30 week visit--failed 1-hour GTT :o(

I am going to do the 1-hour test this week or next, I just asked to take the
lab sheet home. The first time (abt 13w, had a little sugar in urine) I was
told to do it about 3 hours after a nice breakfast. I passed. This time,
the routine time, with a different doctor I wasn't given any instructions.
I would think someone coming in to the lab after eating eggs and meat for
breakfast would fare better on the test than someone who ran in after eating
a Nutragrain bar. Not sure. What were your instructions?

Don't know what I'll do in your position. I'd be tempted to go straight to
the diet, because I suspect that's how I should be eating anyway and don't
.

-- Dagny
EDD 10/6/03


I think if I barely fail, I will just
"zeldabee" wrote in message
...
I went to my 30 week checkup, and it was definitely a good news/bad news
visit. First, the good news--I'd mentioned to my OB a couple of visits ago
that I had been thinking of switching to a midwife, and she'd told me that
a midwife would soon be starting at her practice, and I might want to see
her. This was before I'd called the midwifery services at the birthing
center where I plan to go, and was told that I was too far along and they
wouldn't be able to help me. So I was pleased when at this visit my OB
introduced me to the midwife, and she'll take care of me from here on
unless something goes awry.

The bad news was that I failed the 1-hour GTT I had two weeks ago (though
I'd expected for them to call me if I had). So now I'm supposed to take
the
3 hour test next week. The midwife said it was pretty awful...

What happens if I fail the 3-hour? Would that mean I definitely have GD?
I've always been sensitive to sugar, and I'd never consume as much as the
sweet drink they give you for the 1 hour test all at one time...I wasn't
diabetic before, at least I assume regular checkups would have uncovered
it
if I was, but I've always reacted to sugar.

Should I watch what I eat more carefully? I've been avoiding eating too
many sweets, but I don't avoid them entirely--I'll usually have some kind
of treat every day (e.g., a dish of ice cream). I've tried to focus more
on
making sure I get enough vegetables and protein, but maybe that's not
enough. Will I have to follow a diet?

--
z e l d a b e e @ p a n i x . c o m http://NewsReader.Com/

"zeldabee" wrote in message news
I went to my 30 week checkup, and it was definitely a good news/bad news
visit. First, the good news--I'd mentioned to my OB a couple of visits ago
that I had been thinking of switching to a midwife, and she'd told me that
a midwife would soon be starting at her practice, and I might want to see
her. This was before I'd called the midwifery services at the birthing
center where I plan to go, and was told that I was too far along and they
wouldn't be able to help me. So I was pleased when at this visit my OB
introduced me to the midwife, and she'll take care of me from here on
unless something goes awry.

That's great about the midwife!

The bad news was that I failed the 1-hour GTT I had two weeks ago (though
I'd expected for them to call me if I had). So now I'm supposed to take
the
3 hour test next week. The midwife said it was pretty awful...

What happens if I fail the 3-hour? Would that mean I definitely have GD?

Bummer about the 1 hr GTT. I don't know much about it, but from what I
understand *many* women who fail the 1 hour go on to pass the 3-hour.
Hopefully you'll be one of those! Best wishes!

--
Em
edd 9/23/03

"Dagny" wrote:
I am going to do the 1-hour test this week or next, I just asked to take
the lab sheet home. The first time (abt 13w, had a little sugar in
urine) I was told to do it about 3 hours after a nice breakfast. I
passed. This time, the routine time, with a different doctor I wasn't
given any instructions. I would think someone coming in to the lab after
eating eggs and meat for breakfast would fare better on the test than
someone who ran in after eating a Nutragrain bar. Not sure. What were
your instructions?

I wasn't given any at all for the 1-hour. For the 3-hour, I'm supposed to
fast from midnight until my appointment in the morning. Then they're going
to dose me up with enough sugar to choke a horse. /

Don't know what I'll do in your position. I'd be tempted to go straight
to the diet, because I suspect that's how I should be eating anyway and
don't .

