GD question - how to test for it at home?

I had GD in my first pregnancy and was able to keep it in check with a
carb-controlled diet per the nutritionist's recommendations (200g of
carbs a day total, never more than 30g in one meal).

I have a couple of questions for those who know the rules around this:

1. I am pregnant again (almost three months now) and still have all of
my monitoring equipment so I want to try to reproduce at home the usual
test I would get at the hospital before I go for my check-up in a
couple of weeks, to see what I could expect. What would I need to do?

2. Right now if I do my usual monitoring (fasting, one hour post
prandial and two hours post prandial), then I get rather different
numbers depending on what I eat. My instructions were to have my
glucose at 90 or lower, 140 or lower, and 120 or lower, respectively. I
just had a carb-heavy breakfast just to test where I was at, and at one
hour my reading was 159. At two hours, however, it was 80. Which of
these numbers is more significant? (If I eat a carb-controlled meal
then the numbers are fine.)

Thanks for your help!

On 27 Aug 2006 11:08:18 -0700, "Lady Penelope Creighton-Ward"
spewed forth :


1. I am pregnant again (almost three months now) and still have all of
my monitoring equipment so I want to try to reproduce at home the usual
test I would get at the hospital before I go for my check-up in a
couple of weeks, to see what I could expect. What would I need to do?

A 3-hour glucose tolerance test? You'll need to find out what the
carb load is in that nasty orange crap, suck it down within the
prescribed time period, and test at 30-minute intervals commencing
immediately prior to the first swallow.


2. Right now if I do my usual monitoring (fasting, one hour post
prandial and two hours post prandial), then I get rather different
numbers depending on what I eat. My instructions were to have my
glucose at 90 or lower, 140 or lower, and 120 or lower, respectively. I
just had a carb-heavy breakfast just to test where I was at, and at one
hour my reading was 159. At two hours, however, it was 80. Which of
these numbers is more significant? (If I eat a carb-controlled meal
then the numbers are fine.)

They're both significant. The 159 at one hour shows that you've got
some glucose intolerance. The 80 at two hours shows that you're
recovering pretty quickly and may be able to maintain good control
with diet and excercise only.

Please remember that gestational diabetes is usually the first
manifestation of T2 for many women. Becoming unpregnant doesn't mean
you're magically cured - you should mind your diet and excercise for
the rest of your life, and check your BG periodically. Your doctor
should also ask you to take the 1-hour GTT at least once a year for
the rest of your life.

Note: I'm not a doctor, merely a "former" gestational diabetic who 8
years after pregnancy is an "active" T2 using insulin and taking meds
to deal with what appears to be high insulin resistance coupled with
beta cell failure. YMMV.


Thanks for your help!


+++++++++++++

Reply to the list as I do not publish an email address to USENET.
This practice has cut my spam by more than 95%.
Of course, I did have to abandon a perfectly good email account...

"Lady Penelope Creighton-Ward" wrote in message
ups.com...
I had GD in my first pregnancy and was able to keep it in check with a
carb-controlled diet per the nutritionist's recommendations (200g of
carbs a day total, never more than 30g in one meal).

I have a couple of questions for those who know the rules around this:

1. I am pregnant again (almost three months now) and still have all of
my monitoring equipment so I want to try to reproduce at home the usual
test I would get at the hospital before I go for my check-up in a
couple of weeks, to see what I could expect. What would I need to do?

Do NOT try to reproduce the test at home. There's a reason why it's done in
the hospital. So they can give you insulin or other medical attention if
you get sick. The test they give you is to have you drink glucose syrup on
an empty stomach and then have you sit still for several hours while they
draw blood from you.

2. Right now if I do my usual monitoring (fasting, one hour post
prandial and two hours post prandial), then I get rather different
numbers depending on what I eat. My instructions were to have my
glucose at 90 or lower, 140 or lower, and 120 or lower, respectively. I
just had a carb-heavy breakfast just to test where I was at, and at one
hour my reading was 159. At two hours, however, it was 80. Which of
these numbers is more significant? (If I eat a carb-controlled meal
then the numbers are fine.)

