. while pregnant and was less than my pre-pregnancy weight leaving the hospital. This is not bragging - I threw up until the morning she was born!

[ChristusG]

With baby #1, I passed the 1 hour. With baby #2, I was right at the cut off. With baby #3, I failed the 1 hour. And I refused the three hour. My number was not horrible....I think it was only a few points above the cut off. I knew that at the 3 hour test I would either (A) pass out, (B) throw up, or © all of the above. So I refused it. I just checked my blood sugar a few times a day and watched my carbs/sugar. It worked out just fine.

[beaners]

It makes it more likely for them to "catch" someone with gestational diabetes. I just had a 144 at an office with a 130 cut off for the 1 hour. Other practices I've been at use 140. My 3 hour was "great."

 

They are putting a lot more people through the 3 hour, so that you can identify a larger percentage with GD. It's annoying. In the future I'd rather just do a 3 hour than do both tests.

[Leanna Tomlinson]

And you have to wonder why they changed the number. Is it so they can sell more diabetes supplies? Or is there a legitimate reason?

 

I read that the change stems from a study done on pregnant women with no signs of gestational diabetes. Researchers had non-diabetic pregnant women monitor their blood sugars for several weeks and realized that the blood glucose levels of "normal" pregnant women are actually lower than the blood glucose levels of non-pregnant women after meals. This study changed the protocol for dealing with all pregnant diabetics whether they are TypeI, TypeII or Gestational Diabetics.

[mariposa]

I really have a hard time saying "no" to my dr. (just having a conversation with the nurse this morning has had me on edge all day!) so I appreciate the support and advice.

 

It just seems like such a waste of time and $ (although I have no copay or anything, but still, it's coming from somewhere!).

 

If you want to make sure everything is OK, but you don't want to do the 3hr test ask your Dr. to write a prescription for a glucose monitor and test strips. Offer to test yourself after some high carb meals. If your numbers are below 140 1hr after or under 120 at 2 hours after a meal, you are probably fine. They also want your fasting blood sugar to be under 95. A fasting blood sugar is taken before eating in the morning. If these numbers run high, you can still skip the three hour test and just follow the gestational diabetic diet and monitor your blood sugars at home.

 

Thanks for this info, I'm definitely going to say this if she isn't backing down about it. Obviously, they can't FORCE me to do it, but I'd rather have their "approval" to not do it!

 

I understand the whole big baby thing too, but my labor with my biggest child was 2 hours and he was out in 2 pushes so I think I've proven that's not going to be a problem for me. Also, he had glucose testing because he was big and there was no problem.

 

I eat very healthy and exercise regularly, so I feel confident about bringing that up as well...

Sarah

[mariposa]

Drinking that glucose isn't so hard for me, but my digestion system suffers for DAYS afterwards - one of the main reasons I don't want to do it again! I'm sensitive anyway, so that huge dose of glucose really messes me up!

Sarah

[Leanna Tomlinson]

Drinking that glucose isn't so hard for me, but my digestion system suffers for DAYS afterwards - one of the main reasons I don't want to do it again! I'm sensitive anyway, so that huge dose of glucose really messes me up!

Sarah

:iagree: It messes me up too.....IF I can keep it down.

 

Here's a link that might help you inform yourself before you talk with your Dr.It's from a plus size pregnancy site, but you certainly don't have to be plus size to fail the glucose tolerance test. This site has the most comprehensive information I've found in one place.

 

http://www.plus-size-pregnancy.org/gd/gd_index.html

[FaithManor]

I read that the change stems from a study done on pregnant women with no signs of gestational diabetes. Researchers had non-diabetic pregnant women monitor their blood sugars for several weeks and realized that the blood glucose levels of "normal" pregnant women are actually lower than the blood glucose levels of non-pregnant women after meals. This study changed the protocol for dealing with all pregnant diabetics whether they are TypeI, TypeII or Gestational Diabetics.

 

My endocrinologist is not happy. He is absolutely livid about the number for GD changing based on tests that are notorious for giving false positives. He says that the HbA1c should be the test standard anyway.

 

I always failed the one hr., passed the three hr. and then monitored and gloriously low blood sugars on my normal diet. The docs hated that I proved them wrong and the midwives always said, "Good for you!" Monitoring is best anyway if one is worried because it erases any doubts about false test results.

 

Faith

[ocelotmom]

I would refuse the test. I would tell them to do an HbA1-c if they want to see how your actual glucose is. Or get a glucose monitor and check yourself after a normal meal (as opposed to after a huge dose of sugar.)

 

Most doctors won't go for this, as HBA1C shows average blood glucose levels over the past 2-3 months, so may not detect GD that did not develop until later in pregnancy. (There is a lot of discussion that much GD is actually undiagnosed preexisting diabetes and that HBA1C in early pregnancy should be standard, but I don't think you'll be able to convince a doctor of the converse - that a good A1C later in pregnancy rules out GD)

 

Fingerstick blood sugar tracking, probably several times a day for at least a week rather than just after a "normal" meal, would likely be a better accepted.

[garddwr]

I bought myself a glucose monitor this pregnancy and used that instead--testing fasting glucose and 2 hour post-meal glucose on several days, and a few random tests thrown in. If my numbers were marginal I would test more often and follow the recommended diet. I can't stand the glucose test, rather prick my finger multiple times:tongue_smilie: