4 Our Health

Question:

I had an appt this morning and they wanted me to take the GD test, which I declined. The dr kept pushing, saying that because my dd was 9lbs (but I did have an epidural and IV that time and believe a lot of it was water weight from that because she went down to 7lbs 13oz in the first few days) and I'm measuring just under 3 weeks ahead (at about this time in my previous pregnancy I measured 4 weeks ahead also, which normalized by 36 weeks), I'm at high risk for GD.
My instincts and experience from last pregnancy tell me everything is fine but I'd like some more objective opinions. The dr (not my usual, another in the same practice) tried some scare tactics like accusing me of being selfish by not testing and that I didn't want to take it for ME instead of for the BABY. Of course, not true at all. She also said she wouldn't be my dr if I refused the test, to which I cheerfully replied, "That's ok, that's your decision" Considering she's not really my dr to begin with, certainly no loss there. And when she saw that that wasn't going to work, she took it back. I told her about the information I'd been studying, like Henci Goer, and she completely disregarded it and kept asking if I was hiding something from her and said it was complete BS. And after this discussion she wanted to test me for anemia and cyphyllis which hadn't been mentioned before so I'm not quite sure where that came from or why, but I also declined because I was on the defensive and a little paranoid she'd try to test for something else without my consent.
She also said that if I was diagnosed with GD and managed it with diet, I wouldn't be considered 'high risk.' Does anybody have any experience with how true this might be? I'm sure every dr is different, but I'd still like to hear stories. The nurse taking my urine sample was going to give me the drink prior to the appt at which point I mentioned I was declining the test, her reaction was "Oh, that's not good at all" :eyesroll
I've decided I'm not having my baby there and probably not going back at all, unless I decide to go in person to tell my regular Ob (who I like) that I've decided to go elsewhere. Definately way too interventively minded and they have an astronomical C-section rate (something like 30% I think!!!) and from the reaction I got today, I know I'll be having to fight for everything I want in labor.

Answer:

I had a miserable time with that test. I wanted to decline but caved to the pressure (this being my first baby and all). The problem wasn't so much the 1st, 1-hour screening, which I failed, it was the 3 hour test. I ultimately passed it, but I had to fast beforehand, and couldn't eat for the 3 hours they were doing the test, meanwhile you consume an insane amount of sugar in drink form. My body went nuts, I was shaky and nauseous. For the rest of the day I was so tired and I couldn't eat enough to get full. On top of all of that, my allergies have been great through this pregnancy, but then all of the sudden the next day I broke out in hives and itches all over and I came down with a cold I'm still fighting off.
You're probably fine if you don't have any symptoms like excessive weight gain. However, if you're worried, you could ask if you could take a glucose meter home and test your blood sugar 4 times a day for a few days (once in the morning as a fasting test and then 2 hours after each meal). That is actually what they would make you do if you failed the 3-hour test anyway. The irony is that I asked if I could do that, and they wanted me to do the test instead. It was only afterwards that I found out that if I had failed I would just have to monitor :irked: Anyway, that would (in my opinon) be a more accurate measure of whether or not you really have GD and if your baby is at risk because that would show you how your body responds to your normal diet and activity level instead of how your body responds to more sugar than is in 2 snickers bars.

Answer:

OMG, Jessica -- what a nightmare! I don't have any answers for you, but I, too, plan to refuse the GD test. In my opinion, if I'm eating well, exercising, and not gaining TOO much weight, what's the point? I think you're right to trust your instincts (esp. based on your first pregnancy experience).
I'm just sorry you have to go through this...

Answer:

She also said that if I was diagnosed with GD and managed it with diet, I wouldn't be considered 'high risk.' Does anybody have any experience with how true this might be? I'm sure every dr is different, but I'd still like to hear stories.
I was considered high risk and my insurance company was charged the rate that my OB charges for high risk pregnancy. I did not have GD and all my blood tests showed no problems. My blood pressure and urine tests were always good. But I was of advanced maternal age (36) and I am overweight. The bottom line is if the doctor wants to consider you high risk, s/he will find a way.
I also tried to avoid the GD test because I felt like ultimately it didn't mean a lot. I was exercising regularly and eating well, so what else would I have done? But the doctor and the nurse I talked to were both very adamant about this test and were shocked that I didn't get it done when they first suggested it. So I did go and get it done just because I was confident it would show no problems, and I didn't want to be considered high risk. Come to find out I was one of their high risk patients anyway. Which really ticks me off because I got no extra treatment for this--my appointments took about 15 minutes and an HCP spent maybe 7 minutes at most with me during the 15 minutets. Get on the scale, dip the urine, blood pressure, heart tone check. Good to go.
But I figure they want the high risk designation for various reasons, one of which is that when you are in labor, they can pull that out of their hat as a reason to take more drastic measures earlier on.

