This morning the home phone rings, we are still asleep so we don’t answer it. I know my OBGYN’s office is supposed to call me today regarding the results of my routine blood glucose screen. I also know I told them to call my cell phone.
I fall back asleep and then my cell phone begins to ring and I determine it is the OBGYN office and that I should answer. I drag myself out of bed and sprint to my cell phone to answer the call.
The nurse practitioner on the line informs me I’ve failed the test by 1 point. Their cutoff is 139 and I scored a 140 on my gestational diabetes screen. They want me to come back in for the 3 hour 100 gram test now and they want me to do it this week.
First off, I am not one who just does what someone says I need to. I am a thinking woman and I want to know the reasoning behind the testing and the procedures. Just telling me to come in for another test doesn’t give me any information about why this is even necessary plus not being able to explain the scale they use for determining the cutoff point for the testing worries me.
Since I like to be well informed before I make a decision I’ve put a call in to my midwife in Tennessee and I also consulted the internet for reading and research material on the topic.
Turns out there is much controversy about blood glucose screens and the diagnosing of gestational diabetes in pregnant women. It seems like this is just another ploy for them to run more unnecessary tests and to make more money off me.
Basically, whether or not I have gestational diabetes I should be eating well and taking care to exercise. Proper nutrition is they key in any pregnancy and especially when gestational diabetes is diagnosed.
Given the fact that my OBGYN advised me to “have a candy bar or some ice cream” in my 1st trimester as a means for gaining adequate weight I am pissed that now they are all “um we want to be careful about your blood sugar levels”.
Duh! Blood sugar levels are a big deal and that was why I was so worried about diet and nutrition at the beginning of my pregnancy but my doctor advised me not to worry about it and now look what has happen!
I’ve learned my lesson! I need to trust my gut feelings and listen to my body. I was focused on good diet until they told me not to worry about it, I knew they were wrong but I did as they said because I didn’t want to deprive my baby of anything… now I have to go back to what I was basically trying to do in the first place.
It makes me mad and super reluctant to trust anything they are telling me, it makes me want to fire the OBGYN and just stop with the traditional prenatal care all together.
It makes me so glad I’ve already decided to have my baby 4 hours (and 2 states) away naturally with my awesome midwife. I just can’t believe so many women are bullied and unrightfully advised by doctors in the US and that more people aren’t angry about all this…
“Current evidence is insufficient to assess the balance of benefits and harms of screening for gestational diabetes mellitus, either before or after 24 weeks’ gestation,” the statement concludes. “Until there is better evidence, clinicians should discuss screening for GDM with their patients and make case-by-case decisions. The discussion should include information about the uncertain benefits and harms as well as the frequency and uncertain meaning of a positive screening test result.” from: Guidelines Issued About Lack of Evidence for Screening for Gestational Diabetes
More sources and reading to consider:
Thank goodness you don’t just take the doc’s word for things. You need to be the biggest advocate for your own (and your baby’s) health care. So much more new information is always being made available and the more I learn, the more I learn that doctors don’t know everything and/or aren’t really allowed to talk about things because of contractual obligations. It makes sense to try and do your own research whenever you can. I give you tons of credit for not losing your head over all this. Don’t get me wrong – I’m not against all docs or medicine, I just think everyone should be as informed as they can be and get to know their own bodies as best they can because even highly trained professionals can be wrong and they can’t be trained in EVERYthing!
I say fluff the docs and the little red wagons they rode in on.
You know your body.
witchypoos last blog post..Redneck Mommy is an amateur.
One point???? That’s totally ridiculous and so is being concerned about a blood sugar reading of 140 after drinking 1/2 pound a sugar. How careful was the timing of the test? If they’d waited 60 seconds longer to take the blood would it have read 139? What if they took it five minutes early?
However, your diet — the candy bars and snacks — WILL NOT CAUSE gestational diabetes. If you’ve read that it does, that was incorrect information. Only if you are definitely diagnosed with gestational diabetes would the amount of carbohydrates you eat have an effect on your blood sugar.
