Other tests for GD besides 3 hr glucose?

TCsbride

I get that gestational diabetes is a serious issue, but I'm wondering if anyone knows additional tests that can be done after the 3 hr glucose test.

 This is baby #4 for me (others are 5,4 and 2). My biggest was 5 lbs 7 oz on his due date. Never failed even my 1 hr glucose test. This time around I failed the 1 hr glucose. With my 3 hr glucose my fasting number was very low, first draw was fine, 2nd draw was 4 pts over where they want it and last draw was low. My OB kind of went back and forth and said she'd at least like me to talk to a high risk doctor about it.

So I went yesterday and they gave me a meal plan (which really is what I normally eat minus fruit which I've been craving big time). They showed me how to test my numbers (which were fine at 1 hr past lunch). Then they did an ultrasound and said baby was in 35% (4 lbs at 33 weeks) and showed no risk of being large. They still have me coming in every week though, going to a dietician every week, and seeing my OB every week.

I get that they are being overly cautious, but I've had nothing that has pointed to a risk but one number, which was 4 pts high. I really have no problem with testing my sugar, but the appointments seem to be a huge pain. I can't start taking 3 days a week off work (they can never get me in for the same day and the appointments are always smack dab in the middle and across town) already or I'll end up with about 2 weeks of maternity leave.

So I was curious if anyone knew of additional testing I could request them to do or if anyone has worked out something with their OB (maybe like showing my numbers to my OB and having them call the high risk doctor and saying they are fine). Just seems like a lot of concern for something I honestly don't think I have.

I also do not have any of the risk factors that could cause GD except that I am 29 and they say the risk is higher over 25 and I was 10 lbs over my "ideal" weight prepregnancy. Other than that I'm a non-hispanic white female, past issues with LOW blood sugar, past pregnancies were all good, and no family history of diabetes.

PrimRoseMama

You may not want to hear this, but I would continue with your current plan. I get it that it's a PITA and inconvenient for you. I don't know of any other way to "prove" that you aren't at risk.

I don't mean this in a rude or snarky way, but if you trust your doctor to do what's right for you concerning your pregnancy then why not go with the plan of action until delivery? It seems, to me, to be just as much of a PITA to fight this recommended plan with all the appointments as it would be to just go with the flow.

If you have two doctors that see the need to monitor you then I can't imagine why you would try to get out if it. Yes, I understand work is important, but your health and the health of your LO is more pressing, at least in my mind.

So, I would tough out this course of action until delivery. Scheduling conflicts beat anything compromising your health in the long run.

LaBellaVida

It's all about hormones with GD. I have 2 other kids, never had GD with them. I got diagnosed with GD this time around. I for sure thought I would pass because I did everything right. Yeah, I am a little overweight, but I was active, and ate really healthy after I found out I was pregnant. There is nothing you can do to prevent it. I am surprised that they diagnosed your with it being only 4 points high on one number read. Usually it's 2 numbers need to be over their cut off. For example I failed my 1 hour. Took the 3 hour and my fasting was perfect. My first draw was good...but the other two were higher then they wanted them to be, so therefore I have GD. I don't think there are any other test, but maybe talk to your OB about it. I don't have to go see a dietician, and have only been once. I test 4X a day and keep a log sheet of my numbers, and at every appointment I turn in my sheet to my OB. She looks over it, and give me a new sheet. My numbers are always well within range, and I am strictly diet controlled- no medication needed so that may be the reason why I don't go see a dietician all the time. I have had a few extra appointments for u/s though for a growth scan of the baby, but that's it. Unless my OB is a high risk Dr. (which I don't know if she is) I don't even go see a high risk Dr.

You can still have fruit...just in moderation. I have recently been learning how to cheat within my limits and my numbers are still fine. It's all about portion control, and moderation when it comes to GD I think, and eating healthier. I didn't think I had GD either, and I even told my OB that, however the truth of the matter is, I do see a difference when I test after I have eaten something I was not supposed to, and more then I guess I "needed." It's clear there is a glucose intolerance.

Maybe just talk to your OB about it, and see what other test, if any (which I don't think there is) that you can do. If not...the GD diet plan isn't bad, and it's actually good for you!

TCsbride

I will continue the plan as set forth, but I was just curious if there was any additional testing that I could request. They also kind of seem loosey goosey....like it's kinda important. My regular OB went back and forth about even going and then said I might as well go and see what they say.

They wanted me to go to the dietician on Monday (10th) and then the only appointment they had to see them again was the 12th. I'll be out of town so I asked for both next available. I'm now seeing the dietician the 20th and high risk OB the 25th. I asked how that was "every week" and they said those are the only openings available. Kind of gives me mixed messages that they aren't really THAT concerned to wait till I'm 36 weeks to even check if I need insulin...

Amanda&EricB

Normally Im the first to say, follow the plan. GD is serious, and you clearly have a grasp on that. 

But in your case, Ithink you should talk to your OB and discuss the options. I thought you had to fail two numbers on the 3 hour test to be diagnosed anyway. But the fact that one number was only high, and by only 4 points, coupled with your low/normal post meal numbers, and the u/s showing a small baby, Id lean more towards you not having GD.

Bottom line, talk to your doctor. Express your concerns and questions. 

jane.says

I don't have any experience with GD but based on what you've described, I think I'd ask if I could repeat the 3 hour. It's a pain, but if you end up passing it the second time around, one 3-hour test seems better than all the appointments you're having to endure now.

cyprissa

I'd get a second opinion. The official threshold for diagnosis is failing 2 of the 4 blood draws and you didn't. I also agree that a frank discussion is in order. That's a lot of extra monitoring given the circumstances and I would be questioning it too.

newbeg826

I feel your pain a little, but I will save my story. I am sorta in a similar position.

I will say that sometimes when you have a history of hypoglycemia that it can wear out your pancreas and put you at higher risk for diabetes. This is the category I fall into.

My OB is solely managing my GD. I had to meet with the diabetes management center at first which told me I would have to see a high risk doctor. When I met with my OB she said she would manage the GD and would refer me out when if my numbers were elevated. I check 4 times a day and bring my numbers in every 2 weeks. My numbers have been normal, except maybe 3 high post meals over the past 6 weeks.

I would talk to your OB or even ask the MFM if you could fax in your numbers weekly, and if they are high then you would schedule an appointment. You can also ask for a hemoglobin A1C which is an average of your blood sugar over the previous 3 months.

Some OBs are strict about GD and others are not.

Lastly, a diagnosis of GD should happen if 2 numbers are elevated at your 3 hour unless its your fasting.

Dermy167

A hemoglobin A1C is a blood test they can do to get an idea of how your blood sugars have been running over the past 90 days. It is a test that is used to monitor a diabetic's glucose control. It is not used a lot in pregnancy though because it takes about 90 days to see a difference in your numbers and typically people are diagnosed with GD in the third tri, not leaving much time to see a difference. If the result is well within the nondiabetes range, you could likely make a case for backing off on the monitoring. Also, you need to fail 2 of the blood draws in order to be diagnosed with GD.