Thanks for your help!

With GD I don't know that either number is more signifigant, but you don't
want to be at 159. That's not good.

--
See my webpage:
http://mysite.verizon.net/juliebove/index.htm

Ozgirl wrote:
Lady Penelope Creighton-Ward wrote:
I had GD in my first pregnancy and was able to keep it in
check with a
carb-controlled diet per the nutritionist's
recommendations (200g of
carbs a day total, never more than 30g in one meal).

I have a couple of questions for those who know the rules
around this:

1. I am pregnant again (almost three months now) and still
have all of
my monitoring equipment so I want to try to reproduce at
home the
usual test I would get at the hospital before I go for my
check-up in
a couple of weeks, to see what I could expect. What would
I need to
do?

2. Right now if I do my usual monitoring (fasting, one
hour post
prandial and two hours post prandial), then I get rather
different
numbers depending on what I eat. My instructions were to
have my
glucose at 90 or lower, 140 or lower, and 120 or lower,
respectively.
I just had a carb-heavy breakfast just to test where I was
at, and at
one hour my reading was 159. At two hours, however, it
was 80.
Which of these numbers is more significant? (If I eat a
carb-controlled meal then the numbers are fine.)

Thanks for your help!

I was under an endocrinologist for my GD pregnancies. If I
got any number over 100 my insulin had to be adjusted or if
not on insulin then start it. 159 at any time would have got
my endo moving. I know you are only experimenting but it
does show that you are in a position to have significant
rises after too many carbs. If you have to lower carbs too
much to keep within range then insulin is a better option
for you and the baby. I also don't know why doctors keep
making past GD mothers wait until 28 weeks or so for the
GTT's. The more pregnancies you have after a GD one, the
more likely you are to have GD earlier with subsequent
pregnancies. For my last child I was in insulin by week 9.

I'm probably getting the GTT pretty soon actually, probably sooner than
14 weeks, so in this case, they are being more proactive given my
history.

I don't know your situation, but insulin wasn't necessary in my first
pregnancy, so I'm hoping controlling the carbs will do the trick this
time too.

Wooly wrote:
On 27 Aug 2006 11:08:18 -0700, "Lady Penelope Creighton-Ward"
spewed forth :


1. I am pregnant again (almost three months now) and still have all of
my monitoring equipment so I want to try to reproduce at home the usual
test I would get at the hospital before I go for my check-up in a
couple of weeks, to see what I could expect. What would I need to do?

A 3-hour glucose tolerance test? You'll need to find out what the
carb load is in that nasty orange crap, suck it down within the
prescribed time period, and test at 30-minute intervals commencing
immediately prior to the first swallow.


2. Right now if I do my usual monitoring (fasting, one hour post
prandial and two hours post prandial), then I get rather different
numbers depending on what I eat. My instructions were to have my
glucose at 90 or lower, 140 or lower, and 120 or lower, respectively. I
just had a carb-heavy breakfast just to test where I was at, and at one
hour my reading was 159. At two hours, however, it was 80. Which of
these numbers is more significant? (If I eat a carb-controlled meal
then the numbers are fine.)

They're both significant. The 159 at one hour shows that you've got
some glucose intolerance. The 80 at two hours shows that you're
recovering pretty quickly and may be able to maintain good control
with diet and excercise only.

Please remember that gestational diabetes is usually the first
manifestation of T2 for many women. Becoming unpregnant doesn't mean
you're magically cured - you should mind your diet and excercise for
the rest of your life, and check your BG periodically. Your doctor
should also ask you to take the 1-hour GTT at least once a year for
the rest of your life.

Note: I'm not a doctor, merely a "former" gestational diabetic who 8
years after pregnancy is an "active" T2 using insulin and taking meds
to deal with what appears to be high insulin resistance coupled with
beta cell failure. YMMV.


Thanks for your help!


