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Thursday, May 26, 2011

Sugary Mess Part 2

Ok so I've sat down several times to blog about this. I know there may be plenty of people who disagree with me, but I still feel it's ok for me to have my own opinion as well. Ready? Here goes: I am not convinced gestational diabetes is even real.

Before you totally disregard anything else I say, please allow me to elaborate. I have researched this A LOT the past couple months from various sources, including actual clinical studies. I found three links particularly interesting. They are quite lengthy, but if you're truly interested in why I feel this way, I would encourage you to take a look for yourself here, here, and here.

For those of you who aren't familiar with GD, here's what the "standard of care" is: Around 24 weeks at your doctor's office, you are given a sugary drink called Glucola that contains 50 grams of glucose. After an hour, your blood is drawn. Some women are told to eat normally before this screening, others are told not to eat any sugar, while others are told not to eat at all (doesn't sound very "standard" to me). If your number is higher than 140, you are told you need to do the 3-hour test because, as mentioned before, this is just considered a screening.

For the 3-hour test, you are told not to eat or drink anything except water after midnight the night before. They bring you in first thing in the morning and test your blood sugar right away (fasting blood sugar). Then, you drink the same drink you had for the 1 hour screening again. One hour later, they draw blood again. An hour later, more blood is drawn. Then after another hour, the last blood draw happens. You can imagine how awful this makes a pregnant mom feel. I felt a bit dizzy and extremely sleepy during this test. They offered me a place to lie down and constantly asked how I felt (as I'm sure they understand many pregnant women don't tolerate going half of a day without any food).

Out of the 4 blood draws, if 2 are abnormal, you are diagnosed with gestational diabetes. Here's what's considered abnormal:

fasting: 95 or higher
1 hour: 180 or higher
2 hour: 155 or higher
3 hour: 140 or higher

Here are my numbers from my 3-hour:

fasting: 76
1 hour: 217
2 hour: 184
3 hour: 140

So, my fasting number was excellent and 3 hours after drinking the glucose drink, I was 1 point from having what's considered normal glucose levels. Considering the fact that my blood sugar jumped from 76 to 217 and was STILL able to come back down within a point of being normal in the end speaks volumes to me at my body's ability to process sugar.

Regardless, I was labeled as having gestational diabetes. I was then referred to a class (which lasted 3 hours) at a local gym where I was given a glucose monitor and a few supplies to get me started, a nurse spoke about what gestational diabetes is, and then a nutritionist gave me a meal plan to follow. I won't go into many more details but basically, the nurse informed us the way GD is being tested is already changing from a 3-hour test to a 2-hour test (I have no clue why) and the nutritionist could have summed up the entire hour and a half by saying, "Eat a variety of healthy foods, keep sugar and processed foods to a minimum, eat small meals often (3 small meals and 2 snacks or 6 small meals a day), and exercise." - all of which I was already doing even before I got pregnant.

I've been monitoring my glucose levels 4 times a day since last Wednesday evening - so almost a week. I decided that I wasn't going to change my diet as the nutritionist had recommended (her diet consisted of a very detailed, very confusing way to eat healthy - which I already felt I was doing anyway) and if my numbers were high, I'd take a look at the literature I was given and adjust accordingly.

What I've found? My numbers are absolutely normal with the food I've already been consuming. In fact, they're not even borderline to the limits of what's considered high. The only time my numbers were close to being high (5 points away) was yesterday - Memorial Day - when I had a cheeseburger with mayo and all the toppings, potato salad, and sweet tea for lunch and then a hotdog with baked beans and a lemon bar for dessert (45 minutes before I was supposed to test my levels) at dinner. I've also had a "Like-It" size ice cream from Coldstone (yummy!), homemade mochas at breakfast (Swiss Miss hot cocoa with instant coffee), and various helpings of chocolate.

My question to the doctors would be, if I would have skipped the 3-hour test and agreed to self-monitor the rest of my pregnancy and my numbers looked like they do, would they consider me as having gestational diabetes? I don't know if I'll get to ask this I believe it's best not to make any more "waves" and just jump through the hoops. But still, it was hard to sit at my appointment today and hear the doctor say, "You definitely have gestational diabetes" but then say, "Your numbers look great" after I told him I hadn't changed my diet and not be able to feel safe discussing further why this all still doesn't make any sense to me. Have you ever been called something you don't feel is true? Maybe a liar, or a cheater? Well...being called a gestational diabetic when I feel it's completely not true stinks too - especially when I don't feel like my doctors care to take the time to truly consider how I feel about this.

Do I believe women may be pre-diabetic and perhaps it's caught during pregnancy? Sure. Do I believe women who eat absolutely horribly and don't exercise at all during their pregnancy can have larger babies? Of course.

Besides the research I've done on this topic as well as what my own numbers have indicated, a few things my doctors have said to me confirm my opinion. First, one of my doctors admitted to me that glucose levels may be normal at week 24, but then high at week 28 (this was his reason for telling me if I wanted to completely skip the 3-hour glucose test, he wanted me to self-monitor my levels for the entire rest of my pregnancy - which I couldn't financially do because the supplies are too expensive without insurance). If that's true, then couldn't a pregnant woman pass the 3-hour test at week 24, but if given the same test at week 28, not pass? I even asked the doctor this question and he replied yes. I asked why then, if a woman passes the first time, do they not ever test again? His reply was that something would show up in the urine sample (which they do every visit) to indicate something wasn't quite right. If that's true, then why would monitoring my levels the entire rest of the pregnancy even be necessary if something would end up indicating a problem by my urine sample? Not to mention, what if I had taken the screening and the 3-hour sooner? Due to all of the miscommunication (from my "Part 1" blog about this), I didn't do the 3-hour until I was 30 weeks. Perhaps I would have passed if I would have done it earlier...or later...if glucose levels can and do change.

Secondly, another doctor told me there have been women whose blood glucose levels, after being diagnosed as gestational diabetics, have been completely normal and he wondered to himself if they really did have it. My guess? They didn't.

I guess for me, relying on a one-time test to diagnose something such as this during pregnancy when hormones and blood volumes are constantly changing, makes no sense - ESPECIALLY when some OBs (thankfully, not mine) standard of care for women labeled with this is to induce and perform late ultrasounds to determine the size of the baby (which aren't very accurate) which leads to induction which leads to a higher chance of cesarean. Not to mention, normally the babies are pricked and prodded a lot more after they're born. This diagnosis carries many negative possibilities for both the mother and the baby. Because of this, I feel it's imperative that the way it's diagnosed is seriously reevaluated.

There's a lot more I could say...but if you're still reading, you probably don't have much longer before you give up. Congratulations on making it this far.


Rita said...

Hear, hear! Or Here, here. Whichever is appropriate. I never know! :)

Just wanted to be a voice of support. I totally agree with you and don't think I "had" GD either. Diagnosed with it though. Ate healthier because of it, so ... there's that, at least.

fosterheartsathome said...

I love smart mommas! It must be very hard for OB docs to start seeing wise women who question the standard practice. My dh sees this in all areas of medical care. My conclusion is that these little ripples will turn into a wave of change for pregnant women and the care they receive. Why is the midwifery movement thriving? Why has the amount of homeschoolers doubled? People are beginning to think which evokes action at some point.
Well done my friend! Perfect numbers and still diabetic. Nonsense!

The Mommy said...

You sound like a smart mama!!! I hope the rest of your pregnancy goes well. Sounds like your sweet baby is in great hands!!