If you had any of the risk factors for gestational diabetes, I could see a concern with a reading of 140. However… you are certainly not overweight, you’ve never given birth before to any size baby, and you’ve never mentioned (that I’ve seen) a family history of diabetes of either type, or a history of PCOS.
Ask your OBGYN for a prescription for a glucose monitor and volunteer to keep a record of your food and blood sugar readings at home for at least a week before submitting your body to a complete sugar shock again.
Or ask for a referral to an endocrinologist.
Sorry… I sound a bit strident here… take everything I say with a grain of salt. Or a 1/2 lb. of sugar 🙂
Donna B.s last blog post..Who Is Your Cousin?
hey girl, i’m there with you. let me know what happens.
if you have to start monitoring your levels let me know and i’ll send you my kit and strips; they can get expensive. pamela totally rocked when this happened. she’s the one who discovered i had it, and she was amazing!
don’t let the ob/gyn convince you that you have to have the baby there or she’ll get too big to come out of your yoni or you need a c-section. i did have gestational diabetes and i delivered river in the cabin, naturally, vaginally, and he was only 7 lbs. pamela may have you can some sugar water for safety. we gave it to river after he was born and he did great after that. you rock. just keep listening to your body. NOBODY knows it like you do.
Kari Jenkinss last blog post..Where Did 8 Weeks Go?
I think we must be soul sisters because I TOTALLY get understand every word you’re saying! I am due to have my test in a few weeks and I considered asking them if I could skip it because my PCOs makes it more likely I will get a positive. But I am at a healthy weight, I eat well and I’ve only gained 10 pounds so far. I am dreadfully nervous it will be positive because I KNOW I am healthy and in great shape for a delivery.
You have probably already read it, but the book PUSHED changed my life.
Janelles last blog post..Can we be green with disposable diapers?
Janelle »
Yeah, I read PUSHED too. Didn’t you also read one of Ina May’s books? I am feeling so blessed to be birthing with Ina’s midwives. I would go insane if I was stuck having to birth in a hospital.
And yes, we are soul sisters because I feel the same way about your blog sometimes! ;-P I want your land!!!!
Hey, I follow you on Twitter. I am in a high risk pregnancy this time with my age, diabetes and blood pressure problems. But with past pregnancies I had gestational diabetes. All three pregnancies. Never should a doctor have recommended candy bars and high sugar items with no redeeming value. If she wanted weight gain there are better, healthier ways to do it. One thing, I really don’t think you have gestational diabetes. Why? Well for one, they should have not allowed you to eat before the test. They usually do a fasting blood sugar. This is one blood sugar testing time that is hard to control and should be under 105. They prefer under 95, but 105 is absolutely the max. Then they should have had you drink and then tested you in an hour, without allowing you to eat or drink. This is a true test on how you handle the sugar in your system. By having breakfast and the drink, they allowed you to introduce more sugar into the test than what the controlled test was meant to test. Now that is what I would be mad about and probably would have been very vocal about.
For gestational diabetics, you should only ingest 45 grams of carbs for a meal and 30 grams for snacks. 3 meals and 3 snacks a day, spaced out 2 hours apart and alternated meal/snack. I check my blood sugar 4 times a day. Fasting in the morning and two hours after each meal. Fasting has to be below 105 and two hours after a meal under 120. This is to keep your baby from being large as well as many other problems.
My first child was 7 lbs. 3 oz. My second was 8 lbs. 10 oz. Her shoulders got stuck on my pelvic bone and we came very close to having to break her collar bone to get her out. It was a no going back moment and we came close to loosing her.
I would seriously question your OBGYN about how the test was conducted and request to either go through the initial test again or get a meter to monitor it. You can get a meter free in a lot of cases. The strips are what cost you. For my meter 100 strips are $95 without a prescription and insurance. The test they recommended for you to take next made me so sick it wasn’t even funny. I tried walking to burn it off and I craved water so bad, but was not allowed it. It just made me so physically ill, I laid on the couch moaning for most of the time.
