YANMD but do I have gestational diabetes

July 1, 2013 2:27 PM

Pretty sure I totally screwed up my gestational diabetes test. BUT...

I had a weird schedule and forgot the details and blah blah, did silly things to my gestational diabetes test. That is, I ate nothing this morning until five minutes before I drank the cup o' sugar and what I ate was a bowl of frosted mini-wheats.

They took my blood and the results were way high so now I have to come back in for the three-hour test. I am kind of freaking out A LOT.

I did not have GD for my first pregnancy, I and my husband do not have diabetes in the family, I am not in a high weight category (started at 120lbs, now at 140 at 29 weeks), not in a risk category age-wise, and am white. So I'm outside of the regular risk categories but I understand it can also strike randomly.

I know you are not my doctor but I'm freaking out and reading everything on GD I can find on the internet. None of it, though, says anything about screwed up test results. So, any ideas on how likely it was that I made the test results nutso with my unfortunate diet choices? Has anyone had a high first test that balanced out in the more detailed one?

Also, is it a good idea to start "managing" GD now with exercise and a no-extra-sugar diet or should I "continue as normal" so the next test is relevant to my body as-is?

I am scared of needles and feel like crying. Thank you.

posted by blue_and_bronze to Health & Fitness (18 answers total)

So what you're saying is that you did not fast for the initial glucose tolerance test? Did you tell the person administering the test what you ate and when you ate it?
posted by crankylex at 2:32 PM on July 1, 2013

Why haven't you told your doctor that you may have skewed the test results by eating before the test? You are freaking out unnecessarily. Please go back and talk to your doctor. No one on the internet can diagnose you with GD based on anything you've said.
posted by These Birds of a Feather at 2:41 PM on July 1, 2013 [6 favorites]

Best answer: You ate a bowl of frosted mini-wheats 5 minutes before you drank for the test?

The good news for you is that even if you follow the test instructions correctly, most women who fail the 1 hour GTT will pass the 3 hour GTT (i.e. they do not actually have GD). Usually, their probability of passing the 3 hour test is related to how high the result of the 1 hour test is, but in your case, because you did not have accurate test results, that is irrelevant.

You could ask to do the 1 hour test over again and do it correctly this time, but then you risk having the results be high again and having to do TWO more GTTs (another 1 hour plus a 3 hour). I would bite the bullet and do the 3 hour test now.

There is no harm in trying to adhere to a GD diet now if it will reassure you. I did that when I failed my 1 hour test. I passed my 3 hour test.
posted by treehorn+bunny at 2:43 PM on July 1, 2013 [1 favorite]

Response by poster: Sorry for thread sitting but I feel like I should clear this up right away. I DID report what and when I ate, which is why we're doing the three hour test instead of straight up diagnosing me. (I asked if we could just do the one hour again but no dice.)

I was not instructed to fast until after the glucose drink, it was just that I should have eaten much prior beforehand (like 2 hrs) and not something all sugary. That wasn't on my paperwork so if was mentioned the last time I'd just forgotten in the intervening 4 weeks. :/
posted by blue_and_bronze at 2:44 PM on July 1, 2013

Best answer: When I flunked my 1-hour test, I was freaked, but my internet friends reassured me that a lot of people fail the 1-hour, but pass the 3-hour test. I passed the 3-hour test.

This is a great chance to catch up on your reading or listen to all those podcasts you've been saving up.

And when you go to take the test, tell them that you're afraid of needles. Ask for their best phlebotomist. I had a tech once who was so good I didn't even feel the needle. If they do a good job, tell them.
posted by mogget at 2:51 PM on July 1, 2013 [1 favorite]

I'd follow the advice you were given and do the 3-hour test. For what it's worth, everyone was surprised when GD popped up for me. They didn't diagnose me until I tested high at 3 hours.

Controlling it with diet did great things for my eating habits even after the fact, and exercise is a great thing regardless. There are a couple of really good threads here about managing GD with food and diet, if you'd like more info.

Are you afraid of the needle for the next test, or are you worried about testing after meals if you do have GD?
posted by moira at 3:02 PM on July 1, 2013 [1 favorite]

Just adding: if I'd had a high score just on my first, I probably would have chosen to exercise and modify my diet, but I was very cautious in general during my pregnancy.
posted by moira at 3:09 PM on July 1, 2013

Best answer: Without even counting the milk, a cup of frosted mini wheats almost doubles the usual glucose intake for the one hour test.

If your needle comment is directed more toward testing and insulin than the 3 hour test, you should know that (1) paper cuts hurt more than testing does (2) You might not necessarily need insulin and you might not have to inject it if you do, and (3) if you do, that doesn't really hurt either. (I got through it all fine, and I still hate needles.)
posted by gnomeloaf at 3:53 PM on July 1, 2013 [1 favorite]

I flunked the 1-hour test but passed the 3-hour, too. Don't freak out yet, don't change your diet yet. Do be prepared to be very bored.
posted by The corpse in the library at 4:42 PM on July 1, 2013 [1 favorite]

Response by poster: YAY you guys are the best. Thank you very very much for the reassurance it was exactly what I needed.

