3rd Trimester

Refusing the 3-hour glucose

Did anyone test elevated on the 1 hour glucose screening and then refuse the 3-hour? 

I tested elevated with my first child and passed the 3 hour with no problem. With this pregnancy I just found out that I tested elevated on the 1-hour again. However, I've switched jobs since and taking a day off (or even half a day) to do the 3-hour would mean one less day of paid leave (which I'm not getting much of anyway, a few days). I really would rather not do it if I can avoid it but I'm not sure how important it really is or what the consequence of not doing it would be.

FYI - I'm going to a birth center so I see a group of midwives, not sure if that'll make a difference, and yes I intend to talk to them about it but I got the voicemail Friday afternoon so I'm waiting until Monday to call. 

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Re: Refusing the 3-hour glucose

  • No, I would not skip the 3hr.  I did mine on a saturday morning.  Maybe that would help.
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  • I would not refuse the glucose test. I feel that it is a necessary precaution and every pregnancy is different so your past experience does not necessarily mean that this is the same situation.
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  • Most practices will say that if you refuse the 3 hour then you will be treated like you have GD.  As someone who was diagnosed with GD the amount of time you would have to spend dealing with that is far more than the time you would put in to the 3 hr test.  I failed the 1 hr with my first and passed the 3 hr.  It doesn't mean you can't get GD with your second child.  The effects on your baby of you having GD and not treating it are not good.  

    I know it the test sucks but is it really worth it to not just take it? 

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  • Unless you plan on just assuming that you do have GD and following the diet and monitoring you blood sugar levels with daily finger pricks then I think it is ridiculous.

    Stop being selfish.  Obviously you care more about your new job than your baby.  Maybe you should do a little research on what unmonitored GD can do to your baby. 

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  • imageKellyAnn911:

    Unless you plan on just assuming that you do have GD and following the diet and monitoring you blood sugar levels with daily finger pricks then I think it is ridiculous.

    Stop being selfish.  Obviously you care more about your new job than your baby.  Maybe you should do a little research on what unmonitored GD can do to your baby. 

    I don't care more about my new job than my baby. I do care about losing a day's pay when we can't afford it. My thinking was that I could act like I have it and work with that, but I'm not sure what that entails, which is why I asked.
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  • imagesjBear123:
    No, I would not skip the 3hr.  I did mine on a saturday morning.  Maybe that would help.

    I thought of that but my husband works Saturdays and so I'd have to either pay a babysitter or take my son with me for the test. Neither option sounds great... Also, I'd have to find somewhere that will do it on a Saturday. Good suggestion though. 

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  • I'd take losing a day of Pay over not knowing if I have GD and having any of this happen. But that's just me.

     

    Pregnant women with gestational diabetes tend to have larger babies at birth. This can increase the chance of problems at the time of delivery, including:

    • Birth injury (trauma) because of the baby's large size

    • Delivery by c-section

    Your baby is more likely to have periods of low blood sugar (hypoglycemia) during the first few days of life.

    Mothers with gestational diabetes have an increased risk for high blood pressure during pregnancy.

    There is a slightly increased risk of the baby dying when the mother has untreated gestational diabetes. Controlling blood sugar levels reduces this risk.

    High blood sugar (glucose) levels often go back to normal after delivery. However, women with gestational diabetes should be watched closely after giving birth and at regular doctor's appointments to screen for signs of diabetes. Many women with gestational diabetes develop diabetes within 5 - 10 years after delivery. The risk may be increased in obese women.