Hope this helps. I am passionate about this since I know it runs in my family and never doubted I would get. I have several meters if you can’t find a free one I can give you. And if you do have it, they usually send you to the hospital to have them show you how to use it. That is how I got my free one.
ShariJ-
“By having breakfast and the drink, they allowed you to introduce more sugar into the test than what the controlled test was meant to test. Now that is what I would be mad about and probably would have been very vocal about.”
I though that the eating beforehand was a bit weird too… I couldn’t eat much since it was so early but I did have a huge glass of milk, my prenatal vitamin, my calcium pill and also a touch of coffee with sweetener before drinking the Glucola. I even still have the paper that says my instructions on it. Nothing about fasting or not having sugar/ caffeine before the test.
Thanks for the info about all this and for the offer on the meter. I may take you up on that!
Wow–look at all these amazing women who are commenting on this! You’re right to question your OBGYN. So many times physicians are geared toward driving more testing and income, regardless of necessity. Keep us posted about the outcome!
Hyphen Mamas last blog post..Completely Embarrassing Parenting Moment #94654
Ugh. Sorry you’re going through this.
I’m a big fan of questioning and I’m glad you’re doing that.
My midwives don’t do this kind of GD test because they say it’s not very reliable. They have patients fast for two hours before the test and they also ask what you ate to see if your levels are consistent. No icky drinks or all day fasting.
When my results came back low, they talked to me about it and we came up with a plan with specific steps to alter my diet. Although, even then, I questioned their advice and did some research. I’m not the type who can just follow orders. Must do my own research.
I was on the GD diet through my whole pregnancy, not because I ever had it, but to try to keep the baby’s size down and prevent problems I’ve had in the past.
A friend had a similar problem and all her OB told her was, “Don’t gain too much weight.” My midwives met with me, gave me nutritional guidelines to follow, and checked in with me all the time. SO many problems have been prevented through their nutritional counseling. I wound up with a home VBAC. Haven’t heard what ever became of that friend with the OB (she was also trying for a VBAC, but in the hospital).
I’m right there with ya. I’m floored by how different having a (homebirth) midwife is compared to an OB (or even a hospital midwife–I had one as back-up last time).
I hope you find a resolution you’re comfortable with and I hope it doesn’t involve more of that awful GD drink.
Reizas last blog post..How do I love thee? Let me count the ways (and eat the cookies).
I can’t believe your OB said to eat that junk to gain weight… I have never had an OB tell me that, most of them vocalize how important it is to have a healhty eating habit while prego.
When I took the Glucose test with Riley, my OB didn’t tell me to fast, but she did say to try to avoid certain food right before the test for the fact that certain foods will make your levels go up, and she wanted the most accurate reading she could get. So I ate, but listened to her advice and I passed my 1st one.Your OB doesn’t sound like like someone I would want through my pregnancy. OB’s can be so great if you can get one that really cares about you and their job. Both OB’s I have had where awesome. They gave me all the facts,advice and answered every question that I had and went into depth about them. Don’t give up hope yet on all OB’s cuz there are a few good ones left out there 🙂
melissa is right – there are a few good OBs left out there. My oldest daughter had one of the best and his staff reflected his attitude and knowledge.
The only thing he ‘demanded’ without explanation was a picture of him holding the baby before he would release them from the hospital.
Some docs, regardless of specialty, consider medicine a job. Others, like this man, consider it a calling and a joy.
Donna B.s last blog post..Who Is Your Cousin?
“I though that the eating beforehand was a bit weird too… I couldn’t eat much since it was so early but I did have a huge glass of milk, my prenatal vitamin, my calcium pill and also a touch of coffee with sweetener before drinking the Glucola. I even still have the paper that says my instructions on it. Nothing about fasting or not having sugar/ caffeine before the test.”
Depending on the type of milk you had, you probably ingest a lot of carbs. I use skim milk and have to measure it very closely. Milk is what pushed a friend of mine to be diabetic. She loved milk and drank it all day long. Not that milk is bad, but they don’t usually recommend it in the morning or in large doses. One thing to stay away from right away is juice. It is full and I mean full of carbs that have no redeeming value.