Answer:

i'm overweight, was borderline Type 2 before i got pregnant, and my mom was diabetic, so they considered me at risk for GD from the start. i declined the tests because i've gotten really sick from that glucola crap before, but i have a glucometer at home so i was able to chart my levels for a week and they diagnosed GD from that at 17 weeks. can you afford to buy a glucometer, lancet and test strips? or will the dr. prescribe one for you to test at home? or do you know someone who has one that you can use? you'd need to chart: when you wake up, and 2 hours after dinner, for 1 week. (they're looking for fastings over 90 and 2-hours over 120.)
if you have GD, you're labeled high risk despite how you control it, by diet or insulin, so it sounds like that nurse was just trying to appease you. if large babies run in your family, then if you have GD they'll focus on how that's sugar-related and ignore your history in most cases, from what i've heard. 6-pound babies run in my family, so they were vigilant in u/s measuring but have finally relaxed now that there's no way Willow is over 8 lbs. even with a large margin of error. i'm looking at going to 41 weeks with only 1 extra u/s to check placental calcification at that date which is amazing given an OB practice and hospital birth ... it's really important to shop around for a good perinatologist if you end up having GD! having an endocrinologist on your side is also good. hope this helps!
peace,
meli

Answer:

YUCK! Find another practice, even if you love your Dr there you can't erase the notes recorded by this other person and My experience with these big practices is that you can never be assured that you will be seeing your fave Dr Anyway.
Call me crazy but I think that there needs to be trust between a PG caregiver and patient.

Answer:

what would the consequences be during birth of being labelled GD?
my OB has been good about treatng me like normal, even though i started out pregnancy at high risk for pre-eclampsia - i have several risk factors, including high bp at the beginning. the perinatalogist i saw said he wouldn't "let" me go past 40 weeks. my OB, however, says if i'm fine, i'm fine, and there's no reason to set an arbitrary deadline. she also said i would not automatically need an IV or continuous EFM during labor either.

Answer:

what would the consequences be during birth of being labelled GD? during birth a woman with GD might need a glucose (or dextrose) and insulin drip, to regulate her sugar if she's not eating or drinking something like fruit juice. 1/4 cup fruit juice per hour is recommended. most practicioners will assume a big baby until proven otherwise, a level 2 u/s might be helpful, but the machine's margin of error needs to be taken into account. the baby is likely to be born with low blood sugar, which isn't a problem if they're fed mom's colostrum right away, but most hospitals still assume a bottle of sugar water or formula will be needed.
before birth, they'll be looking for earlier placental failure, especially calcification. there'll be a lot of NSTs and BPPs to watch baby's progress.
induction seems WAY too common for GD moms! i have no idea what percentage of inductions are truly medically necessary. hence the importance of education and a good birth plan.
both my OBs had said continuous EFM and IV, and induction, wouldn't be needed ... until we wanted to talk about the birth plan at 34 weeks (i think a lot of drs. pay lip service to non-interventionist births, so they don't scare off patients?). it took me 3 weeks to negotiate it back down to non-interventionist, and i shudder to think what happens to moms who have less information than i do, or are unable to argue with their doctors! i controlled the GD tightly with a combo of diet and low-dose insulins so i have more bargaining power.
peace,
meli

Answer:

I was diagnosed with GD in my first pregnancy. I never would have known. I eat well and exercise but sometimes that is just not enough. I am glad I found out because it forced me to eat even better. I was on a special diet and had to check my blood during the day. To me it was worth it. I was able to control it through diet and exercise and was never considered high risk. I was able to continue seeing my midwives and delivered a very healthy boy all natural and totally under my control. I have to say that yes the test sucks and having to eat a certain way and check my blood was not dandy but there is no way I would ever mess around with not doing this. Even though I thought I ate right and exercised enough - when I looked at my diet compared to what they had me on it was way off. I am in my second pregnancy now - and they want to test me earlier. Even though I am not looknig forward to it there is not way I am going to chance it. I say no to everything else they throw at me but not this. My blood sugars did not go back to complete normal after the birth either like you are sometimes told. I now know that I have to work even harder when I am not pregnant to keep myself healthy because I have a higher risk of developing adult onset.
good luck with your choices.

Answer:

meli thanks for the info - i'll remember to stay strong if my OB changes her tune in a couple weeks. she knows we have a doula and we're taking bradley classes, so it won't be a shock that i want to keep things as natural as possible... and we've already been asking her about EFM, etc., otherwise i don't think she would have mentioned anything until 34/36 weeks.
one friend of mine who had insulin-dependent GD was induced early, but she was also fighting hyperemesis and PUPPS and high blood pressure, so her body was basically rejecting being pregnant any longer :( 37 weeks, kiddo was fine.