    Complications

    • Delivery-related complications due to the infant's large size

    • Development of diabetes later in life

    • Increased risk of newborn death and stillbirth

    • Low blood sugar (glucose) or illness in the newborn

  • The only way you should skip the 3 hour is if you are just going to assume you have GD and go on the diet. Otherwise, you need to do the test. It is irresponsible and dangerous not to. Do what is best for your child. What is best is to take the test. Every pregnancy is different, so just because you passed last time doesn't mean you will this time.
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  • I failed the 1 hr. test with a 140, which is only 5 pts. above my practice's cutoff, and the MW I saw that day doesn't think I have GD (LO is measuring normally and everything), but I am still taking the 3 hr. test.  I have a combination of risk factors for GD, so if there is even the smallest chance I have it I want to take the 3 hr. and know for sure.  Also, I know moms who had GD with their second pregnancy but not their first, so just because you didn't have it with your first doesn't mean you don't now.  I know it sucks to schedule the 3 hr. test, but if you do have GD it is something you need to manage for your baby's sake, and it's good to know about because there are things to do to lower your own risk of developing type 2 diabetes later on.
    DD born 10/10/07 * DS born 11/25/11 * #3 due 3/9/2015
  • No, I would not skip it, especially since you don't know what assuming GD would entail...and why would you want to change your diet and do daily finger pricks if you don't have to?
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  • Ok, here you go, this is what it entails.  Spending over 100 dollars a month on test strips so you can prick your finger and test your blood a min of 4 times a day.  Meeting with a dietician weekly to monitor your blood sugars.  Counting every carb you eat from now until after the baby is born.  Spending an extra hundred plus dollars at the grocery store every week buying the foods that you CAN eat.  I 'm not sure what you do for a living but missing half a day of work's pay probably is less than you will spend just in "start up" costs of being diagnosed with GD.  Not to mention the extra time you will spend doing NST's at the OB's office.  Taking hours off at a time for those.  Are you getting what i'm saying here?  1/2 day lost pay isn't gonna put a dent in the end result cost if you are treated like you have GD.
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  • I would find away to take it.  I didnt have it with my first to pg and I have it will the third.  Can you fit it in before or after work?  I would take to the clinic and ask what options you have.  Maybe they can work something out. You can't be the first patient to have conflicts like this.

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  • imagediddlenation:
    Ok, here you go, this is what it entails.  Spending over 100 dollars a month on test strips so you can prick your finger and test your blood a min of 4 times a day.  Meeting with a dietician weekly to monitor your blood sugars.  Counting every carb you eat from now until after the baby is born.  Spending an extra hundred plus dollars at the grocery store every week buying the foods that you CAN eat.  I 'm not sure what you do for a living but missing half a day of work's pay probably is less than you will spend just in "start up" costs of being diagnosed with GD.  Not to mention the extra time you will spend doing NST's at the OB's office.  Taking hours off at a time for those.  Are you getting what i'm saying here?  1/2 day lost pay isn't gonna put a dent in the end result cost if you are treated like you have GD.

    I think it depends on how bad your tests come back.  I did not have to do any of that. I take a daily pill and watch what I eat. I dont do test strips and dont do NST's.  But, I do agree a half days pay is well worth the test. 

     

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  • My first pregnancy, I was cleared for GD.  With my second pregnancy, I failed the 1-hour, 2-hour and took the 3-hour and failed it miserably and was diagnosed with GD.  I was able to control it through diet and luckily never had to administer insulin but if left untreated it could have brought on a whole slew of complications not just for me (increased weight gain, large baby, c/s at delivery) but for baby.  DS was born with jaundice and had trouble controlling his own sugars and that was with my dietary changes.  I shudder to think of his overall health if I had not followed up on the testing.  This time around I was cleared after the 1-hour test so you just never know.  Every pregnancy is different so IMO I don't think I would take the chance of refusing it in the hopes of having an extra day of paid leave. 
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  • imagediddlenation:
    Ok, here you go, this is what it entails over 100 dollars a month on test strips so you can prick your finger and test your blood a min of 4 times a day.  Meeting with a dietician weekly to monitor your blood sugars.  Counting every carb you eat from now until after the baby is born.  Spending an extra hundred plus dollars at the grocery store every week buying the foods that you CAN eat.  I 'm not sure what you do for a living but missing half a day of work's pay probably is less than you will spend just in "start up" costs of being diagnosed with GD.  Not to mention the extra time you will spend doing NST's at the OB's office.  Taking hours off at a time for those.  Are you getting what i'm saying here?  1/2 day lost pay isn't gonna put a dent in the end result cost if you are treated like you have GD.

