Okay I am going to fail the test

[BaileyBea]

I failed my 1-hour glucose and after being on vacation for nearly 2 weeks I am finally scheduled to take the 3-hour test tomorrow morning. I thought the test was for Thursday but they called and told me it's for tomorrow. ARGH!

Okay here's the background: I didn't fail w/Baby #1. I walked 5 miles everyday w/him and I gained 20 lbs.

Baby #2: No longer walk my 5 miles everyday because of sacrum/back problems. I just barely got approval by my Dr. to take walks again 2-weeks ago. I eat healthy.. grilled fish w/Veggies, cheese, eggs, cottage cheese etc.. I quit drinking sodas a while back. Think I failed the test because I had a burger and fries 2 days before. But normally I do not eat like that. I have gained 19 lbs and Dr. told me I was under weight since I lost so much weight after DS was born.

However..... I have had an unusual 32 hours. We had a delay at the airport in Seattle and we waited over 8 hours for our flight to Dallas and then got stuck in Dallas overnight in a hotel because our flight got in after midnight. This means that I didn't have choices to the healthiest eating. But I did carry a lot more bags than I should have for a pregnant woman and I did walk a lot.

Breakfast yesterday: Yogurt (lowfat) and bagel w/Cream Cheese
Lunch (late due to flight mix ups): Shrimp and fries (ARGH! those potatoes are going to kill me tomorrow I just know it!) Water & Diet Coke (sorry baby I needed a boost).

Dinner (ate after midnight mostly): 1/2 a wheat cheese sandwich, Doritos (that DH gave me during the 4 hour flight because I was going to faint from hunger) and spinach salad. Water

Breakfast today: Scrambled Eggs, Bacon, some pancakes (not all), 1 strawberry, and hash browns. (I was starving and I ate it all)

Lunch: Late lunch - chicken tacos w/salsa and cheese.

Dinner: I plan on having grilled chicken Spinach Salad at a local restaurant.

What do you think? Am I going to fail? I am just dreading this test. I feel like canceling for a couple more days but DH doesn't want me to.

ARGH! I am so dreading this!

TIA

[spanannie]

I would postpone the test another 2 days; I don't think it would hurt anything. I would be careful about carbs for those 2 days. Also walk before blood draws; just around the medical center (outside of the office).

When I was waiting for my blood draw, when pg with Zach, I walked until it was time to go back. I gained SO much weight with him that I needed all the help I could get. I passed the 1 hr, fortunately.

I'll be keeping my fingers crossed for you! I'm glad you are back in town...I need to E-mail you...have some baby/kid stuff for you...look for an e-mail from me later!

[brittone2]

Your diet doesn't look particularly high in carbs...I mean, if you want to be sure you pass maybe reschedule, but I don't think it is that high in carbs. When you ate carbs you at least tended to balance them w/ protein (burger w/ fries :))

I just had my one hour GTT today. I'm getting two GTT tests this pg'cy as the OB backup for my midwives wants it that way due to my PCOS. I am on metformin which is an insulin sensitizer, and that really helps reduce the risk of GD. I stopped metformin at 12 weeks w/ DS's pg'cy and still passed my one hour. I am crossing my fingers that I pass today's one hour. I've had several 3 hour GTTs in the past (when not pg) and don't really want to do another one.

Many, many people fail their one hour and go on to pass their 3 hour GTT. Hopefully that will be the case for you.

I might try to reschedule if it is convenient, but your diet doesn't look particularly bad. I'd just up your protein as much as possible. If your yogurt has sugar, I'd eat cottage cheese instead. Maybe try to minimize the amount of fruit you consume, no potatoes as you said, etc.

I wish you the best no matter what you decide to do!

[mammabear]

I'm not a regular poster, but I just had to chime in on this one. A friend recommended that I cut out carbs for 2-3 days before my 1 hour glucose screen. I did that and FAILED MISERABLY!!! My results were almost high enough to qualify for going straight to the dietician!

For the 3-hour test I got the opposite advice; carb up! Apparently, when you deprive your body of carbs it is very difficult to recover in the 1-hour period to the bolus of glucose in your system. So the theory is that you can get your body used to the greater amount of glucose its going to get during the test and your body will better recover from the glucose bolus.

The results of my 3-hour test were well under the normal cut-offs, they were actually pretty low, and I didn't even do any walking between the blood draws.

