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OB to quick to label, advice appreciated


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  #1  
February 4th, 2010, 07:01 AM
homeschooling mom of 2
Join Date: Aug 2009
Location: Jersey Shore, but MI is home
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Hi Ladies,

I'll try to keep this as short as possible, so thank you for reading it all.

I have an almost 6yr old who was born 9lbs 13oz, I failed my 1 hour with her years ago but passed the 3 hour perfectly. Her sugars were tested at birth because of her size and they were normal.

Fast forward and I'm pregnant again. Due to my DD's size (ignoring the fact I passed the 3 hour and her sugars were normal) my new OB practice said they wanted me to do the 1 hour test early. I took it in the 2nd tri and again failed the 1 hour (by 2 points), I took the three hour and passed with perfect numbers. I was surprised when they told me just weeks after passing the 3 hour that I had to take the 1 hour again ("because everyone takes it at 28wks") my perinatologist even guessed I'd fail. I did fail. I have a major issue with blood draws and the three hour makes me sick all day, plus my DH is traveling pretty much the rest of the month making it impossible to go take it (my DD is homeschooled and we have no family here to watch her 1/2 a day and no close friends) so I asked if I could instead get a home meter to test with to see how my numbers were. The OB yesterday immediately said "sure we'll treat you like you have GD" um... that wasn't what I was requesting, I don't want to be labeled and treated as having GD until we figure out if I actually do. What seems more likely is that I always fail my 1 hour, always pass the 3 hour, and just have big babies... when I asked her what my numbers were from the 3 hour 2 months prior she said they were "absolutely perfect" so I asked if the 1 hour results were just likely a fluke and she said "no your daughter was so big you probably had it then too" I reminded her that I passed with that pregnancy and my daughter tested perfect at birth and she just shrugged which really annoyed me, I hate my concerns being dismissed.

Regardless I was getting my script for a home meter which is what I wanted, I go to leave and then find out now they want me in every week, want me to make extra appointments with the perinatologist, and to go to the hospital to see the nutritionalist. The last 2 being pretty much impossible unless they make an exception to their h1n1 no kids in the hospital rule since like I said I have my DD with me 24/7.

I'm feeling very ignored and upset that they are so quick to label/treat me before really even seeing what my numbers are. I picked up my meter yesterday and already started testing. I ate a very high carb/sugar dinner last night to get an idea (juice, chicken, asparagus, tons of white rice, and chocolate raisins) and after an hour my number was only 124. This morning my fasting (well 10 1/2 hours after a big bowl of icecream last night, like I said I wanted realistic results not knowing what it would be if I was following a diet) was only 81.

So my plan right now is go go ahead with the 4x per day testing but to hold off until at least Monday to see what my numbers are looking like with no changes to my diet. If they are falling into the normal range then I think I'll let my OB know on Wednesday that I won't be making those other appointments and they can remove the label.

Do you guys think that sounds like a fair plan? If I actually have high numbers then I of course want to know and receive treatment as needed but I don't want to be labeled if I don't actually have it. For what it's worth I'm already scheduled for a c-section due to the difficulty of my first birth and not wanting to experience that again.

Thanks for reading and opinions!
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  #2  
February 4th, 2010, 09:13 AM
homeschooling mom of 2
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as an update. Had a "typical breakfast" (not healthiest, but typical for me) of big mug of sugary coffee, and a fried egg on 2 slices of white bread. Since I'm overly curious I did a one hour reading and a two hour reading. One hour was 122 and two hour was only 90. Sounds good right? I definitely going to hold off on a scheduling any additional appointments until after seeing how my numbers look this whole weekend on my typical (if some what crappy) diet
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  #3  
February 4th, 2010, 01:09 PM
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I'm sorry you're so frustrated. I think your approach is a good one. I did this myself starting at 8 weeks pregnant but for a different reason. I started getting high sugar numbers around 16 weeks pregnant and I felt the test at 28 weeks would have been too late for me.