Well, I passed on my usual ice cream dessert last night... )

--
z e l d a b e e @ p a n i x . c o m http://NewsReader.Com/

"Alicia Elliott" wrote:
But my natural inclination is to
take with a grain of salt a great deal of what the medical community
tends to speak of as 'risk' and 'treatment'. (Eg, the cesarean rate has
gone up by almost half over the last 30 years due to medical
interventions when they aren't necessary).

This worries me, as I read that c-section rate is higher in women with GD,
since they tend to have "big babies"...I really want to avoid a
high-intervention birth. I'm worried that I might risk out of the birthing
center I want to go to.

The truth is, the medical
community likes to cover themselves, and it doesn't always benefit the
people involved.

Try looking it up online as well if you are still unsure. I imagine that
a number of other people will post their findings to you too. Good luck
either way.

This I've done, and AFAICS I'd probably have to monitor blood sugar, and
possibly even take insulin, in addition to modifying my diet, if I do have
GD.

--
z e l d a b e e @ p a n i x . c o m http://NewsReader.Com/

zeldabee wrote in message
...
So I was pleased when at this visit my OB introduced me
to the midwife, and she'll take care of me from here on
unless something goes awry.

Great! I hope you and she get along well and that you're able to
continue care with her throughout the rest of your pregnancy, and birth.

The bad news was that I failed the 1-hour GTT I had two
weeks ago (though I'd expected for them to call me if I had).
So now I'm supposed to take the 3 hour test next week. The
midwife said it was pretty awful...

I've had the three-hour GTT before (while not pregnant) and didn't think
it was that awful. It's just like the one-hour, just two hours more of
sitting and waiting (and two extra blood draws of course, but those
don't bother me). Just be sure to take something interesting to do!

What happens if I fail the 3-hour? Would that mean I definitely
have GD? I've always been sensitive to sugar, and I'd never
consume as much as the sweet drink they give you for the 1 hour
test all at one time...I wasn't diabetic before, at least I assume
regular checkups would have uncovered it if I was, but I've always
reacted to sugar.

If you fail the three-hour, then they probably would diagnose you with
GD. I think that regular checkups would not necessarily detect diabetes
unless they specifically tested your blood sugar level or did a GTT.

Should I watch what I eat more carefully? I've been avoiding eating
too many sweets, but I don't avoid them entirely--I'll usually have
some kind of treat every day (e.g., a dish of ice cream). I've tried
to
focus more on making sure I get enough vegetables and protein, but
maybe that's not enough. Will I have to follow a diet?

Once you have the results of the three-hour GTT they will be better able
to advise you on exactly what you need to do to control your blood
sugar. I think the usual thing to do is see if you can control it
through diet first, and if not, then move on to more drastic measure.
The people I know IRL who have been diagnosed with GD have had to check
their own blood sugar level X number of times per day, and were able to
keep their numbers within range just by eating carefully. For example,
one woman told me she could not eat just an apple and nothing else with
it. She had to eat some kind of protein (IIRC) at the same time. So it
wasn't even necessarily different foods than she would normally eat, she
just had to watch the timing and food combinations. Since you eat
little sugar normally, your body probably just isn't used to having to
produce a large amount of insulin all at once and didn't respond quickly
to the one-hour test. Hopefully the longer test will give your body
time to respond and bring the sugar level down so that GD is not
diagnosed. You actually don't want to avoid sweets in the days leading
up to the test. Eat normally, or even add just a little extra, like
some chocolate syrup in that bowl of ice-cream or something. I saw in a
later post that you're not supposed to eat the morning of the test but
in general, if you can eat that morning, that is the time to avoid carbs
and sugar and go for protein. Like Em said, a lot of people "fail" the
one-hour screening test but do fine on the three-hour diagnostic test.
I hope that happens for you! Good luck.
--
Cheryl S.
Mom to Julie, 2 yr., 3 mo.
And a boy, EDD 4.Sept

Cleaning the house while your children are small is like
shoveling the sidewalk while it's still snowing.

