didn't pass the gestational diabetes screening - updated!!

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didn't pass the gestational diabetes screening - updated!!

Postby slugmom » Mon Sep 15, 2008 1:07 pm

Hi Jeff,

last week I had a 1 hour glucose tolerance screening for gestational diabetes.

The labwork said I did NOT have to fast before it, and so I ate lunch before going in (between 12:30 - 1 pm) and had a chickpea and whole grain pasta soup.

I just got a call that my results were "borderline high" - 147 after the 1 hour from drinking the orange goo. So now they want me to go in for the 3 hour glucose test where you eat "an extra piece of bread with each meal" for 3 days prior, and then fast for 12 hours before being tested.

I don't know whether what I ate for lunch just before going in may have skewed my results, or not.

I guess I'd like to know what the best approach to not flunking the 3 hour test is. My biggest concern is getting slapped with the 'gestational diabetes' label and being pressured to eat a high protein, low carb diet. Would it be better to make sure not to have even whole wheat *flour* products and sweetened things (all fruit sorbet, etc.) in the week before the test?

I've been following Dr. McDougall's plan for about 6 weeks.

Background info:
I'm 5' 0" and weighed 131. when I first found out I was pregnant -- I had been following Dr. McDougall's plan and losing weight for several months, but when the nausea hit I fell off the plan and ate very poorly for the first 20 weeks or so. Got back on the plan when I was feeling better and my husband was diagnosed with high blood pressure. I'd gained about 17 pounds in those first ~22 weeks, but then dropped back down a little to about 142 over the first few weeks back on the plan, and have bounced around near there, in the 142-144 range the last few weeks. Even though I lost a little weight, I feel like I'm eating plenty, I'm not trying to lose weight or *diet* -- just eat healthy. I think a lot of it was losing some water retention weight from the prior junk food eating.

So at ~28 weeks I weighed 143 on the day I went in for testing. I'm caucasian and 39 years old.

Thanks,
Kim
Last edited by slugmom on Mon Sep 29, 2008 11:16 am, edited 1 time in total.
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Postby slugmom » Mon Sep 15, 2008 1:43 pm

oh, and apparently my iron was low, too -- my midwife wants me to start taking 325 mg of ferrous sulfate a day. I know I should try to get more from dietary sources, but I am NOT a "leafy greens" kind of person -- even in smoothies I can taste just a little and can't get them down. I can do some broccoli, but I don't think I eat a LOT of any of the 'big iron sources' ...
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Postby karin_kiwi » Mon Sep 15, 2008 2:08 pm

Quickie response about the iron - it is totally normal and healthy for iron levels to decrease in the latter parts of pregnancy. In fact, there have been a couple of studies that showed to artificially increase iron levels to "normal" "not pregnant" levels (through supplementation) can cause problems. I don't have the studies at hand (haven't worried about it for a number of years) but maybe someone else does.

I don't know what your numbers are, but unless they are really low I would not worry. A little bit of research should give you some info that you can use.

I had to do the GTT for both my pregnancies and that's not how I was supposed to do it. I've never heard the extra piece of bread thing. And not doing the initial glucose test after a fast????? That doesn't sound right to me either.

If you're worried about 'flunking' the test, just make sure you're very strict with no oil and no high fat plant foods; lots of fiber. But also remember that the GD label shouldn't be put on you on the basis of just this test - there are other symptoms that should be present, too.

And at the end of the day, however you do on the GTT, nobody can make you eat anything you don't want to. It is your choice. And it's also your choice how much you want to engage your health providers in a discussion about what you're doing or let them think you're following their directions (lie). All these tests have margins of error and are subjective in their interpretation - and if your people are concerned about your diet they're going to be very very aggressive about seeing problems in your test results.

Good luck!
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Postby slugmom » Mon Sep 15, 2008 4:34 pm

Karen,

my understanding is that it's the 3-hour test that labels you ...

my urine dips have been fine all along, with regard to sugar levels.