I would recommend eating a hamburger and fries and seeing what your numbers are. Or even some bready pizza. Those throw my sugar numbers through the roof because of the low protein content. Your breakfast, even with the sugar in your coffee, actually wouldn't be a bad diabetic breakfast. I still have coffee in my sugar every morning.

Keep doing what your doing and show the doc your numbers. She should be satisfied with a weeks worth of data showing you clearly don't have high sugar numbers. And since you have the meter, you could check once a week or something to make sure nothing is creeping up. That would help too.

Good luck!
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  #4  
February 4th, 2010, 02:00 PM
homeschooling mom of 2
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Thanks for the post!

I figure a bowl of cereal would be worse but because I've had issues with hypoglycemia (nothing tested/documented just my experiences) I tend not to eat really sugary things in the first place as I will feel a drop in sugars big time... I'm sure whole grain bread would be better but I was glad to see my "normal" breakfast tested out fine. I am going to make a point to "test" different foods I normally eat, including pizza (yum) to see what that does, I just about never eat fries or burgers but I do like my pasta and rice etc so it'll be good to see how my levels are after a dinner of pasta and garlic bread etc.

I'm actually fine with even continuing to test 4x a day, what I want to avoid is the actual label and being expected to undergo additional appointments or HAVING to go see the perinatologist or nutritionalist if I don't actually have GD. Might try to go at least once to meet with a dietician regardless as I feel like it would be good just for health reasons and weight loss after the baby

I'll let you guys know how my numbers look over the weekend with my standard diet items.
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  #5  
February 5th, 2010, 06:47 AM
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I would try following a low sugar diet (not cutting out carbs though, we need those) and testing your sugars ... make sure you bring those with you.. once they see that your sugars are normal they will probably back off... but if you keep eating sugary things it might make your sugars look higher and they will probably bother you.
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  #6  
February 5th, 2010, 07:12 AM
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Thanks for the advice, my 2 hour sugars even after icecream have been 100-107, is that high enough for them to be concerned? I thought that sounded really good, especially after having something high in sugar?

Thanks!
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  #7  
February 5th, 2010, 11:07 AM
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thought I'd update in case anyone was curious.

I thought yesterdays numbers weren't to bad especially since I felt sick and was in bed all day. Today DD and I had errands to run so I was curious as to how that exercise would affect things. Morning reading was 78 right out of bed, 2 hours past breakfast it was only 70, decided to really test things with lunch and had a dunkin donuts grilled cheese flatbread, medium coffee w/sugar, and yes a donut... 2 hour reading was only 94. My "exercise" was just walking around the grocery store and kohls a bit. I have a feeling my normal levels w/o eating all this junk (like I said I wanted to really test my body) and getting even a bit of exercise would remain in the 80 range.... will try to eat better this coming week and get off my butt some and report back
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  #8  
February 5th, 2010, 12:23 PM
rebeccabaltimore and more's Avatar (rebeccabaltimore)
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Honestly, your numbers are all normal, except for the 70, that's too low. I'd keep monitoring, but you seem to be right on track.
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  #9  
February 5th, 2010, 12:28 PM
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I thought the 70 seemed low too, even checked it 2x. My breakfast was only some low fat cottage cheese and canned peaches though so maybe that's why? (I'm not a big breakfast eater normally). My friend asked how I felt at 70, honestly I felt fine... was starting to get a bit hungry (went to lunch right after that reading) but not light headed or anything like I can be after having cereal for breakfast etc.

I think I'm a testing junky now, just finding this all so interesting, wish the test strips were cheaper, going to have to use my refills from the original script to get help from insurance so I can keep checking even after I have her (I have suspected hypoglycemia in the past).
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  #10  
February 5th, 2010, 01:43 PM
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I will be honest, hypoglycemia is actually very, very rare, though it was overdiagnosed in the past.

Blood sugar lows can actually be caused by high sugar foods - your body sends out an initial large wave of insulin, and once the sugar is processed, your blood glucose levels plummet. Because I take insulin but my pancreas still makes it (just not enough) I actually struggle more with lows and can't feel them until I hit the 60's. Since many people would be able to feel a level of 70, you might be at that level quite a bit, habituating your body to that level and thus not feeling it. Also you were busy at the time - I know that if I'm busy and distracted, I can't feel it until I hit 45!

