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Old 12-15-2012, 06:57 PM   #1
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Anyone Ever Refuse Glucose Screening?

On what grounds?

Does anyone know if there is an assessment that can determine if the glucose screening is necessary for a given individual?

Just wondering; thanks!!
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Old 12-15-2012, 07:22 PM   #2
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Re: Anyone Ever Refuse Glucose Screening?

I did for my last two kids they can do a Hemoglobin A1c test instead. they don't like to do it but I told them it was that or nothing.

Edit "on what grounds" I told them my body my choice end of discussion

Last edited by tjs77tsa; 12-15-2012 at 07:23 PM.
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Old 12-15-2012, 07:25 PM   #3
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Re: Anyone Ever Refuse Glucose Screening?

I did. My midwife did urine dips at each appointment and I never had any risk factors for GD, so I declined with her support. It didn't used to be SOP for every pregnancy like it is now - only when indicated by other symptoms and less unpleasant screenings (the urine dip). The percentage if women who develop GD is pretty low and the test has a significant false positive rate, which causes extra stress on those mamas who have to retest and are fine. I prefer a low testing and intervention approach to prenatal care. That said, I would (and did) go ahead with tests my midwife felt were necessary because she was supportive of my low intervention approach and what she wanted was medically indicated (not for GD, but for preeclampsia). Hope that helps.
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Old 12-15-2012, 07:31 PM   #4
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I declined.

- High rate of false positives due to shock reaction to the test
- Unnecessary sugar load on my body
- Fasting is unnecessary and potentially dangerous
- Testing/treating GD has no positive health impacts during pregnancy
- I am personally low-risk for GD
- Already follow a low-glycemic/"GD diet" as part of my lifestyle
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Old 12-15-2012, 07:40 PM   #5
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Re: Anyone Ever Refuse Glucose Screening?

When I worked in OBGYN those who declined were usually given a monitor and told to log blood sugars for a week. Also, I've seen alot of false positives come through.
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Old 12-15-2012, 09:18 PM   #6
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Quote:
Originally Posted by KelseyH
I declined.

- High rate of false positives due to shock reaction to the test
- Unnecessary sugar load on my body
- Fasting is unnecessary and potentially dangerous
- Testing/treating GD has no positive health impacts during pregnancy
- I am personally low-risk for GD
- Already follow a low-glycemic/"GD diet" as part of my lifestyle

There are significant health implications made possible when GD goes untreated, for both mom and baby. Shoulder dystocia, brachial plexus injury/brain damage/stillbirth, co-morbid with congenital hypothyroidism, ketoacidosis, severe jaundice and low blood sugar at birth can lead to brain damage and mental retardation, risk of future diagnosed diabetes. Mom: risk of full-blown diabetes, eclampsia/pre-eclampsia, c-section.

The actual percentile risk/annum for any mother is approximately 7% --half do not exhibit elevated risk factors.

Since when has fasting for 12 hours ever been dangerous?

I'd say the risk in NOT being tested (or requesting an alternative meal-based evaluation [although not standardized like the glucose test]) is just not worth it.
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Old 12-16-2012, 01:20 AM   #7
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Quote:
Originally Posted by mama1980

There are significant health implications made possible when GD goes untreated, for both mom and baby. Shoulder dystocia, brachial plexus injury/brain damage/stillbirth, co-morbid with congenital hypothyroidism, ketoacidosis, severe jaundice and low blood sugar at birth can lead to brain damage and mental retardation, risk of future diagnosed diabetes. Mom: risk of full-blown diabetes, eclampsia/pre-eclampsia, c-section.

The actual percentile risk/annum for any mother is approximately 7% --half do not exhibit elevated risk factors.

Since when has fasting for 12 hours ever been dangerous?