Answer:

I wish you luck with everything that you want during your pregnancy and labor.
I had GD with my now 2 year old and boy was it a horrible time for me. She was my first pregnancy and after the time i had with her i really didnt think i would be having anymore children because i didnt think i could do all that again. I couldnt do the diet because on it i lost almost 30lbs in a total of 3 weeks, so off onto insulin shots i went. I ate by the book, ate at the same times everyday, check my own sugar, and had to call with a report to my Dr every morning with my numbers the day before.
I was induced with her at exactly 38 weeks because my placenta started to stop working. I didnt "need" the insulin anymore as i did before hand.
I am pregnant again and i am now 33 weeks and low and behold i do not have GD this time around. How? I have NO idea and neither does my Dr but i am very happy.
I do know that after i had my 1st baby (while GD) after i had her they had to take her away to check her sugar levels to make sure her sugar wasnt too low because of my condition. She weighed 6Lbs 13oz and wasnt too big at all, even though my GD was bad.
I wish you good luck!!

Answer:

At my practice, they told me they would evaluate me as if I had GD if I refused the test. For example, they said, when the baby gets to a certain size, they recommend induction. They have two different cutoffs for what is "too big," one for GD and one for no GD. They said that's because GD babies distribute their weight differently than non-GD babies, leading to an increased risk of shoulder dystocia. Around this time, she was saying I had about an 8-9 pound baby (he actually ended up being 7lbs 3oz).
Now, I wasn't going to let them just induce like that, regardless of what they though my baby weighed. But I really wanted to do what I could to avoid a battle over whether to induce me, so I agreed to the test.
Like hilary122, I had a miserable time with the tests. First, I took the Glucose Challenge Test, where you have to down a can of orange fizzy glucose solution, and get your blood glucose tested after the end of an hour. If you do this test, make sure you get your whole hour! My lab retested my blood glucose after about 55 minutes, and I ended up with a very slightly above normal result.
After that, I had to take the Glucose Tolerance Test, the three hour test where you have to fast. Like Hilary, the GTT made me feel sick, sick, sick. It was just terrible. It really destroyed my whole day.
To make matters worse, the lab screwed up the blood work on my GTT, so they told me to take it again. I refused, a lot of drama ensued, and eventually I took the damn test again, spending another day sick and miserable at the lab. Luckily, I passed that test with flying colors.

Answer:

Yup-borderline GD with first baby who incidently was born on his due date weighing 8 pounds 3 oz.
After reading all of Henci Goer's info and with awesome support from our Bradley teacher, we changed docs at 33 weeks from an OB practice (there was only one doc there we really liked anyway) to a family doc. who left me alone!!! No talk of stress tests, inductions, ultrasounds or shoulder dystocia. Was the best thing I did, because we had a beautiful birth!

Answer:

I think you could take the test, but without that glucola crap.
My first pregnancy I went part to a OB, part to a birth center. At the birth center, their test involved going to the birth center first thing in the am (no food) and getting your blood drawn. Then, going to eat a nice big breakfast of a specific menu (I know waffles with syrup and fruit was on it), then going back an hour after, and getting another blood draw. This was the healthy equivalent of glucola.
I actually didn't take that test :hide: because I was nauseous and ate a couple crackers first, which was a no-no. Ended up taking the glucola test anyway, and it didn't effect me at all.
BUT, you don't have to take glucola. Maybe if your doctor won't take that, you could just take the test at a birth center? There are more reasonable options.

Answer:

I refused the test. My mw said it was fine, b/c I wasn't showing any signs of early GD like gaining too much wt, gaining too quickly, spilling protien into urine, etc. This is my 3rd baby though, and I never had GD with the other 2, so I don't know if that makes a difference. Course, I refuse everything pretty much so they probably figured it wasn't worth fighting with me :LOL

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I've heard that in some countries they don't routinely test unless you're at risk---- and one indicator is if it's in your family. Sisters, mother?

Answer:

High risk is defined as anyone over age 25, so that is a lot of people right there.
I had a big first baby too, but I was told that even without that, I would be "high risk" due to age. Then there are other things like family history of diabetes, and whether you yourself were large at birth, and whether you are overweight now.
I took it last time, and passed no problem. Thinking back on it, I was given the glucola a week ahead of time and told to drink it an hour before and then come in for blood draw. They had no way of knowing whether I drank all of it, half of it, or any of it, or whether the timing was just right.
I really don't want to do it this pregnancy, as I KNOW I won't have GD and the test is such a pain in the butt. But, I would also be worried that I would be treated differently if I refused the test. Good luck finding an OB that will think it is fine to skip it. I bet there aren't very many.