+++++++++++++

Reply to the list as I do not publish an email address to USENET.
This practice has cut my spam by more than 95%.
Of course, I did have to abandon a perfectly good email account...

That's all very helpful info, I appreciate that you took the time to
let me know.

Julie Bove wrote:
"Lady Penelope Creighton-Ward" wrote in message
ups.com...
I had GD in my first pregnancy and was able to keep it in check with a
carb-controlled diet per the nutritionist's recommendations (200g of
carbs a day total, never more than 30g in one meal).

I have a couple of questions for those who know the rules around this:

1. I am pregnant again (almost three months now) and still have all of
my monitoring equipment so I want to try to reproduce at home the usual
test I would get at the hospital before I go for my check-up in a
couple of weeks, to see what I could expect. What would I need to do?

Do NOT try to reproduce the test at home. There's a reason why it's done in
the hospital. So they can give you insulin or other medical attention if
you get sick. The test they give you is to have you drink glucose syrup on
an empty stomach and then have you sit still for several hours while they
draw blood from you.

2. Right now if I do my usual monitoring (fasting, one hour post
prandial and two hours post prandial), then I get rather different
numbers depending on what I eat. My instructions were to have my
glucose at 90 or lower, 140 or lower, and 120 or lower, respectively. I
just had a carb-heavy breakfast just to test where I was at, and at one
hour my reading was 159. At two hours, however, it was 80. Which of
these numbers is more significant? (If I eat a carb-controlled meal
then the numbers are fine.)

Thanks for your help!

With GD I don't know that either number is more signifigant, but you don't
want to be at 159. That's not good.

--
See my webpage:
http://mysite.verizon.net/juliebove/index.htm

Good point about this being potentially dangerous if done at home. I
hadn't thought of that. That kind of carb bombardment should never
happen in real life, of course, so I can see why it's best done at the
hospital if it must be done.

"Lady Penelope Creighton-Ward" wrote in message
ups.com...
I had GD in my first pregnancy and was able to keep it in check with a
carb-controlled diet per the nutritionist's recommendations (200g of
carbs a day total, never more than 30g in one meal).

I have a couple of questions for those who know the rules around this:

1. I am pregnant again (almost three months now) and still have all of
my monitoring equipment so I want to try to reproduce at home the usual
test I would get at the hospital before I go for my check-up in a
couple of weeks, to see what I could expect. What would I need to do?

2. Right now if I do my usual monitoring (fasting, one hour post
prandial and two hours post prandial), then I get rather different
numbers depending on what I eat. My instructions were to have my
glucose at 90 or lower, 140 or lower, and 120 or lower, respectively. I
just had a carb-heavy breakfast just to test where I was at, and at one
hour my reading was 159. At two hours, however, it was 80. Which of
these numbers is more significant? (If I eat a carb-controlled meal
then the numbers are fine.)

Thanks for your help!

The 159 is of greater concern, mostly because it means your insulin is
kicking in full throttle, which is why it was down to 80 (relatively low for
2 hours after a meal). Your sugar should be below 120 an hour after a meal.

I had GD with my first, not with my second and I have to get tested again at
28 weeks with this pregnancy (2 of the 4 readings were high, they need 3 to
be high, or something like that).

Good luck,

Jen

On Sun, 27 Aug 2006 22:17:42 GMT, "Julie Bove"
spewed forth :

Do NOT try to reproduce the test at home. There's a reason why it's done in
the hospital. So they can give you insulin or other medical attention if
you get sick.

I've never had this test (3hr-GTT) performed in a hospital. It's
always been done at a "standard" lab (the sort that draws blood 99% of
the time). The last time I had a 3hr GTT and nearly passed out due to
the carb load the receptionist offered to call 911 - they don't
administer insulin due to liability reasons.

YMMV of course, and your doc may order it performed in hospital for
whatever reason.


+++++++++++++

Reply to the list as I do not publish an email address to USENET.
This practice has cut my spam by more than 95%.
Of course, I did have to abandon a perfectly good email account...