"zeldabee" wrote in message
This worries me, as I read that c-section rate is higher in women with GD,
since they tend to have "big babies"...I really want to avoid a
high-intervention birth. I'm worried that I might risk out of the birthing
center I want to go to.
snip

I hear you about fear about a high-intervention birth (I've had various
moments of anxiety most possible complications that might risk me out of
the birth center). Anyway, I don't know anything about your birthing center,
but I looked up gestational diabetes in my copy of the "transfer of care"
section of my birth center's Administrative Policies (I asked for this info
several appts ago & the doctor copied it out of their operations book for
me). Apparently, they won't take a client who has pre-pregnancy insulin
controlled diabetes. With regard to gestational diabetes, you will still be
able to have your baby at the birth center as long as the diabetes is diet
controlled. Even if it is diet controlled though, you are still required to
have a "consulting physician" involved with your care & not just the birth
center doctor. This particular birth center doesn't do the traditional
glucola GTT though, just a post-prandial, & I suspect that they are not so
quick to "diagnose" as a more mainstream doctor may be.

Good luck! You will probably pass the 3-hour & can move on to worrying about
what if you have pre-eclampsia and have to risk out, etc!

--
Em
edd 9/23/03
P.S. I forgot to say before that I find it kind of odd that they just waited
until your next appt. to tell you that you "failed" instead of calling
you...

"Em" wrote:
"zeldabee" wrote in message news
[...]
So I was
pleased when at this visit my OB introduced me to the midwife, and
she'll take care of me from here on unless something goes awry.

That's great about the midwife!

Yes, I'm glad. I really think I'll do better with a midwife.

The bad news was that I failed the 1-hour GTT I had two weeks ago
[...]

Bummer about the 1 hr GTT. I don't know much about it, but from what I
understand *many* women who fail the 1 hour go on to pass the 3-hour.
Hopefully you'll be one of those! Best wishes!

Thanks...

--
z e l d a b e e @ p a n i x . c o m http://NewsReader.Com/

"Cheryl S." wrote:
zeldabee wrote...
So I was pleased when at this visit my OB introduced me
to the midwife, and she'll take care of me from here on
unless something goes awry.

Great! I hope you and she get along well and that you're able to
continue care with her throughout the rest of your pregnancy, and birth.

I hope so too. I liked her. Right away she had some suggestions about
dealing with the swelling in my feet (vitamin B6, and a glass of grapefruit
juice each day, heartburn permitting).

The bad news was that I failed the 1-hour GTT I had two
weeks ago (though I'd expected for them to call me if I had).
So now I'm supposed to take the 3 hour test next week. The
midwife said it was pretty awful...

I've had the three-hour GTT before (while not pregnant) and didn't think
it was that awful. It's just like the one-hour, just two hours more of
sitting and waiting (and two extra blood draws of course, but those
don't bother me). Just be sure to take something interesting to do!

Awfully boring...during the wait for the 1-hour, I was too jittery to sit
still and read. So was the baby. Well, not that he can read, that's a
little optimistic...but he really jumped around.

[...]

[...]Will I have to follow a diet?

Once you have the results of the three-hour GTT they will be better able
to advise you on exactly what you need to do to control your blood
sugar. I think the usual thing to do is see if you can control it
through diet first, and if not, then move on to more drastic measure.
The people I know IRL who have been diagnosed with GD have had to check
their own blood sugar level X number of times per day, and were able to
keep their numbers within range just by eating carefully. For example,
one woman told me she could not eat just an apple and nothing else with
it. She had to eat some kind of protein (IIRC) at the same time. So it
wasn't even necessarily different foods than she would normally eat, she
just had to watch the timing and food combinations.

I suppose I can deal with whatever is required, though it might be
difficult because my life is in such an uproar now, and it's hard to make
time to prepare food.

Since you eat
little sugar normally, your body probably just isn't used to having to
produce a large amount of insulin all at once and didn't respond quickly
to the one-hour test. Hopefully the longer test will give your body
time to respond and bring the sugar level down so that GD is not
diagnosed. You actually don't want to avoid sweets in the days leading
up to the test. Eat normally, or even add just a little extra, like
some chocolate syrup in that bowl of ice-cream or something.