I'd say the risk in NOT being tested (or requesting an alternative meal-based evaluation [although not standardized like the glucose test]) is just not worth it.
That's JMO. And since we typically eat early dinners and early breakfasts (5pm and 6am) I, personally, would be fasting for, at the minimum, eighteen hours. That is not safe IMO.
In my risk-benefit analysis, the typical GD test does not make the cut. I may consider a post prandial test or periodic glucose monitoring if I start to show signs that I may be dealing with GD, but that is highly unlikely.
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Old 12-16-2012, 06:26 AM   #8
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Re: Anyone Ever Refuse Glucose Screening?

Quote:
Originally Posted by mama1980 View Post
There are significant health implications made possible when GD goes untreated, for both mom and baby. Shoulder dystocia, brachial plexus injury/brain damage/stillbirth, co-morbid with congenital hypothyroidism, ketoacidosis, severe jaundice and low blood sugar at birth can lead to brain damage and mental retardation, risk of future diagnosed diabetes. Mom: risk of full-blown diabetes, eclampsia/pre-eclampsia, c-section.

The actual percentile risk/annum for any mother is approximately 7% --half do not exhibit elevated risk factors.

Since when has fasting for 12 hours ever been dangerous?

I'd say the risk in NOT being tested (or requesting an alternative meal-based evaluation [although not standardized like the glucose test]) is just not worth it.
I very much agree with this. I'm also so surprised that so many people think this test is so inconvenient and unpleasant. I mena, drinking the sugary stuff is a tiny bit unpleasant, but really it's just a drink. And I never had to fast for 12 hours. I have always just had to not eat or drink for 2 hours after taking the drink and then they draw blood. I guess that's the initial screening test.
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Old 12-16-2012, 06:52 PM   #9
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Re: Anyone Ever Refuse Glucose Screening?

Quote:
Originally Posted by KelseyH View Post
I declined.

- High rate of false positives due to shock reaction to the test
- Unnecessary sugar load on my body
- Fasting is unnecessary and potentially dangerous
- Testing/treating GD has no positive health impacts during pregnancy
- I am personally low-risk for GD
- Already follow a low-glycemic/"GD diet" as part of my lifestyle
this.

I am on my 4th pregnancy and have never taken the Glucose screening and never would.

I am hypoglycemic (typically LOW blood sugar, resulting from my pancreas over-producing insulin) and I cannot even drink a whole cup of orange juice without getting ill and my blood sugar going crazy. There is no way I would consent to consume that amount of sugar in under an hour. I actually would be surprised if I have that much refined sugar in a whole 24 hour period (same as what is in the glucola crap that have you drink).

Besides that, I think the test is really poorly designed and even more poorly carried out.

I test at home on my own blood sugar monitor. I provide 3 fasting blood sugar levels, and 3 after-meal levels, w/a descrip of what I ate for each meal. I think that should suffice, and I think it is way more accurate than blindly testing the mass pregnant population with a major dose of sugar and then a blood draw an hour afterwards. If my blood sugars were coming back high, I would monitor them longer, and if they continued to be high, I would put myself on the GD diet. But I see no need for the Glucose screening.

My typical blood sugar range is between 60-100. It very rarely exceeds 100. I am very careful, and very aware of the symptoms of my blood sugar fluctuating. *PERSONALLY* I truly feel I'd know something was wrong, just b/c I already have to monitor my levels pre-pregnancy anytime I feel "off" . So I am already aware of what it feels like, and how my body reacts to my typical diet.

Last edited by Kiliki; 12-16-2012 at 07:15 PM.
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Old 12-16-2012, 07:03 PM   #10
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Re: Anyone Ever Refuse Glucose Screening?

Quote:
Originally Posted by KelseyH View Post
I declined.

- High rate of false positives due to shock reaction to the test
- Unnecessary sugar load on my body
- Fasting is unnecessary and potentially dangerous
- Testing/treating GD has no positive health impacts during pregnancy
- I am personally low-risk for GD
- Already follow a low-glycemic/"GD diet" as part of my lifestyle
Same thing for me. I declined both times. I already exercise and eat a relatively low-sugar/carb diet (not LOW carb, but mostly organic and always carbs with fats and protein, etc. Also I hate needles, so there wasn't a good enough reason for me to get the test. If any risk factors emerged, I would have checked my sugars for a bit.
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