I really don't think I have gestational diabetes, but I also have been told it can be relatively symptomless and still cause problems.

I know no one can make me eat any way, but I also don't like the idea of lying to my care givers, nor do I want to have to fight the people I'm supposed to be working with. I'm not a high medical intervention person - this is actually my first hospital birth after 3 homebirths - and it's reminding me, with all the "preventative" screenings and tests, why I preferred the homebirth low intervention route. My midwife is fairly supportive, but she still has to comply with the rules of the medical practice and hospital with whom she works.

On the iron - aside from the side effects of iron supplementation, I wonder why else it would be not recommended? I usually run borderline low even when not pregnant (get turned down donating blood once in awhile) ...

bleah.
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Re: didn't pass the first gestational diabetes screening

Postby JeffN » Mon Sep 15, 2008 5:36 pm

slugmom wrote:Hi Jeff,

last week I had a 1 hour glucose tolerance screening for gestational diabetes.

The labwork said I did NOT have to fast before it, and so I ate lunch before going in (between 12:30 - 1 pm) and had a chickpea and whole grain pasta soup.

I just got a call that my results were "borderline high" - 147 after the 1 hour from drinking the orange goo. So now they want me to go in for the 3 hour glucose test where you eat "an extra piece of bread with each meal" for 3 days prior, and then fast for 12 hours before being tested.

I don't know whether what I ate for lunch just before going in may have skewed my results, or not.

I guess I'd like to know what the best approach to not flunking the 3 hour test is. My biggest concern is getting slapped with the 'gestational diabetes' label and being pressured to eat a high protein, low carb diet. Would it be better to make sure not to have even whole wheat *flour* products and sweetened things (all fruit sorbet, etc.) in the week before the test?

I've been following Dr. McDougall's plan for about 6 weeks.

Background info:
I'm 5' 0" and weighed 131. when I first found out I was pregnant -- I had been following Dr. McDougall's plan and losing weight for several months, but when the nausea hit I fell off the plan and ate very poorly for the first 20 weeks or so. Got back on the plan when I was feeling better and my husband was diagnosed with high blood pressure. I'd gained about 17 pounds in those first ~22 weeks, but then dropped back down a little to about 142 over the first few weeks back on the plan, and have bounced around near there, in the 142-144 range the last few weeks. Even though I lost a little weight, I feel like I'm eating plenty, I'm not trying to lose weight or *diet* -- just eat healthy. I think a lot of it was losing some water retention weight from the prior junk food eating.

So at ~28 weeks I weighed 143 on the day I went in for testing. I'm caucasian and 39 years old.

Thanks,
Kim


Hi Kim

First, congratulations on the pregnancy!

I would never accept the diagnosis for any thing on the basis of one test. And, no medical diagnosis should be made on the basis of one test.

While I can tell you some things you can do to help improve the number on the next test, I don't think that is really the issue, as what really matters is not the result of a test, but your lifestyle and diet. Numbers are just biomarkers and indicators of disease and not the disease itself. The number of the test doesn't matter, your lifestyle, diet and health matter. What matters most is passing the "test of life" and not just a one time test for GD.

While you are not my patient and I can not tell you what to do, if you take the test, I would encourage you to be as adherent to the lifestyle and diet in the strictest form (MWL or MM) as you can be from this moment up to you take the test. Not so much for the results of the test but because that would be the best thing for you to do in regard to your health and the health of the baby. This also includes activity, so make sure you are getting in the recommended amount of activity each day also. If you do this, then you should pass the test anyway. If not, stay adherent and then ask to take the test again.

Also, no one can force you to eat anything or follow any diet. Heck, I wish everyone would be as adherent to the McDougall program just because Dr McDougall told them so. :) After all, think about it, why are you (or anyone else) so obligated to listen to their MD in following unhealthy advice, but at the same time, no one feels as obligated to follow healthy advice when it comes from a MD like Dr McDougall, or Esselstyn?

There is no health to be gained from following a high protein, low carb diet.