Just wanted to give you some hope; maintaining a normal diet (which sounds like what you're doing anyway) should not make you fail the GTT.

[RJPO]

I had my one hour GTT today as well.

Does a person's diet in the days before the test have a big effect on whether you pass or fail the test? My OB has never mentioned anything about it, so I've always assumed that you should just eat normally up until midnight the night before.



Rachel
mom to Mary, James, and Elizabeth (due 8/06)

[mom_hanna]

Eat normally before your test. If you do not have GD, your test should not be affected by what you eat because your body can handle it. If you do have GD, you will likely fail no matter what you eat. Starving yourself of carbs before the test will just make your body react more to the sugar in the test as it will be a shock to your system.

I failed the 1 hour with dd and passed the 3 hour easily. Just my two cents.

Jennifer

[MayB]

I wouldn't do anything different, and I would be careful about walking around between blood draws. Check with your Dr. or the techs. While the walking may cause you to pass the test, if you are at risk for or do have GD, wouldn't you rather know so you can do what's right for you and your baby?

I had GD with my second pregnancy: failed the 3 hour screening (barely) and moaned and complained about the dietician and extra doctor's visits at first. Looking back, I'm grateful for the extra care and learned a lot about healthy eating and healthy lifestyle. I hope you pass the three hour test but if you don't, you'll be fine. Good luck.

[o_mom]

Except, there is not much evidence that treating GD improves outcomes at all for mother or baby. However, diagnosis and treatment does increase risk of interventions including induction and c-section. So, there is no "right" thing to do here.

[cmdunn1972]

If you're concerned that what you ate recently is not typical due to traveling, then you should inform then of that fact before they take the test. They may say that you should postpone and do it when your schedule normalizes.

It seems you've been avoiding sugars, which is good. However, you have been taking in some other refined carbs such as fries, pancakes, bagels, and Doritos. (You didn't mention if there were croutons on the salads.) That could skew the results a bit.

It might be a good idea to print out a detailed list of what you ate (include any croutons) and give them to the person who does the blood draw.

[overcome]

Oh my Nancy...I have no idea what I ate before either one of my tests ( I failed the one hour one too) but I am quite sure very few veggies were involved!!

Although I failed the 1 hour test, I passed the 3 hour test. Bring a couple snacks with you so you can eat right after the test is over. There was a chinese place right next door to the lab so as soon as I was finished with the 3 hour one, I went right in and ordered three dishes :-) I took the leftovers home for DH.

Good luck!!

[rfeibelm]

Nancy,

I don't mean to be catty - but I didn't realize the GTT was a test to be "studied for" or prepared for. It is a test to evaluate how your body is handling it's insulin/glucose needs during pregnancy. You should be eating well for the sake of your pregnancy and your own body - not just to pass the test!

I had GD with my pregnancy and I had none of the risk factors! I am very small and only weighed 103lbs before I got pregnant. I did gainmore than I should have my 1st trimester, but only gained 32lbs total by the end. I failed my 1hr (barely) and had screwy results on the 3hr (high fasting, but passed 1 and 2hr, failed 3hr or something like that). They were actually going to send me home as if I passed, but I insisted on the dietician consult. because of insurance, I actually had to go to the endocrinologist and ended up insulin controlled 2 weeks later!

So, now that I've written that book, the gist of my post is - eat healthly and control carbs for the sake of your health, not just so you can pass a test!

PS. Please do not take offense to my postings, I just know how much it sucks to have GD and that we all do whatever we can to keep our babes healthy!

[kep]

>Does a person's diet in the days before the test have a big
>effect on whether you pass or fail the test? My OB has never
>mentioned anything about it, so I've always assumed that you
>should just eat normally up until midnight the night before.

I always thought the same thing, too. I didn't eat any differently leading up to my test, and mine came back fine.

I do think having to drink that icky, icky sugary soda-like drink is just so cruel. Esepcially if you've been battling naseau/vomitting anyway. You poor thing. Yikes, I guess mine will be coming up in a few months, too.


Kelli
Proud Mommy to Lukey (4.2003)
And a new baby due Christmas Eve, 2006

http://bd.lilypie.com/8dPKm4/.png

http://b4.lilypie.com/G0VTm4.png

[BaileyBea]

I moved the test to Friday morning. Mostly because I had a mix-up w/the babsitter and second because when I got up this morning I could barely keep my eyes open. I am just so drained from the trip.