    This! Lancets, test strips and the glucose monitor are not cheap even with good insurance. Also, with a new job it is going to be very stressful to try to check your sugars and keep with with carb counts all the time, especially if your job constantly keeps you busy. I would highly recommend taking the time off and doing the 3 hour test. If you go ahead and assume you have GD, the time and money will far outweigh the time and money you will lose from taking a few hours off to just take the test. 

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  • I would absolutely NOT skip the 3 hour. I know that work is important, but the health of you & your baby is even more important IMHO. Just because you tested clear the first time does not mean that you will again. Every pregnancy is different and you don't want undiagnosed GD complicating things.
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  • Considering the potential risks of GD to the baby, no, I would not skip it. Especially if I had already been flagged as a higher-risk candidate. Unfortunately having to suck up annoying medical visits are part of being a parent.
    Raising a threenager since 11/11
    Baby boy #2 due 5/6/15
  • I took the 3-hour on a Tuesday starting at 7am at a clinic.  I was done by 10:30am and got to work by 11am.  So if you get in early enough, you may not even lose half a day.  Some clinics have evening hours.  And for what it's worth, I was in there with two other ladies taking it, too.  They had their very little kids with them - it's not 100% ideal, but it was not that bad for the kids to hang out for three hours (they were coloring in the waiting room, which is where we all sat in between blood draws).  

    You really need to just make this work - the consequences of not taking the test are just as expensive as the day of paid leave you may lose.

  • Don't refuse this test. I work prn in a lab at a hospital. It is a 24 hour facility. The other two hospitals in town also offer 24 hour lab services to outpatients. You could come in a midnight and do your gtt for all the lab cares. Ask what your options are to do it as an outpatient at a lab in your area if you can't do it at the OB's office during office hours.

    ETA: All you will need from your OB or midwife or whatever... is a script (like what they'd write an rx on) that says you need a 3 hour gtt and to fax the office the results when it's done and signed of course. Easy to do this option.

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  • imageArcadianDreams:
    Considering the potential risks of GD to the baby, no, I would not skip it. Especially if I had already been flagged as a higher-risk candidate. Unfortunately having to suck up annoying medical visits are part of being a parent.
    This.  And SockMonkeySam nailed the risks.  Surely missing a day of work or lugging your LO to a doctors office on a Saturday is worth potentially saving the life of your unborn child.

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  • Most labs open early, like 7 am - you could be out of there by 10. I dont know what kind of schedule you have, but if you're 8-5, that's not missing much. I don't think you should skip it. I see midwives too, but I don't think they would be OK with me not taking a critical test like this. You will probably save yourself time and money in the long run if you actually pass it rather than just assuming you have it.
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  • imagediddlenation:
    Ok, here you go, this is what it entails.  Spending over 100 dollars a month on test strips so you can prick your finger and test your blood a min of 4 times a day.  Meeting with a dietician weekly to monitor your blood sugars.  Counting every carb you eat from now until after the baby is born.  Spending an extra hundred plus dollars at the grocery store every week buying the foods that you CAN eat.  I 'm not sure what you do for a living but missing half a day of work's pay probably is less than you will spend just in "start up" costs of being diagnosed with GD.  Not to mention the extra time you will spend doing NST's at the OB's office.  Taking hours off at a time for those.  Are you getting what i'm saying here?  1/2 day lost pay isn't gonna put a dent in the end result cost if you are treated like you have GD.

    Yes, this is what it entails-no joke. I miss being able to eat what I want, even healthy stuff like fruit and milk, but my baby is worth it. I wouln't do this if I didn't have to, though.

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  • When you contact you midwife see if you can do it on a Saturday or when you are off. You might be surprised about their flexibility.
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  • Look into taking the 2 hour GD test... My OB said it's much easier, less time, more accurate, and it's starting to take the place of the 3 hour.