I live on peanut butter for snacks. It has a lot of protein but is low in carbs. It tends to fill me up. Also, sugar free jello and pickles are considered freebies. They don’t do much filling up but sometimes the jello is sweet enough to fix my sweet tooth. Nuts are another good thing to eat. Almonds are my favorite right now for snacking. Generally I keep a lot of fruit around but still have to measure it. Sometimes I will have an apple with a couple of slices of cheese.
Looking for my free glucose monitor link so I can send it too you.
after going through all the testing with 2 pregnancies and feeling they were all completely useless, I simply waived them all with Odessa.
Memarie Lanes last blog post..Goodbye
I had the glucose tolerance test after my son was born. he weighed 10 lbs 8 oz. It seemed rather stupid at the time to test me for it after he was born.
If you tested at 140, I wouldn’t worry about it. Just eat right and watch your carbs and you should be fine. But by all means, get a blood meter and monitor your blood sugar. It never hurts to know.
Karens last blog post..A Preview: Sunset at Imperial Beach
Congratulations on taking a stand. Too often, doctors just don’t listen to their patients and it is frustrating. You are right to go with your instincts as you know your body best. This is your health and the health of you baby here, you need to feel that you trust your OB and you clearly don’t. I wouldn’t want to be in that state of mind either when the day comes.
Fraxels last blog post..Fraxel Laser Treatment Removes Old and New Scars
I am SO fired up about this myself right now!! I just “failed” my one-hour test at 138. This is my fifth pregnancy, and I’ve had four healthy, normal/smallish babies (between 6 and 7lb12oz) with no GD, always passed the 1-hour. WELL, this time, with a different practice, I was not told to fast or anything, and because I run every morning, I needed something to eat after my run and before my dr appt an hour later. So I ate high-fiber cereal w/skim milk and about 1/4 cup of half-caff. Dumb me. Because I scored a 138, I now have to do the dreaded 3-hour test.
When I questioned this and asked to speak to the dr., I was basically informed that if I refused, I would be treated as a GD patient and be required to see a nutritionist for diabetics, do finger pricks, go to the high-risk dr for regular ultrasounds, yada yada yada. So the more attractive solution is, of course, to take the *@#!! test. I’m assuming they would drop me from the practice if I still refused this course of action. I have hated this practice from the get-go, as the staff has the “I have to be here” attitude, and they require you to sit through a torturous “education” session upon your pg diagnosis to hear of all the bad things that could happen if you are 35 or over, all the tests you should have, etc. One leaves feeling annoyed and deflated and diseased, rather than just “pregnant” and blessed. I am not the type to homebirth, etc., although I’m very much the “natural” type in other respects. I see medicine as a wonderful tool to assist a difficult birth or a life-threatening emergency, but NOT to force in situations where it is not indicated at all just to cover one’s legal fanny!
I get weak from skipping a single meal. I am lean, I run daily, and I eat a lot of very healthy, whole food. This is not to sound self-righteous, but rather to illustrate the low chance of having GD. I have not gained more than 25 lbs in my last 3 pregnancies. To fast like this during pregnancy (and then gulp down hideous amounts of sugar) is ridiculous given the low probability of even needing the test.
Not to mention: I homeschool four children. Who is going to watch them until noon on a SCHOOL day on my last week of the academic year? We actually do work, given that I have two elementary students in the mix. My husband, who must take a 1/2 day off work during a very busy season of his professional life. Then, if I can feel well enough to drag my butt back to my car, I’ll come home and feeling really “ready” to care for four kids under eight??!! NOT!!
I’ve researched extensively and have been shocked to find that such a pain-in-the-rear, sickly test has such little scientific merit. I am afraid of this test simply because of the blood sugar crash it will likely induce in me, and I highly, highly resent the “do it or else” spirit that is so pervasive at my OB practice.
GRRRR! Sorry to rant, but this issue has been an eye-opening one for me.