I would recommend you read the hot topics links on the Main Site for diabetes as well as in this forum.

Here is a recent one specifically on Gestational Diabetes.

http://www.drmcdougall.com/forums/viewtopic.php?t=7811

And one from my website on weight gain in pregnancy

http://www.jeffnovick.com/index.php?opt ... tid=28#588

Also, there are several peoples stories here on how well they did in regard to controlling their blood sugars by applying the principles in their strictest forms. You may want to review those also.

In Health
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Postby slugmom » Tue Sep 16, 2008 5:07 am

Jeff,

Thank you for taking the time to reply, and for your sensible answer and the links. I appreciate it and feel better equipped to persevere in all this. And you're exactly right, following the MWL or MM guidelines are healthy regardless of what some screening has said, that's good to be reminded of. I do know I have room to be a bit stricter with my application of the program. :)

I do exercise, walking around 5 'exercise miles' a day at a moderate level.

I just want to double check, in the other thread on gestational diabetes you mentioned you did not think fruits would be a problem, but that they could be limited to 2 servings a day to see what happens. Since I have not been (and really don't think I will be) diagnosed but am facing the 2nd test, do you think I should limit them in the days between now and taking the 3 hour test? Also, regarding the mention of flax seed -- is that considered a helpful addition, or simply an optional ('it won't harm you any') one? I know that limiting oils is part of it, and didn't know whether 1-2 T. ground flax would be adding to the problem, or if there were specific benefits to it's addition.

Thank you again,
Kim
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Postby JeffN » Tue Sep 16, 2008 5:40 am

slugmom wrote:Jeff,

Thank you for taking the time to reply, and for your sensible answer and the links. I appreciate it and feel better equipped to persevere in all this. And you're exactly right, following the MWL or MM guidelines are healthy regardless of what some screening has said, that's good to be reminded of. I do know I have room to be a bit stricter with my application of the program. :)

I do exercise, walking around 5 'exercise miles' a day at a moderate level.

I just want to double check, in the other thread on gestational diabetes you mentioned you did not think fruits would be a problem, but that they could be limited to 2 servings a day to see what happens. Since I have not been (and really don't think I will be) diagnosed but am facing the 2nd test, do you think I should limit them in the days between now and taking the 3 hour test? Also, regarding the mention of flax seed -- is that considered a helpful addition, or simply an optional ('it won't harm you any') one? I know that limiting oils is part of it, and didn't know whether 1-2 T. ground flax would be adding to the problem, or if there were specific benefits to it's addition.

Thank you again,
Kim


Hi Kim

In regard to your 2 questions, it depends. There is no one simple answer as it will depends on you. For most people, it will probably not matter, however, if you are sensitive (IR), either one may be an issue.

If passing the test if your main concern than eliminate them both.

The key issues in IR is activity (I do not know what "exercise miles" are), naturally occurring high fiber foods, minimal to no refined/processed foods, weight, belly fat, and dietary fat.

Instead of the slice of bread at each meal, you can take a dose of Konsyl at each meal for the 3 days before and they will help lower your numbers and make sure you go for a long walk the night before and in the AM if you can.. :)

Good luck and keep up posted

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Postby slugmom » Tue Sep 16, 2008 6:58 am

JeffN wrote:
slugmom wrote:I do exercise, walking around 5 'exercise miles' a day at a moderate level.



Hi Kim

...
If passing the test if your main concern than eliminate them both.

The key issues in IR is activity (I do not know what "exercise miles" are), naturally occurring high fiber foods, minimal to no refined/processed foods, weight, belly fat, and dietary fat.

Instead of the slice of bread at each meal, you can take a dose of Konsyl at each meal for the 3 days before and they will help lower your numbers and make sure you go for a long walk the night before and in the AM if you can.. :)


Dear Jeff,

Thanks again for your very quick reply!

i think I will go ahead and limit fruit and not do the ground flax this week, until I do the 3 hour test, if I understand you correctly saying it can't hurt and increases my odds of passing the test. I really don't think I am insulin resistant, but I guess that's why they screen people, just to be sure.

