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Old 12-16-2012, 07:04 PM   #41
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Re: Anyone Ever Refuse Glucose Screening?

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Originally Posted by steph410 View Post
I'm not sure this statement is accurate or up to date. According to my OB and most everything recent that I have read, it is recommended for all pregnant women to do the screening test (not the more extensive test that would come later if you failed the initial screening).

you can always refuse it, but that doesn't mean it's not recommended.
Straight from ACOG.com on September 2011

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All pregnant women should be screened for GDM, whether by patient history, clinical risk factors, or a 50-g, 1-hour glucose challenge test at 2428 weeks of gestation.
Basically they are saying providers should obtain their patient's histories and risk factors not that all women should automatically be forced to go through a 1 hour glucose challenge test.

Here is the link so you can read it for yourself.

For me my only risk factor was that I was 26 years old. Not 25. I have no diabetes in my family at all. My midwife was fine with testing me after eating a meal which is logical and my blood sugars bore out what we both knew, I didn't have GD. Now if both of my parent's had diabetes, I was african american, obese and 30 years old she probably would have been a bit more insistent on me going through more extensive testing because I would be positive for a lot of risk factors at that point.

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Old 12-16-2012, 07:13 PM   #42
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I had zero risk factors and DID have gestational diabetes. I wouldn't risk it.
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Old 12-16-2012, 07:26 PM   #43
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Re: Anyone Ever Refuse Glucose Screening?

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I had zero risk factors and DID have gestational diabetes. I wouldn't risk it.
Even the ACOG doesn't say that every woman has to be go through a test and they are pretty conservative to say the least. I am sorry you ended up with GD but I still don't think just because someone had a pretty rare experience that means everyone should be tested but I think that's a decision that should be left up to each woman. But automatically shoe horning every single woman into an unpleasant test isn't right either.

For anyone that is curious here are the risk factors:
http://www.mayoclinic.com/health/ges...N=risk-factors


Age greater than 25. Women older than age 25 are more likely to develop gestational diabetes.

Family or personal health history. Your risk of developing gestational diabetes increases if you have prediabetes slightly elevated blood sugar that may be a precursor to type 2 diabetes or if a close family member, such as a parent or sibling, has type 2 diabetes. You're also more likely to develop gestational diabetes if you had it during a previous pregnancy, if you delivered a baby who weighed more than 9 pounds (4.1 kilograms), or if you had an unexplained stillbirth.

Excess weight. You're more likely to develop gestational diabetes if you're significantly overweight with a body mass index (BMI) of 30 or higher.

Nonwhite race. For reasons that aren't clear, women who are black, Hispanic, American Indian or Asian are more likely to develop gestational diabetes.
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Old 12-16-2012, 07:51 PM   #44
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Re: Anyone Ever Refuse Glucose Screening?

I also think just b/c someone "tested positive" doesn't mean much. Was that person positive b/c of ONE point? Two? Three? It's just totally bogus to take something like a human body, that reacts to so many different variables each day, and make a hard line in the sand and say "if you have a blood sugar of 145, you have GD. If your Blood sugar is 144, you don't."

I'm certainly not saying GD doesn't exist. But are we naive enough to think that other things, like sleep, stress, normal daily diet, physical activity, mood, illness, etc don't affect blood sugar? so that a person who is otherwise healthy in every other conceivable way, tests positive for an inexplicable condition (b/c no one can explain WHY women get GD), and suddenly is thrown into a "high risk" category?

It is so very clear to me that this is another way that hospitals, OBs, and pharm companies (which are BIG BUSINESSES) are trying to cater to every woman as quickly as possible and push them all through a cookie cutter system for maternity care.

The reality is, you could have normally high blood sugar, and not have GD. You could be eating utter CRAP, and so your body isn't functioning properly, which is making your sugars high. You could have something wrong with your pancreas.

Not all high levels = GD. And (IMO) not all low levels = no GD.

It's more about seeing the person's overall health as a whole picture, and not looking at one tiny piece of the puzzle to try to assume what is going on. And, that, I think the current system fails miserably at.

There are studies I've read (don't ask me where, no idea, not looking right now) that say that there is inconclusive evidence whether a GD diet helps at all with mothers who have GD. I am not convinced that GD is being screened for properly OR treated and managed properly.

Last edited by Kiliki; 12-16-2012 at 09:15 PM.
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Old 12-16-2012, 08:55 PM   #45
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Quote:
Originally Posted by Kiliki
I also think just b/c someone "tested positive" doesn't mean much. Was that person positive b/c of ONE point? Two? Three? It's just totally bogus to take something like a human body, that reacts to so many different variables each day, and make a hard line in the sand and say "if you have a blood sugar of 145, you have GD. If your Blood sugar is 144, you don't."