    All you have to do is fast the night before, drink the glucola drink and then 2 hours later have one blood draw. Very simple. Ask your MW about it.
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  • imageKellyAnn911:

    Stop being selfish.  Obviously you care more about your new job than your baby.  Maybe you should do a little research on what unmonitored GD can do to your baby. 

    Sheesh over react much?

    OP - the test is important, and I would recommend you take it.  Is there anyway you can make up your hours at work?  Stay late or work through lunches a few days?

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  • The risk of GD increases as you age - so you are more likely to have it with this pregnancy than the last. Not having it with a previous pregnancy does not mean that you won't with this one - in fact you are MORE likely to have it this time than last time.

    A couple ideas for you:

    1. take the test starting at 7 a.m. and finishing at 11 so you only miss 1/2 a day

    2. explain your situation and ask if you can drink the stuff at home at 6 am and have your first blood draw at 7 a.m. so that you can finish by 10

    3. talk with your job about the situation and ask if they can work with you a bit - can you work through lunches a couple days? come in early and/or leave late? 

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  • If it was elevated with your first but you ended up passing the 3 hour and now its elevated again, its possible you were borderline with the first and have actual GD this time around. I would either take the 3 hour test OR take the precautions as if you'd tested and found out you indeed do have GD. My question is...why bother with the 1 hour if you weren't willing to take the 3 hour?
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  • I would not skip it. Just because you passed the first pregnancy doesn't mean you will this time. Consequences:

    https://www.mayoclinic.com/health/gestational-diabetes/DS00316/DSECTION=complications

     

     

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  • Can you explain the situation to your employer and ask to make up the time by working 30 min more per day for 6 days or skipping lunch breaks for a few days? I would think your employer would work with you since this is a medical issue that you need to take care of and it's only a few hours. I would not skip the test, its given for a reason to protect you and your baby. Every pregnancy is different and just because you passed last time doesn't mean you will this time. Last pregnancy I tested pretty high on the 1 hr. This time I tested 40% lower and was WAY under the threshold. It could easily go the other way.
  • imageceliabwatson:

    imagesjBear123:
    No, I would not skip the 3hr.  I did mine on a saturday morning.  Maybe that would help.

    I thought of that but my husband works Saturdays and so I'd have to either pay a babysitter or take my son with me for the test. Neither option sounds great... Also, I'd have to find somewhere that will do it on a Saturday. Good suggestion though. 

    This makes it sound like you are making excuses not to take it.

    Talk to your employer about the importance of the test - maybe you can find a way to make up the time if needed, talk to your MWs about taking it at a time which will be convenient for you - take your son if you don't want to / can't pay a babysitter (bring books, toys, activities, etc. to keeps busy between the blood draws).

    You absolutely should not skip the test.

  • High blood sugar damages you and your baby.  My doctor told me that you can do damage to your insides by allowing numbers to go too high, even if GD is for a short period of time.  Not worth it.  
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  • imageJules08:
    imageceliabwatson:

    imagesjBear123:
    No, I would not skip the 3hr.  I did mine on a saturday morning.  Maybe that would help.

    I thought of that but my husband works Saturdays and so I'd have to either pay a babysitter or take my son with me for the test. Neither option sounds great... Also, I'd have to find somewhere that will do it on a Saturday. Good suggestion though. 

    This makes it sound like you are making excuses not to take it.

    This. We all have busy lives but have found the time to do what is needed for our babies. Take your kid with you if your funds are that tight. It might not be the most relaxing 3 hours of your life, but it sounds like a really simple solution. Or ask if you can just get the drink ahead of time and come in to get your blood taken. 

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  • I'm going to go against everyone and say skip it if you feel the need to. As long as you eat healthy and don't eat lots of sugary foods, you will be fine. 

    Our mothers didn't take glucose tolerance tests while they were pregnant with us, so I don't see why people now-a-days think we have to do every little test and take every little precaution, even the unnecessary ones.