"Exercise miles" - LOL - I just meant that I walk purposefully/briskly/continuously (i.e. for exercise) 5-6 miles a day, usually in the morning. As opposed to steps/miles that add up a bit here and there as I carry laundry and get groceries and the like. I do my main walking in the morning, just to be sure it gets done, but 3-6 days a week add an extra half-hour walk (or more) with my family so that my husband also gets a little exercise in. I've been walking at least 2-3 miles since January, and increasingly more through the spring and summer to get to the distance/time I am now.

I don't know what Konsyl is (*now I do, I looked it up), but I'd rather just stick to eating real food, rather than taking any supplements to try and change my outcome, since I'm fairly confident that I shouldn't need extra measures. At least, considering the fact that my diet has been relatively healthy and can be improved a little with some minor adjustments, and I have been exercising regularly. I am guessing that, if anything, it was my lunch right before the test that factored in to my 1 hour screening -- is it not normal to have blood sugars be in the 140's after eating? -- but the test specifically said fasting was not necessary, so I didn't.

I will keep you posted, thanks for your help!

Kim
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Postby slugmom » Wed Sep 17, 2008 10:46 am

ugh, it looks like I wont be able to get to the lab until next week, I'd just as soon get the test over with.

Just wanted to double-check ... sweet potatoes are maligned by the popular press but are a *good* choice for MWL -- they're fine for a 'controlling blood sugar' diet as well, aren't they? Can they be one of my staple starches in this 'trying to be as careful as possible before the test' time?
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Postby JeffN » Thu Sep 18, 2008 11:54 am

slugmom wrote:ugh, it looks like I wont be able to get to the lab until next week, I'd just as soon get the test over with.

Just wanted to double-check ... sweet potatoes are maligned by the popular press but are a *good* choice for MWL -- they're fine for a 'controlling blood sugar' diet as well, aren't they? Can they be one of my staple starches in this 'trying to be as careful as possible before the test' time?


Yes.

Sweet potatoes (& potatoes) are excellent foods.

The popular press does not know how to treat & reverse diabetes. Also, ignore the Glycemic Index and Load as they are irrelevant to you. There are many low GI foods that are unhealthy. GI is not a relevant issue. Unrefined, unprocessed, high fiber, low calorie dense, high nutrient dense, high satiety "intact' whole foods is, regardless of what their GI or GL is. You can read the 2 newsletters on this topic & my website.

We can discuss the Barnard study on the GI at a later point but the GI was not the relevant issue to the success of the program in the study. It was the principles I mentioned above.

Most of all remember, your goal is a lifetime of excellent health for you & your baby, & not the results of 1 test.

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Postby slugmom » Thu Sep 18, 2008 11:57 am

Thank you, I appreciate your response and your continuous pointing us back to the REAL goal. I'm glad I asked!

thanks again!
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Postby slugmom » Mon Sep 29, 2008 11:16 am

I got my results back from Thursday's test:

For a 100-gram oral glucose tolerance test
used to screen for gestational diabetes,
normal blood values are: - My levels were:
__________________________________
· Fasting: less than 95 mg/dL - 70
· 1 hour: less than 180 mg/dL - 141
· 2 hour: less than 155 mg/dL - 138
· 3 hour: less than 140 mg/dL - 86

Now just to keep on focusing on the truth, that even though I was worried and careful to get best results, I need to remember not to use the good results for the sake of 'liberties' but keep my eyes on *optimal health* :)
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Postby Faith in DC » Mon Sep 29, 2008 12:10 pm

good news Kim. It was a scare.
Faith
I'm in training for maintaining
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Postby karin_kiwi » Mon Sep 29, 2008 5:25 pm

Excellent. That must be a relief! :)
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Postby hope101 » Mon Sep 29, 2008 5:28 pm

I'm very happy for you and baby slug! :-D
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