I'm not trying to trick the test. I just rather eat like I normally do for a few days before taking the test. I just didn't want the poor choices I made while traveling to affect the test since that's not how I normally eat.

Since I am finally working out again I also wanted to be able to resume my 5 mile daily walks again. I'll probably just do a couple miles today though. I'm a little sore from all the stuff I had to carry on this trip still.

So Friday is the day. Thanks for all the responses. I'll tell you how it goes on Friday.

[wirefunk]

test

[ribbit1019]

I was only able to pop in for a sec last night! I hope the test goes well for you Friday!

Christy
My Waterbabies
Maddy 6/9/04
http://b3.lilypie.com/nlacm4/.png
& Jarred 3/8/06, 14 lb 24 1/2" @ 10 wks, a happily breastfed babe.
http://b1.lilypie.com/KH1pm5/.png
http://img.photobucket.com/albums/v221/steitzsmith/Other/jump.gif

[cmdunn1972]

That's a good idea, and I like your reasoning.

My guess is that they test (for any test) assuming that since the date/time they pick is relatively random it's a snapshot of typical circumstances. However, considering that you've been traveling and your diet has been anything but typical, it wouldn't be an accurate test.

So, it's good that you moved the date. :) I hope it goes well!

[dhano923]

I had Gestational Diabetes with both my pregnancies. If your body is processing sugars properly, the carbs and sugar you eat are processed in 2 hours after you eat them. If your body is not processing properly, then your sugar levels will still be high. That's why the 3 hour GTT is the way it is -- it checks, pre-sugar, 1 hour, 2 hour and then the 3rd hour is supposed to be back to normal.

Eating carbs days or even hours before won't affect your 1 hour GTT UNLESS you are already having insulin resistance.

[ohiomom]

>Except, there is not much evidence that treating GD improves
>outcomes at all for mother or baby. However, diagnosis and
>treatment does increase risk of interventions including
>induction and c-section. So, there is no "right" thing to do
>here.
>

I was really surprised at this post because I had never heard there was a "downside" to screening for and treating GDM. I did a quick and dirty pubmed search and am consistently finding that treatment reduces perinatal problems. It's a bit frustrating, though, because I am at home and not at work so I don't have access to the full text of the articles, and have relied on just the abstracts (which is not always wise). There does seem to be debate about the "low-high" glucose results, but again, I can't read the comments to fully follow.

I failed my 1 hr GTT with DD, but passed the 3 hr. If I fail the 3 hr I'm screwed because I can't eat fat thanks to my gallbladder and I can't live on low-carb veggies and protein predominantly and get in enough calories without massive attention to my food choices. I pray I pass my 1 hr next week. That said, I'd never consider not screening and treating GDM. If there truly is an increased induction and c-section rate among those ID'd as having GDM, it could potentially be related to larger than usual baby size, blood pressure issues for the mother, etc.

Here are a few of the links.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=15846171&query_hl=10&itool=pubmed_DocSum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=16647890&query_hl=1&itool=pubmed_DocSum

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=16643713&query_hl=1&itool=pubmed_DocSum

http://clinical.diabetesjournals.org/cgi/content/full/24/1/35

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=15951574&query_hl=10&itool=pubmed_DocSum

Ohiomom
DD 7/30/03
DS 5/05 ^|^
DD EDD 9/29/06

edited to fix spelling

[m448]

Continuing on the effectiveness of treating "gestational diabetes" I found this when I was going to be tested the 2nd time around:

http://www.gentlebirth.org/srcFiles/gdhgoer.html

I researched some more and finally decided for my CNM to take fasting glucose levels at different intervals spread over several visits. We did 12 hour, 1 hour, 2 hour and 3 hour. Despite me testing high on the 1 hour for both pregnancies but passing the 3 hr glucola test the first time I had exceedingly normal/low levels when done with fasting finger pricks vs. the inflated glucola levels.
Marielle. In fact, I was eating healthier and weighed less this time around but my sugar spiked higher on the 1 hour glucola result. I went 2 weeks over with each child and had 7 1/2 lb babies each time (despite their growth rates later on accelerating due to their daddy's genes) and both boys had normal glucose levels at birth.


