While we're on the subject of GD....

rae_dylanzmom · October 2010

We discussed various tests with our MW back when we interviewed her and I mentioned that I'd heard bad things about this test. (I'm still wondering why an easy blood test - like they do for regular diabetes -wouldn't provide adequate results, but I'm no doc.)

She handled the question by saying that as long as things were looking good, she wouldn't force me to take the test. She did follow it up to say that if she thought I really needed it she'd force feed the drink to me if she had to. (OK, that sounds awful as I read it, but it was actually quite funny and stuck a great balance between letting us call the shots, but not at the risk of jeopardizing my health.)

So, my question is.... is this test standard for most people or does something come up in your checkups that raises a red flag to test for it?

capitalB · October 2010

My midwives give everyone the test, regardless of risk factors.

jteneback · October 2010

What are the "bad things" you have heard? My MW does the test for everyone but uses food instead of Glucola. You can have GD with no symptoms.

Rachiemoo · October 2010

as far as i know it is very standard.

triumphantreturnofplanningbug · October 2010

My MW group only recommends it if you have two or more of the risk factors, and since I'm OLD (29! gasp!) and have a BMI that's in the "overweight" range (don't even get me started, kwim?), they recommended it.

utlawgirl · October 2010

As far as I know, it is a standard test that everyone gets, at least in the U.S. It's pretty darn important, since there are usually not any symptoms before you're diagnosed. I didn't have any. You can also get is regardless of whether you have any risk factors for it. What "bad things" have you heard about the test?

dukeylouise · October 2010

It is standard for any pregnancy. The inital test isn't bad. The drink isn't nearly as bad as anyone says. The one that sucks is the 2nd test if something shows up on the first test. Still that one isn't that bad either.

RayRay007 · October 2010

I don't know what "bad" things OP's talking about, but I had read in Ina May and Gentle Birth, Gentle Mothering, that there isn't much point in getting it, especially if you don't have any risk factors. It's better to just eat well in the first place. If you get the test, and are diagnosed with GD, there isn't much they can do about it except for diet, and if you are eating well already, well then, what's the point of being diagnosed except that it will cause undue stress. That is what I got out of those books anyway, and that is probably oversimplifying it. I would probably decline a GD test.

LydiaE2 · October 2010

RayRay007:
I don't know what "bad" things OP's talking about, but I had read in Ina May and Gentle Birth, Gentle Mothering, that there isn't much point in getting it, especially if you don't have any risk factors. It's better to just eat well in the first place. If you get the test, and are diagnosed with GD, there isn't much they can do about it except for diet, and if you are eating well already, well then, what's the point of being diagnosed except that it will cause undue stress. That is what I got out of those books anyway, and that is probably oversimplifying it. I would probably decline a GD test.

That is not what I have heard. A fair amount of laddies over on the high risk board have GD, some of them are on various meds to control their blood sugars, some are even on insulin. If you have GD it is very important to control your blood sugars as well as you can. GD can cause huge babies (some over well over 10 pounds), it also ups the risk of pre-e, respiratory distress syndrome (for the baby), and a number of other issues (uti, type II diabetes later in life).

I had the test while pregnant with DS. My doctors wanted me to fast for 8 hours before the test. I made a 9 am appointment, and drank the glucose drink at 8 am. The nurse took my blood at 9 am while I waited to see my doctor. All in all a pretty painless test.

The info on risks for mother and baby from GD came from the Mayo Clinic's GD page: Gestational diabetes

Annierose1 · October 2010

From what I've heard, it's pretty standard. And I do know of many risk factors associated with GD. It's better to be safe than sorry.

pepomntpat · October 2010

It's standard and IMHO all knowledge is power.

You can choose based on the results what interventions to use and not use (diet change, blood sugar monitoring, insulin, induction, etc). You can't choose those things if you do not know.

I think it is ridiculous to remain ignorant about such things, just as I think it is ridiculous to blindly do whatever your doctor says just because he/she is a doctor.

honkytonk_kid · October 2010

RayRay007:
I don't know what "bad" things OP's talking about, but I had read in Ina May and Gentle Birth, Gentle Mothering, that there isn't much point in getting it, especially if you don't have any risk factors. It's better to just eat well in the first place. If you get the test, and are diagnosed with GD, there isn't much they can do about it except for diet, and if you are eating well already, well then, what's the point of being diagnosed except that it will cause undue stress. That is what I got out of those books anyway, and that is probably oversimplifying it. I would probably decline a GD test.

I think you're definitely oversimplifying it. The problem with what you said is varying opinions of "eating well." I'm a fairly healthy eater, probably even above average. But I look at the GD diet and cringe. It's requires much more thought and planning than about 90% of pregnant women put into their diet.

Diet is not the only thing that can be done. Many women with GD have to take insulin daily to control it. And women without risk factors get it all the time.

I don't understand what the problem is with drinking the equivalent of a Sunkist and getting your blood drawn. Seriously- why is that so hard? GD can have serious complications.

eta: OP, in my experience it's fairly standard. I would encourage you to take it regardless of risk factors.

boynextdoor1 · October 2010

The things I've heard about the GD test is that it has a high false positive rate. I often wonder if, since they test just about everyone for it, they are applying pathology to the mysterious and natural processes of pregnancy? For me, it doesn't make any sense at all that I have GD. My BMI has always been between 17-19. I haven't had a soda in 9 years. I eat organically, rarely have sweets, never eat candy or chips or junk food. I excersize and stay fit, I'm a size 4-6, and I've gained 26lbs during the pregnancy.