The canned peaches may have caused your low, as they are FULL of sugar. All canned fruits, even the "lite" variety, are packed with sugar, unless they are no sugar added. I switched to the no sugar kind when I was diagnosed with diabetes (a year ago last Wednesday) and honestly I prefer them now.
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  #11  
February 5th, 2010, 03:31 PM
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Thanks for the info, I knew canned fruit was super high in sugar... but I do eat them from time to time with cottage cheese and since I want accurate results w/o doing a special diet I figured I should include them during this "test "period where I see what my sugars would normally look like.
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  #12  
February 8th, 2010, 12:22 PM
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As Rebbecca said, sometimes high sugar foods can actually cause lower blood sugar b/c your body "over does it".

70 is lower, but with in a normal range for pregnancy, anything lower than a 70 is not okay. If my blood sugar is below 70 I can't bolus (give myself insulin)

I hope you are able to get everything sorted out.
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  #13  
February 8th, 2010, 12:29 PM
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I'm going to have to figure out the best breakfast food to have... I seem to be having issues with my levels going to low after breakfast, especially if I'm out and about and walking around etc. Yesterday I had some whole grain toast w/peanut butter and then a yogurt... my 2 hour was 81 which isn't to bad but I was feeling a bit hypo. Today I had an egg on 2 slices of bread and was out shopping... my reading was 66 at 2 hours (actually didn't feel to bad, just hungry).

My levels 2 hours after lunch and dinner tend to be 94-115 (higher for dinner but I do tend to eat more and sneak in a dessert and be less active in the evening).

Looking forward to talking to my OB on Wednesday and telling them to pull that GD off my chart.
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  #14  
March 1st, 2010, 12:08 AM
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Wow.. It's funny how they were quick for labeling you as diabetic and I had to beg and pled to get a referral to my Endo.. I even started monitoring my BS on my own and a Midwife quickly labeled me as already type 2 diabetic because my FBS was high.. This is something you don't say to a pregnant woman at the end of their first trimester! I don't trust midwives at all.. Oh, after I had my son, my FBS went back down to the 70's and 80's..So as of now, I'm diabetic free.. I was one of the rare women to get GD early on in pregnancy..

Since I had GD with my dd, I wanted to follow the diet.. But if your still eating your normal foods and getting normal numbers, I'd suggest keep doing it until you notice your numbers going up.. If you want to try to avoid having another "chunky"monkey, maybe following the diet is a good thing..

Oh, was also able to eat a donut and one hour later my BS was in the 70's.. Only certain foods would bring my numbers up, so I just avoided them.. I even ate food when I was being induced with my son, my blood sugars stayed in the 70's though out my induction..

So go with your instincts..
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  #15  
April 24th, 2010, 12:54 PM
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I, like you, went thru the riggam and roll about this GD stuff. I thought it was stupid to eat a freaking boatload of sugar (which I normally would not eat) and expect it not to go up. I flunked the first test by 1 point. I refused the second one- needle phobia.

What I find interesting is the labeling of it all. I did not want to be labeled either. I am a licensed insurance rep and all of that info goes on your MIB log for insurance and medical carriers and life insurance carriers, etc.. I expressed this info to them and they really could care less.

I did do the testing too to see how things affected me. My numbers were interesting to me, as they are to you. What I found out was I could eat a piece of fudge if I drank a glass of milk or ate a piece of string cheese with it. The protein in it cancels out the carbs. I started "playing" with things at 28 weeks when I was tested w/the first hour thing and oddly enough, the last 3 weeks I ate whatever I wanted- my #'s totally went the other way and they kept telling me they would go up and up the bigger the placenta got. They didn't.

It does not sound like they gave you any sort of reference on where your #'s should be, but fasting when you wake up should be under 100. Also, 2 hours after a meal they should not be over 120. ANYTHING within this range is super!!!