(And I do mean needles for the insulin part. I can handle the occasional stick but the 4 times a day made my spine do wiggins-dance. NO FEAR of being bored, with two toddlers the idea of 3 hours at the doctor's with a book sounds blissful. :) )
posted by blue_and_bronze at 4:54 PM on July 1, 2013

Many people feel that it is not even necessary to do the 1 hour GTT on women who have no risk factors for gestational diabetes, because the incidence of gestational diabetes is so low in this population. See here for an article showing that less than 1% of women without risk factors ended up having GD.

You may enjoy this article from Evidence Based Birth, pointing out that the 1 hour GTT is only 76% sensitive, meaning that 24/100 women who take the test will have a falsely positive result for GD. It reiterates the point about women with no risk factors not needing screening, and points out that the American College of Obstetrics and Gynecologists agrees with this point.

"In the 2001 gestational diabetes guidelines, ACOG says that if you are low-risk and meet all of these following criteria you may not need to be screened: Age less than 25, not a member of an ethnic group with an increased risk, BMI less than or equal to 25, no history of abnormal glucose tolerance or macrosomia, and no known diabetes in a first-degree relative.

However, if you use these criteria, then only 10% of pregnant women would be exempted from screening. ACOG says that because only 10% would be exempt, “many physicians elect to screen all patients as a practical matter."

Because you have had a positive screening test, the above information won't help you justify not being tested now. But it will hopefully reassure you of the very low likelihood that your next test will be positive. IANYD.
posted by treehorn+bunny at 4:57 PM on July 1, 2013 [1 favorite]

Best answer: Heh... no need to freak out, most likely - I did almost the EXACT same thing as you (ate nothing all day, ate a handful of Craisins immediately before the test... yes, I know, I KNOW). I failed the one-hour, passed the (non-Craisin-augmented) three-hour with flying colors. But oh, how I fucking FREAKED OUT in between the two. Don't be like JulThumbscrew: no freaking out!
posted by julthumbscrew at 5:24 PM on July 1, 2013 [1 favorite]

If you do turn out to have it, GD really isn't so bad. It doesn't necessarily mean you have to take insulin. My wife had it, and she actually rather liked the excuse to eat lots of steaks. She could eat lots of things while controlling her blood sugar as long as she balanced it properly and got some exercise.
posted by Emanuel at 7:39 PM on July 1, 2013

I had GD with both pregnancies. The first was mostly controlled through oral medication, though I did have the 4x/daily finger sticks which hurt. The second required insulin injections, which, while annoying and time-consuming, actually hurt considerably less than the regular finger sticks.

But the most important thing to remember is that, like the swelling and the back pain and the constant peeing, GD is largely temporary and you will get past it, as uncomfortable and inconvenient as it may be in the moment. It will pass like everything else.

Best of luck!
posted by justonegirl at 7:48 PM on July 1, 2013

The most useful way GD was explained to me is this: Imagine you have a house with central air conditioning. Now imagine you add on to that house. The AC you have now isn't going to be enough to also cool that add-on. Your pancreas (well, islets of Langerhans, I guess) is your AC in this scenario; it's overloaded due to the pregnancy. All this is to say: although yeah, you totally threw the test with your Mini-Wheats, don't think about GD as a moral issue. It's not. It's OK about your not being in the risk categories. Sometimes this stuff just happens. And you may not have it after all.

Big hugs, and I hope the next test goes well.
posted by fiercecupcake at 8:16 PM on July 1, 2013 [1 favorite]

I failed the one hour test and passed the three hour. The three hours in the lab was *dreamy* - take your book, your knitting, your laptop, whatever and enjoy it :)
posted by robinpME at 9:44 PM on July 1, 2013

Just for the record, to spread the reassurance even further, gestational diabetes is a bother, but not nearly as bad as you think. You basically can't even feel the tiny needles that you use for injection, especially in the belly roll where they have you give them. And I'm saying that as a pretty genuine needle-phobe. Yes, it's a set of bother -- insulin around meals + blood tests a couple fo times per day. But, honestly, isn't most of pregnancy a nonstop series of insults and indignities? This is pretty small potatoes.

I had it, I controlled it (even more tightly than is common, i think, because my practice is superparanoid), it went away the day I delivered, I moved on to next set of challenges. Five years out, blood sugar great. So anyway, 3-hour may clear you, or maybe you have this thing and you'll be fine then too. As you know, the great mantra of parenthood is This Too Shall Pass . . .
posted by acm at 8:41 AM on July 2, 2013 [2 favorites]

Came in to say just what acm said. You're probably fine but in the event that you fail the 3-hour test, you'll be fine too. I know that, for me, it made me eat a whole lot better than I would've if I hadn't had it so it ended up being good in the long run. And, man, that first Coke tasted sooooo good after the baby was born!
posted by dawkins_7 at 1:47 PM on July 2, 2013 [1 favorite]