ETA: Also, the 2nd time around I was told to avoid certain carbs/sugars before the test whereas the first time I was just told to eat as normal then drink the glucola and no food until the blood draw. My sugars were higher when I was told to avoid the carbs and my MW also mentioned that the threshhold for diagnosing women with GD were lowered recently to "catch" more borderline women. This means that more women were being diagnosed and prodded towards induction at 39 weeks. Knowing I could very well go late as usual I knew I had to fight against a false GD diagnosis in order to keep intervention at bay.

Ian - born 10/03
&
Ryan - born 01/06

[ohiomom]

I'll make a point to read the full text articles tomorrow. I just want to point out your article referenced is 10 yrs old and it references a lot of older articles. There has been more outcomes-based data available on this topic recently (based on the PubMed search I did), so it's possible the newer studies may have been better controlled, etc. I simply don't know, not having read the full texts yet.

I know the moms here do a lot of their own research and won't just abandon or avoid treatment without making their own informed choice. As I said in my last post, I was just surprised as I had never heard of downsides and wanted to see for myself what was up with that. Not trying to pick a fight by any means!!

Ohiomom
DD 7/03
DS 5/05 ^|^
DD EDD 9/29/06

[m448]

I know it was published in 1996. I'm not meaning to spark a debate but to provide information precisely to spark thought and research. I would never encourage anyone to avoid or abandon treatment as I did not either. In fact, in my previous post I outlined what I requested of my caregiver in what to me is more precise treatment than an inflated glucose reading via the glucola (i.e. the fasting finger pricks).


Marielle


Ian - born 10/03
&
Ryan - born 01/06

[o_mom]

I'll admit that some of these have been published since I last did research on it (5 years ago), but none of them are super compelling. Even that last one has some major flaws and the conclusions are not rock solid as the authors would like you to believe.

The research I looked at came to the conclusion that while treatment of GD does result in slightly smaller babies, the complcations such as shoulder dystocia are not reduced. Part of the problem is that studies that show a difference are more likely to be published than those that didn't. In research it is impossible to prove no effect, so there can never be a study that says treatment does nothing, just that they didn't see any effect. We also have a litigation-minded medical system and people don't sue over treatment, but lack of it. This makes many physicians err on the side of intervention even if it has no beneficial effect.

I'm not saying that anyone is wrong for getting tested or treated, but that it is not as cut and dried as OBs make it out to be (i.e. you will have a massive baby who will die if you don't treat this).

[mom_hanna]

What I have read and been told is that GD can cause large babies that end up too large for vaginal deliveries, hence the c-section. GD can also cause high blood pressure and other problems in moms so treatment of GD is to prevent more intervention than necessary, not create more. GD is also very easy to treat, so why not treat it if it reduces complications down the road? That would be the main reason for me to do the glucose tests, and if I fail, then I treat the GD.

[o_mom]

nak so excuse the typos...

The problem is that while GD is associated with larger birthweight, is is usually just adding fat. Fat is not too big for a VB since it squishes, it is mainly head size and positioning that determines if a baby can come out vaginally. I would also add that standard care in the US (monitors, restricted beds, flat on back delivery) adds to the idea that babies are "too large for vaginal delivery". With the other complications, those have been associated more with maternal BMI and weight gain, not GD, and most of the studies do not control for this because they are not large enough to do so.

When you diagnose GD, then OBs tend to start looking for problems and get induction happy. Induction has a spectacular failure rate, especially in first-time moms (double risk of CS). So you have a doc who is "on the lookout" for a large baby and pushing induction at 37-39 weeks to "make sure baby isn't too big". Induction means monitors, restrictions, etc which set you up for a c-section. That is if they don't tell you the baby is already too big to even attempt a vaginal birth. It's kind of a self-fulfilling prophecy.

The only thing that has conclusively been shown is that GD increases your risk of developing diabetes later. Even in the NEJM study that was cited earlier, none of the complications were significantly reduced in the treatment group and the only things that was significant was an increase in NICU admission and a higher rate of induction in the treatment group. The only way they made significance was by combining all adverse outcomes and even then there is no way to know if the adverse outcomes were in patients with GD as 20% or more of the control group had normal glucose levels.

Not every medical organization even agrees that screening should be universal, but in our risk-reduction medicine better to screen than be accused of missing something. The fact that they were even allowed to run a study with a "no-treatment" control group tells me that it is not considered unethical to not screen or treat GD.