The only risk factors that I had were that I'm 29 and 1/32 Cherokee, and I have a family history of one elderly type 2 diabetic- and I think that is because he eats terrribly and is overweight. I failed the first test by two points, and if I hadn't, I may have never been diagnosed as high risk and wouldn't be threatened with induction at 39 weeks right now!

The thing that frustrates me the most is that most first time mothers have their babies 8 days after their estimated delivery date!

nosoup4u · October 2010

boynextdoor1:
The things I've heard about the GD test is that it has a high false positive rate. I often wonder if, since they test just about everyone for it, they are applying pathology to the mysterious and natural processes of pregnancy?

This is what I've never understood, either. I think it's like a LOT of things with maternity care in the US - it goes overboard by insisting all women test (the rate of GD is actually under 5%, but the way the current test is run, your chance of being diagnosed is somewhere between 3-15%). Not to mention that different providers have different cut-offs of what's considered GD, and that your body processes glucose differently at 24 vs 28 weeks. Until it's standardized enough that the results are consistent accross the board, I don't see what the point of testing for it is (for me, personally, that is).

Henci Goer has really good things to say about GD testing, this is a good article to read: https://www.ivillage.com/gestational-...ach/6-a-129188. And she writes more about it in "Obstetric Myths and Research Realities", though I can't seem to find it online right now, this is an excerpt that was in the book: https://www.gentlebirth.org/archives/gdhgoer.html

I also find it interesting that other countries don't routinely test for GD the way the US does - I think things would be much, much better if the actual importance of nutrition during pregnancy was taught and tracked than making every pregnant woman drink some glucola (and hyperventilating when some of them turn it down...).

Like any test and procedure, it really does come down to an individual woman's decision to do it or not - whether or not other people are horrified or think she's risking life and limb for it.

kesrya · October 2010

I've read a fair amount of opinions from the medical community about the extremely high false positive that the PP mentioned. The "cut off" as to what is GD and what isn't (since your ability to process sugars always changes in pregnancy) is considered by many to be arbitrarily low, and more women are being diagnosed with this than actually have it.

All of my pregnant patients who were diagnosed with GD were required to do nothing other than change their diets and monitor blood sugars. No one was given medication or insulin - and this is probably b/c most of these women fell in that arbitrarily low category. Some were induced early for threat of large or stillborn babies -- none of them have had large babies. So I view the whole thing with suspicion. Not b/c GD isn't a potentially serious - it is - but b/c too many women are being treated for a disease they don't actually have, and being forced into early inductions that they don't need and come with their own set of complications.

To the OP -- I had a similar situation in that my MW had led me to believe that she really only does this test if there is consistently sugar showing up in the urine tests. However, last month I was in and saw the birth assistant instead of the MW and she said I was scheduled for the GD test next time -- which happens to be tomorrow morning. Like others, she uses apple juice and a banana, and no fasting -- in fact, fasting is considered a bad thing for pregnant women to do. If I had been asked to fast for a long period of time and drink something with artifical sugar that I would never normally partake in (it is way more sugar than a soda - and I don't even drink soda) I would have declined the test. But as it is, I'm going to enjoy my banana and apple juice tomorrow morning after my hearty protein filled breakfast

rae_dylanzmom · October 2010

Thanks for the replies. The 'bad things' were just about the how the test is administered. Fair point that it's probably not all that bad; just not as simple as a regular test for blood sugar.

RayRay's comments (although flamed by some of you), seem to be in line with my thinking. Knowledge is power, but as another post mentioned, I wonder if we've pathologized (if that's a word) this condition. On the other hand, reading the Mayo Clinic's site on GD, the complications for unmanaged GD certainly is daunting.

Thanks again ladies for the help!

SoxChamps · October 2010

Thanks soup, that was the link I was going to post! I am still considering declining the test this time. I want to, but my HB midwives would prefer that their clients take it to keep things smooth with their hospital midwife back ups. I see their point but I think I will get a little closer and also discuss it with the back ups when I see them. I do not want to get labeled as high risk over a false positive, and I don't have much confidence in the test. When there are different standards for testing as far as results and method, and the pregnant body over time changes the way it metabolizes anyway, I just don't have much confidence in the test.

BananaBlitz · October 2010

pepomntpat:

It's standard and IMHO all knowledge is power.

You can choose based on the results what interventions to use and not use (diet change, blood sugar monitoring, insulin, induction, etc). You can't choose those things if you do not know.

I think it is ridiculous to remain ignorant about such things, just as I think it is ridiculous to blindly do whatever your doctor says just because he/she is a doctor.

I completely agree with this.

I has diagnosed with GD at 25 weeks. I had no red flags that I would get it. I was a healthy weight, ate well balanced meals, exercised regularly, no family history, and am in my mid-20s. I wasn't one who just barely failed the test -- I bombed it.

You can absolutely choose the methods you want to use to treat it if you were diagnosed. I was given several options.

BananaBlitz · October 2010

RayRay007:
I don't know what "bad" things OP's talking about, but I had read in Ina May and Gentle Birth, Gentle Mothering, that there isn't much point in getting it, especially if you don't have any risk factors. It's better to just eat well in the first place. If you get the test, and are diagnosed with GD, there isn't much they can do about it except for diet, and if you are eating well already, well then, what's the point of being diagnosed except that it will cause undue stress. That is what I got out of those books anyway, and that is probably oversimplifying it. I would probably decline a GD test.

The GD diet is completely different than just "eating well"

christina1776 · October 2010

Does anyone know if the risks change with subsequent pregnancies? I had a really hard time physically with the test during both previous pregnancies, and tested negative both times. Im just wondering if i can expect to be fine the 3rd time around or if i have to go through the ordeal again?

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