High-Risk Pregnancy

Passed 3 hour but still diagnosed???

Okay so maybe I'm just dumb but I am totally confused and rather bothered by all of this. I failed my 1 hour the cutoff was a 130 and I failed at 142. So I took the 3 hour and I passed every draw. My highest number was after the first hour and I was at a 170 and I was told the cutoff was 190. Now I was overweight to start and was told I was allowed to gain 15-25lbs. I am 34 weeks and I have gained 18lbs so far. I have never gained more than a lb a week except one month. So my Dr. and I have not quite seen eye to eye on a few things however, she is now stating that I absolutly have GD and she is certain of this because of my weight gain, that I failed the 1 hour and that my first hour was high on the 3 hour. I am going to go see a dietician but not happy about this at all. Did anyone else pass the 3 hour but still be diagnosed with GD?
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Re: Passed 3 hour but still diagnosed???

  • What was your fasting blood sugar? Perhaps that was elevated... It's the only thing I can think of-- we have 2 conservative MFMs that we work with that will sometimes diagnosed GD based on a high fasting blood sugar alone (higher than 95).  Otherwise, I have never heard of anyone passing the 3-hour and then still being diagnosed with GD.  It's why we have this blood test.  You can't diagnose someone based on weight gain.  All you can do with someone if you think they are gaining too much weight is tell them to cool it.  I'd discuss this with my ob.  The diet, although boring, won't kill you.  But the diagnosis will stay on your medical records.  You may want to bring that up if it really bothers you that much.
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  • Yes I agree. However, I did bring this up and was told that no one I talk to went to medical school therefore they don't know what they are talking about she got semi offended and told me that if I wished to transfer my care to another Dr. that that would be my choice. I really wish I could however, I am not comfortable with a complete stranger delivering me. She is a very well known Dr. in my area and I know lots of people who have had her and had no problems. Oh yeah and my fasting numbers were fine. I truely don't understand. Just because I keep gaining weight and I was fat to begin with I have GD? I don't get it but was just making sure it wasn't just me doubting her.
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  • Well, I did go to medical school, am an ob/gyn chief resident, and do know what I'm talking about.  So you're not wrong.  And you are talking to someone who knows a lot about GD.  We have a huge amount of GD in our patients (lots of obese, lots of type 2 DM, lots of family history of DM, and lots of hispanics who are at higher risk)  I normally stay out of GD discussions because people manage GD differently that we do at my hospitals and it just drives me batty, but this is different. 

    We get talked to about situations like this.  Not everyone will agree with our diagnoses and opinions.  Even if we have evidence based medicine to back them up.  If you can come to some sort of agreement to disagree with your patient, you can move along smoothly.  However, I'm struck by your situation.  Being overweight and gaining too much weight can put you at an increased risk for GD but it cannot diagnose you with GD.  Even without GD, it can still put you at an increased risk for a big baby (over 4000g or 8lb8oz, which is considered macrosomic), which can cause problems during delivery.  If your doctor is worried about a shoulder dystocia during a vaginal delivery or needing to do a c-section because of suspected macrosomia, this is an odd way to prevent it. 

    You're definitely justified to question your doctor.  People question their doctors for a lot less, and it doesn't matter how well respected they are.  Talk to your doctor again.  Try not to be aggressive, or it sounds like your doctor will go on the defensive again.  Have a plan.  I can provide you with a bunch of medical literature on GD, if you like.  You can e-mail me for it.  If worse comes to worse, she may insist on the diet, which won't kill you-- but you don't look big to me!  Of course, I'm used to ladies on the 250-300lb range, so my judgement is a bit skewed.  I'll be available until the end of the week, then I go in for induction this weekend.

    GL!

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  • damn your dr sounds like shes got some kind of attitude! that makes no sense that she would say you have GD when you passed the 3 hour test! 

    it doesn't sound like you really are gaining more than they want since you're well within what they said you could gain.

     

    i know you said you're uncomfortable with a stranger, but i'd be pretty uncomfortable with a dr who doesn't listen to you and then cops such an attitude and offense when you have a legitimite concern!  

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  • All my research states that the one hr can't diagnose you and you have to fail 2 out of the 4 draws in the 3 hr test to be diagnosed. I think its rude and unprofessional for your dr not to explain why they are giving you this diagnosis without the data to back it up. Maybe they are being safe than sorry, but one thing is for sure, trust your gut and if that means changing drs you should. Good luck and you look great to me!
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  • Thank you so much for all of your responses. It makes me happy that I questioned her even though she got so unnerved about it. She never explains anything to me and I am the type of person that I want to know. I don't want things butter coated and I don't want to be left in the dark for my own good. If I truely do have GD I have no problem with doing whatever necessary for my baby, but I just don't believe that I have to go through the entire GD diagnosis and BG meter and all.
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  • I was diagnosed with passing numbers as well. (71, 167, 145, 109).  It was very frustrating.  In the end, it has been better for my son (who was getting quite large) for me to be following the GD diet.  Hopefully, you will be able to get great readings just by limiting your carb intake. 

    I know, it sucks, but you'll get used to it and it WILL curb your weight gain.  And the meter isn't bad at all...I've become weirdly obsessed with knowing my bs all the time, lol.

    GL!  I hope everything works out for you and your baby :)

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  • imageExpectantSteelerFan:

    I technically passed the 3 hour (for my dr., you had to fail 2 draws, and I failed one by 3 points, but only passed another by 1 point).  I was referred to mfm to follow the gd diet, but mfm decided to just treat me as if I was GD.  It ended up being a good thing because my glucose levels really were elevated after eating and I eventually had to take glyburide.  LO measured large as well.  I'm still trying to get my levels under control now...

    I say, see the dietician, test your sugars if they tell you to, and if you really don't have GD, your levels will show it and they will tell you you can stop.  Better to be safe.

     

    Thanks. This is what my husband and I decided too. I will still continue to educate myself on this issue however I feel now that if something was wrong and I did nothing about it and my son suffered because of it, it would be my fault and I would have a hard time living with myself for that. I am going. Damn it.

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