Ozgirl wrote:

I was under an endocrinologist for my GD pregnancies. If I
got any number over 100 my insulin had to be adjusted or if
not on insulin then start it. 159 at any time would have got
my endo moving. I know you are only experimenting but it
does show that you are in a position to have significant
rises after too many carbs. If you have to lower carbs too
much to keep within range then insulin is a better option
for you and the baby.

This is not a position that has much empirical
support at this point. Studies of the use of insulin
for GD are woefully inadequate (as opposed to what we
know about the use of insulin in pregnancy for those
with pre-existing diabetes or glucose intolerance).

I also don't know why doctors keep
making past GD mothers wait until 28 weeks or so for the
GTT's. The more pregnancies you have after a GD one, the
more likely you are to have GD earlier with subsequent
pregnancies. For my last child I was in insulin by week 9.

It is unusual for someone who has normal glucose
metabolism when not pregnant to have problems that early
in pregnancy. The current US recommendations for GD
screening are woefully inadequate for detecting pregnant
women who have pre-existing problems. They leave you
vulnerable to wonky blood sugars in the early weeks when
the stakes are the highest. True GD doesn't show up
until later in the pregnancy, which is why they don't
screen for it earlier. Testing too early misses many
women who would be diagnosed if tested later.
Now, once someone has been diagnosed with problems
during pregnancy, they ought to be followed while not
pregnant to see if there are problems when not pregnant.
If there are problems, even if not full blown T2, then
they *should* test earlier in pregnancy...but that's not
GD, per se.

Best wishes,
Ericka

Ericka Kammerer wrotelerance).

I also don't know why doctors keep
making past GD mothers wait until 28 weeks or so for the
GTT's. The more pregnancies you have after a GD one, the
more likely you are to have GD earlier with subsequent
pregnancies. For my last child I was in insulin by week 9.

It is unusual for someone who has normal glucose
metabolism when not pregnant to have problems that early
in pregnancy. The current US recommendations for GD
screening are woefully inadequate for detecting pregnant
women who have pre-existing problems.

I want to add something to this discussion that no one EVER mentioned to
me despite my two GD pregnancies! If I had know about this I could have
been spared many years of significant misery.

If you develop GD during a pregnancy and were normal weight before the
pregnancy started, there is a very high probability that you may have a
genetic form of diabetes which many doctors don't know about. It's
called MODY. It often only shows up during a pregnancy, though GTT
testing before the pregnancy would have shown abnormal post-meal values
had it been done.

This genetic diabetes causes beta cells from birth to have difficulty
secreting insulin in response to incoming glucose. This causes high
post- meal blood sugars, though fasting blood sugars are usually normal.
With the stress of the baby on the system, the beta cells lose their
ability to cope completely. This may cause huge weight gain during
pregnancy that which makes doctors think you have Type 2, but unlike the
case with Type 2, the weight usually comes right off after the baby is
born.

Most importantly, people with this condition are NOT insulin resistant,
and don't have the markers for "metabolic syndrome" that suggest a type
2 diagnosis. It is NOT type 2 diabetes, but something else, and if you
have it your kids have a 1 in 2 chance of having it too. My daughter has
inherited mine.

Things to remember: with milder cases of MODY the fasting blood sugar
may be normal and the A1c only mildly impaired--high 5% or low 6%, which
many doctors will ignore. But testing after meals will show very high
blood sugars, often in the diabetic range, and the person may have
urinary tract and yeast infections that won't clear up. They may also
feel like crap after eating any high carbohydrate meal or fall asleep
after eating a lot of carbs.

If you fit this pattern, insist on a glucose tolerance test after you
are done nursing your baby, and if you aren't seeing normal numbers,
find a doctor who understands the issue and will work with you for
better control.

There's more on MODY at http://www.phlaunt.com/diabetes/14047009.php


--Jenny

http://www.phlaunt.com/diabetes Diabetes Info

http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood
Sugar Under Control