There is a book out called the insulin resistance diet that explains how to balance protein and carbs (not more than 30 grams of carbs per 14 grams of protein) per meal. I totally recommend it and I learned a lot. I worked during my pregnancy and found that Lean Cusine makes about 10-15 meals that had decent carb/protein balances that kept me perfect in level. My average was in the 80's too and though I personally felt bad if I ate something and it took me to the 100's- I was still within the range and certain foods affect everyone that way. Period. Like Pizza- if you took a non-diabetic person and fed them 4 slices of monster white break pizza, there #'s would be high too- don't let anyone tell you they won't.

Hang in there. Learn to balance the proteins with the sugars and I promise you'll be fine. Like I said, I learned and was still able to have my chocolate and eat it too without being on insulin or those insulin glyco pills.

Last edited by Linz; April 25th, 2010 at 08:08 PM.
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  #16  
April 25th, 2010, 08:09 PM
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A healthy person's pancreas can handle even a boatload of sugar without a rise in blood glucose levels. I can't say whether or not you have GD having failed by one point, however given all of the adverse consequences for your baby, skipping the 3 hour GTT, against doctor's recommendations, based on a misguided understanding of the pathophysiology of diabetes and a fear of needles comes across as irresponsible. My first child died because I was an undiagnosed diabetic. Diabetes is often symptomless, and my child died as a result, so I really feel I have to be honest with you. It appears as though your child was born healthy and for that I am glad but I have to caution others reading your advice.
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Last edited by rebeccabaltimore and more; April 25th, 2010 at 08:15 PM.
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  #17  
April 25th, 2010, 08:14 PM
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I'm very sleep deprived as I had my little girl almost 3 wks ago but as a quick follow up since I see people are still responding. I did refuse the 3 hour however I also tested at a min. of 4x per day with a glucose meter and never once regardless of what I ate had a high reading... my OB prior to my DD's birth told me that they had to label me and treat me as though I had GD for insurance reasons since I didn't take the 3hr but that looking at my numbers it was clear I didn't have GD. They actually told me to stop going to the NST's and extra ultrasounds in the last couple of weeks since there was no need. I wouldn't recommend anyone just refuses the glucose test however if someone wants to make an informed decision and follow through by testing daily I also think that's a wonderful alternative, I learned far more by testing my sugars all the time then I would have by taking and passing the 3 hour (for instance I actually have issues with low blood sugars and hypoglycemia). My DD also had no glucose issues.
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  #18  
April 25th, 2010, 08:17 PM
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Candi I am so very glad your little girl is here safe and healthy! I'm not a doctor but I absolutely agree with you that you did not have GD. You really just did not meet the diagnostic criteria.

She is so cute!!! Enjoy your little one!!!!
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  #19  
April 26th, 2010, 07:34 AM
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Thanks for pointing out the irresponsible factor- misguided for certain, but your opinion none the less. I did do my testing - FOR MYSELF- 4x a day as it was educational as well for me to see how things affected me. What I saw too was that my ranges were in the 80's as well.

I don't believe your comment that any normal human can eat a boatload of sugar and their liver, though I think you said pancreas, will process it fine. Everyone's sugars go up with foods that they eat- it's just a matter of how high they go up and for how long they stay up. I think YOU need to make sure you explain this because unless you do read and learn about things like this and most people don't- they don't have a clue where their numbers are supposed to be normally or at a 2 hour range. That is the truth. So, it is nice that you've assigned yourself the position on this board as resident diabetic, but not everyone's system runs like yours does and though your advice is equally helpful, you do not know it all nor do I. I can only express my experience and opinion. Thank you Rebecca.
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  #20  
April 26th, 2010, 01:05 PM
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Livers do not process blood sugars, pancreases do. That's a pretty fundamental piece of infomation in understanding diabetes. I'm glad you monitored at home, that is always helpful.

If I had been more knowledgeable about diabetes, maybe I would have noticed something amiss and my son would still be alive today. instead, constant exposure to MY high blood sugars in utero destroyed my son's kidneys and he was stillborn at 18 weeks. So please understand my caution, I do not ever want to see another woman lose a child because of undiagnosed diabetes.
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