    My point is, they didn't even have these tests when we were being born, and we seem to all be alive and well. Just saying. :) 

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  • I failed my 1 hour test by 5 points and my OB's office actually uses the lower cutoff number of 129. I had a 134. It didn't really seem like a big deal to me. My OB recommended I do the 3 hour test. Did it suck? Yes. Was it inconvenient? Very! But I'm glad I took it bc I ended failing the 3 hour test by a lot, which is something I never expected would happen,

    The complications that can occur with GD (macrosomia, hypoglycemia, jaundice) can also occur in babies whose mothers do not have GD, but why risk it? If your LO ended up with complications and you had refused the test, you would never know if it was due to GD or not. Could you live with not knowing?

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  • imageceliabwatson:

    imagesjBear123:
    No, I would not skip the 3hr.  I did mine on a saturday morning.  Maybe that would help.

    I thought of that but my husband works Saturdays and so I'd have to either pay a babysitter or take my son with me for the test. Neither option sounds great... Also, I'd have to find somewhere that will do it on a Saturday. Good suggestion though. 

    I had to take all 3 of my kids with me, and they did fine. Get it done, its an important test.

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  • imageerinshoeman:

    I'm going to go against everyone and say skip it if you feel the need to. As long as you eat healthy and don't eat lots of sugary foods, you will be fine. 

    Our mothers didn't take glucose tolerance tests while they were pregnant with us, so I don't see why people now-a-days think we have to do every little test and take every little precaution, even the unnecessary ones.

    My point is, they didn't even have these tests when we were being born, and we seem to all be alive and well. Just saying. :) 

    You're right, a lot of our mothers didn't take it.  DH's mother didn't do it with her first 2 pregnancies, his younger sister was born vaginally and she was so big it damaged her insides almost to the point of sterilization, all because it turned out that she had GD and hadn't been properly caring for herself.  She was lucky to get pregnant again, and guess what, she took the test and it turned out she had it again. She also now has type II diabetes because of it.  Don't skip the test.

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  • imageerinshoeman:

    I'm going to go against everyone and say skip it if you feel the need to. As long as you eat healthy and don't eat lots of sugary foods, you will be fine. 

    Our mothers didn't take glucose tolerance tests while they were pregnant with us, so I don't see why people now-a-days think we have to do every little test and take every little precaution, even the unnecessary ones.

    My point is, they didn't even have these tests when we were being born, and we seem to all be alive and well. Just saying. :) 

    You are 100% right that most of us are healthy, alive and well but my mother bore 2 10 lbs babies and an almost 11 lbs baby and now has type 2 diabetes which is quite common later in life if you had GD.  My younger brother was also quite sick at birth and hungry all the time...could his sugars have been out of whack because of undiagnosed GD?  My mother also gained about 70 lbs each pregnancy which is way too high in my opinion but other than that she was  completely healthy throughout her pregnancies.   So because they didn't test for it doesn't necessarily mean that it didn't exist and that they were better off without it.  

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  • Thank you for your advice everyone. I will look into my options for taking it. 

    I'm a teacher so making up hours at another time is not an option, and the suggestions of working through lunch made me laugh because I already work at lunch every day (like eat with the kids, am still on duty, barely get to eat my own lunch). I don't mean to imply anything by laughing at your comment, it would be a great suggestion in most jobs, just made me laugh.

    We do have a teacher work day coming up Oct 28 so I might be able to take it that day and make up that time on another day, but it's probably not a good idea to wait that long. Anyway, I'll call the midwives on Monday and find out what my options are for timing.

    Oh, and you can't drink the thing ahead of time because they start with an initial fasting blood draw on the 3 hour. 

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  • Honestly, I wouldn't skip it.  The consequences could be very detrimental.  You could end up having GD, making your baby and your health unsafe.  Better safe than sorry.  
  • There could be a lot of consequences if you don't have it done. not to freak you out, but LO could die if you have GD and do not control it....
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