This is useful information. ) Not that I want to "beat" the test--if
there might be a problem with my blood sugar, I want to know about it--but
I don't want my regular habits to stack the deck against me, or lead to a
false positive (is that possible?).

I saw in a
later post that you're not supposed to eat the morning of the test but
in general, if you can eat that morning, that is the time to avoid carbs
and sugar and go for protein.

I've been told to fast from midnight until my appointment at 9:00am. So,
maybe I'll have a hamburger at midnight.

Like Em said, a lot of people "fail" the
one-hour screening test but do fine on the three-hour diagnostic test.
I hope that happens for you! Good luck.

Thanks. This is actually reassuring.

--
z e l d a b e e @ p a n i x . c o m http://NewsReader.Com/

zeldabee wrote in message
...
This worries me, as I read that c-section rate is higher in
women with GD, since they tend to have "big babies"...I
really want to avoid a high-intervention birth. I'm worried
that I might risk out of the birthing center I want to go to.

At the birth center I'm planning on going to, you're only risked out if
you require insulin treatments. If you have GD but it is
diet-controlled only, you are still OK. I think that the higher C rate
among women with GD is probably, at least somewhat, a case of
self-fulfilling prophecy on the part of the OBs involved. Also they
tend to induce women with GD, and as all we good mkp readers know ;-),
induction increases your risk of C-section. So maybe it's not
necessarily the fact they had GD, but that they were induced, that was
directly responsible for ending up with a C. GD would just be an
indirect factor, in leading to the doctor wanting to induce in the first
place.
--
Cheryl S.
Mom to Julie, 2 yr., 3 mo.
And a boy, EDD 4.Sept

Cleaning the house while your children are small is like
shoveling the sidewalk while it's still snowing.

Ericka Kammerer wrote:
zeldabee wrote:

[GD and interventions]

Different places have different policies, but many birthing
centers will still take you as long as you're not on insulin. Also,
the higher c-section rate is as likely to do with overly aggressive
management as with any actual *need* for a c-section. You *can* say
no to the c-section if it doesn't seem warranted to you.

I think my chances are much better now with the midwife than with the OB. I
get the impression that this MW tends to avoid interventions.

And while
you are at slightly higher risk of having a larger baby if you have
GD, the combination of pre-pregnancy weight and pregnancy weight
gain is actually a better predictor of birth weight than GD status--
and most big babies are born to non-GD women and most babies born
to women with GD are not big.

Oh, well, I'm probably likely to have a big baby anyway, then. I was
overweight to start. I've gained about 25 lbs and I'm now 30 weeks. Then
again, my mother has been heavy her whole life, gained 80 lbs when she was
pg with me, and I was 6 lbs something when I was born. She gained a lot
with my siblings, too, and they were also average-sized.

This I've done, and AFAICS I'd probably have to monitor blood sugar,
and possibly even take insulin, in addition to modifying my diet, if I
do have GD.

Why? Most women can control it with diet alone.

Well, I did say possibly...I'd hope I would be able to control it with
diet.

Furthermore,
the research on the efficacy and desirability of using insulin for GD
is highly controversial, with several respected organizations
questioning its use. (Note: this is just with true gestational
diabetes--women with true diabetes are in a different boat and
may well need insulin.)

This is interesting. Is there a way to tell if a pg woman might have had
undiagnosed diabetes pre-pregnancy? In other words, is there any difference
in response to the tests?

And, of course, as others have mentioned,
the 1 hour test is only a screening test, and not a very good one
at that. Most people who fail the 1 hour test pass the 3 hour test.

Here's hoping.

Personally, I really wouldn't borrow trouble on this one.
*IF* you have gestational diabetes, it's not even clear from the
literature that you *should* treat it, much less that you have to
sign up for a whole slew of invasive procedures.

I won't sign up for anything without looking into it, but I don't know how
much I can resist pressure.

--
z e l d a b e e @ p a n i x . c o m http://NewsReader.Com/