I'm certainly not saying GD doesn't exist. But are we naive enough to think that other things, like sleep, stress, normal daily diet, physical activity, mood, illness, etc don't affect blood sugar? so that a person who is otherwise healthy in every other conceivable way, tests positive for an inexplicable condition (b/c no one can explain WHY women get GD), and suddenly is thrown into a "high risk" category?

It is so very clear to me that this is another way that hospitals, OBs, and pharm companies (which are BIG BUSINESSES) are trying to cater to every woman as quickly as possible and push them all through a cookie cutter system for maternity care.

The reality is, you could have normally high blood sugar, and not have GD. You could be eating utter CRAP, and so your body isn't functioning properly, which is making your sugars high. You could have something wrong with your pancreas.

Not all high levels = GD. And (IMO) not all low levels = no GD.

It's more about seeing the person's overall health as a whole picture, and not looking at one tiny piece of the puzzle to try to assume what is going on. And, that, I think the current system fails miserably at.

There are studies I've read (don't ask me where, no idea, not looking right now) that say that there is inconclusive evidence whether a GD helps at all with mothers who have GD. I am not convinced that GD is being screened for properly OR treated and managed properly.
Very, very well said. Much of what you noted rings true for MANY more things than just GD - things in our healthcare system as a whole, not just OBs and prenatal care.

I found this site and the resources listed on this page to be very helpful with my personal research when I decided what to do about GD testing: http://www.gentlebirth.org/archives/...ab.html#Doubts
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Old 12-16-2012, 09:17 PM   #46
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Re: Anyone Ever Refuse Glucose Screening?

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Very, very well said. Much of what you noted rings true for MANY more things than just GD - things in our healthcare system as a whole, not just OBs and prenatal care.
yes, I completely agree.

And, ty for the link. Lots of good info.
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Old 12-17-2012, 02:43 AM   #47
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Re: Anyone Ever Refuse Glucose Screening?

I refused as I tend to have low blood sugar anyway, and didn't want the sugar load of those glucose drinks. My midwife allowed me to check my levels at home with my glucometer and report back to her.
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Old 12-17-2012, 07:10 AM   #48
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Quote:
Originally Posted by Kiliki
There are studies I've read (don't ask me where, no idea, not looking right now) that say that there is inconclusive evidence whether a GD diet helps at all with mothers who have GD. I am not convinced that GD is being screened for properly OR treated and managed properly.
I'd be interested in what you mean by "at all". Do you mean keeping blood sugars low, or something else. For me the diet certainly helped in that arena. By the end I knew how many "sugars" I could eat before my blood sugar would get wacky. One splurge of a pizza night where I had a measly 2 slices sent my blood sugar through the roof. I was meticulous with my diet and never had to go on insulin.
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Old 12-17-2012, 07:24 AM   #49
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Re: Anyone Ever Refuse Glucose Screening?

Just a couple of thoughts. It is absolutely true that some people "naturally" have high sugars. If they aren't pregnant, they are called diabetics. It is important to their health to know this and get it under control. It is not normal to have elevated sugars. If it predates pregnancy, it still needs to be controlled.

Another thought is that there aren't "false positives" because it is a screening test, not a diagnostic test. The screening is designed to catch 90% or more of those with GD. Definitely some who are caught in the screening will pass the actual test for gd.


The #1 risk factor for GD is pregnancy. The placenta causes impaired glucose metabolism that can become progressively worse throughout pregnancy. GD is not caused by your diet. It can be controlled with diet. However, even if you eat well and keep it under control, that doesn't mean you no longer have GD. And, not everyone can control with diet alone. And, even some who start out controlled with diet can need insulin as pregnancy progresses.

A1c is a great test. The problem is that, by the time your A1c is elevated in pregnancy due to GD, it can be too late. A1c measures months of average sugars. Since glucose metabolism can get progressively worse, the A1c won't catch up with your actual late pregnancy glucose numbers until

after delivery.
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Old 12-17-2012, 07:36 AM   #50
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Re: Anyone Ever Refuse Glucose Screening?

There are definitely alternatives to the standard glucola screening. But, I truly believe that it is very important to do some form of test/screening for GD. It is easy to work with if you know. GD is a very common condition of pregnancy and can lead to serious health problrems for baby. The excuse that you don't eat sugary foods is really missing the point. The screening is with gucola because it is easy and consistent. But, a glass of OJ or a bowl of pasta, has the same effect on your blood sugar. They're just not as easy to use as a control.

So, ask if you can eat a carbon loaded meal or get a meter and check correctly through your pregnancy. But, for your health and that of your baby - do something to test. High sugars have little to know symptoms at levels that can be harmful.
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