- Pregnancy
- Baby & Toddler
- Parents
- Getting Pregnant
- Baby Names
- Product Reviews
-
Registry
- Community
-
More
Want a personalized experience?
Download the free app
High-Risk Pregnancy
Options
Is GD a black and white diagnosis or is there gray territory?
I am getting conflicting information from my OB practice vs. the GD education program I was referred to and the internet. I have not been told "you are diagnosed with GD" that I recall.
On the 1 hour test I got 146 and they want 140 but I think a lot of that has to do with taking it first thing in the morning rather than afternoon. My numbers from the 3 hour test are: 98, 168, 98, and 92 with maximums desired by the practice of 95, 180, 155, and 140. I was told by the OB that because I failed the fasting number, that was good enough to fail the whole thing despite not even being close to being above normal for any other number. The nutritionist's sheet and the internet say that if at least 2 of the numbers are high then the diagnosis for GD is positive.
I am okay with testing to keep them happy and the reminders that it is good to stop work and eat (even though my busiest season will be right when the baby is due so I really should spend every moment prepping so others can know what needs done while I am gone).
My concern from the nutritionist's presentation yesterday is what it will mean for delivery and future pregnancies - that is covered in a few weeks. Of course, my question to the nutritionist was "what am I classified as if not meeting the threshold for GD"? She said that some providers are overly cautious. "Cautious" I can live with but I don't want the label if I don't meet the clinical requirements for a diagnosis. Do I have the label due to the provider being cautious or do I not have the label and instead have something else? If just them being cautious, do I need to push to ensure that it is not listed as a diagnosis on my medical record? Disclaimer: I used to audit health care records for fraud and am pretty sure that they would have to diagnose me as such in order to support the referral expense to my insurance for "treatment" unless there is something special about GD that allows extra cautious without a supporting diagnosis other than monitoring. As a friend said, some things in this world are black and white like you are either pregnant or not. Other things have gray territory like those who may be told they have prediabetes as a warning to be monitoring with the hope that it will turn around. Forever, on my medical questionnaires when it asks if I have been diagnosed with GD or any other pregnancy complication, what is the answer? And will I be subjected to the early testing next time? How might it impact my desire to have a VBAC this time? Will they want to do excessive monitoring or limit my meal choices while in the hospital? My last kid was 7.75 pounds at 39 weeks. I weighed the same when I got pregnant both times and am on track for the same gain this time as last time. The dietician said that it could simply be the particular hormones with individual pregnancies or just being a couple years older that cause GD.
This discussion has been closed.
Re: Is GD a black and white diagnosis or is there gray territory?
Nobody ever said I had GD. While waiting to get in at nutritionalist office, my OB stated my fasting s which were ranging from 9497 were ok.
That being said , my endo put me on night time insulin at 34 weeks with fasti g s creeping up to 102.
My after meal s don't even come close to the 140 cut off they gave me.
I'm now 37 weeks and I take 15 units at night and my fasting have been 8590.
I was told the 90 cutoff fir fasting AM s are because of the latest DM study. That it has changed within the last year so more and more women have "gestational diabetes"
I was really upset at first , mostly bc I feel like there was not enough education given to me on it...and when you read about it , it's such a big deal. After I relaxed and listened to my body, I felt better about everything....hang in there, it goes fast!
With my first, my 1 hour level was outside of the standard range and so I did the 3 hour test. I don't remember which hour was elevated, but only 1 was and it really wasn't elevated by much. Even the nurse educator that I first met with after the diagnosis noted that the numbers weren't too high and that I shouldn't have any problems with monitoring it. Still, I was diagnosed with GD and I was in a bit of disbelief for the first few days. I was not obese and the only risk factor I met was being over age 30. Most of the people I know who had GD were not obese- but over 35.
After a few days, it became harder and harder to keep my levels w/in the recommended range w/diet and exercise alone and it was very frustrating at first, but I gradually accepted it. I eventually went on insulin- starting with just one meal and then winding up 4 x a day by the end- however, they were all low doses. I say the GD was a bit of a blessing in disguise because it forced me to stay in shape and eat healthy; I actually felt the best during the 3rd trimester as a result.
There was no need for an insulin drip at delivery- my doctors told me that was for the very extreme cases. The hospital could have cared less about what I ate after I delivered (although that might have been more due to the fact that I wound up at a different hospital than planned). I had to mention the GD testing at 6 weeks postpartum to my doctor.
I'm 9 weeks now and just had to take the 1 hour test. It was normal and I'll have to retest.
The only non-pregnancy downside to the GD diagnosis was that I didn't get the super cheap premium rate for life insurance because now I'm at this supposed risk of developing type 2. As though I wouldn't make some serious lifestyle changes to avoid that happening.
I was 25, fit (normal BMI), and have no diabetes in my family and got diagnosed. It's hormone driven... you can help reduce your risk (or the level of treatment you may need) but just because you don't fit the mold doesn't mean you don't have it. I had a friend who was diagnosed because two of her numbers were two points UNDER the threshold. Her GD got worse as her pregnancy went on and her fasting required medication to control.
That said, I had two normal vaginal deliveries with no blood sugar issues for either one of us post-delivery. We're all happy & healthy and my blood sugars went back to normal immediately. I gained 14lbs with DD & 15lbs with DS.
As for how much monitoring you'll receive for the rest of your pregnancy and at the hospital, that varies by OB. I could eat normally after delivery but they did have me test my blood sugar after my meals - once I hit 4 clear ones, I no longer had to test.
Socializing foster puppies since 2009
Chart for TTC#2
Unfortunately there is no hard and fast set rules when it comes to GD. What would be passing for some practices is a hard fail with others and even after being diagnosed, there's differing opinions in treatment, where numbers should fall, how frequently to test, etc. The guidelines get changed every few years, some practices keep up with them, some don't. If you want to read more about the latest GD conference, you may want to check here:
https://evidencebasedbirth.com/diagnosing-gestational-diabetes-the-nih-consensus-conference-day-1/
https://evidencebasedbirth.com/diagnosing-gestational-diabetes-the-nih-consensus-conference-day-2/
I had GD with both pregnancies and have a preferred/top tier rate with my life insurance (no one cared about my GD/GI). I continued care with my low risk OB both times as well. I was not charged (nor was my insurance company) any different with my diagnosis.
You failed by your fasting number which is usually the harder of the numbers to control as it is most driven by your hormones. At my OB's practice, anything 90 & above is an automatic fail.
I made little change in my diet and kept my numbers in line both times, as I'm more glucose intolerant while pregnant than anything else. However with each pregnancy I did find that there were a handful of foods that raised my blood sugars - you may (eventually) find this is the case for you. With #1 it was anything with rice (black/white/brown/rice milk/etc), with #2 it was white flour tortillas.
Also, for what it's worth, I didn't dramatically bomb my 1 hour test either. I failed by less than 10 points both times I took it.
Socializing foster puppies since 2009
Chart for TTC#2