Rufusal of Glucola screening for GD?

Brenda - posted on 01/30/2009 ( 20 moms have responded )

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Okay I've never heard of anyone refusing the glucose test. On my babyzone board a woman was talking about doing research and deciding to refuse the glucose test. Personally, I don't see any reason to refuse a test that poses no risks to myself or the baby, but I'm just wondering if any of you know the reason someone would refuse the Glucose test?

(xposted to Natural birthing and breastfeeding moms)

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In Canada (my MiL is a family practitioner in Toronto), glucose tolerance tests are ONLY given when there are symptoms or signs of risk (blood pressure, things in the urine, etc). She was shocked when I told her 'everyone gets them' down here, and viewed it not only as, in her words, "litigation-driven medicine," but cruel to the mother because the fasting and whatnot is extremely uncomfortable for a lot of women, especially for the 3-hour test.



In her practice (she has 4th-generation patients!), there have been no negative repercussions from following this conservative practice, which is the gold standard of medicine in Canada. In her view, the women who test 'positive' to a GTT but show no other symptoms are not actually having a problem -- but it leads to more and more and more interventions by the OB in the pregnancy, often meaning an induction and early-born babies.



If I'd known her views before I got mine, I might have chosen to refuse as well ...

Crystal - posted on 02/01/2009

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I believe it's necessary to see a medical professional, I also think that a midwife is preferable over an OB if possible. I do think testing for GD is a necessary evil because it can lead to problems.

I am a natural mommy for the most part, but I also believe in the medical community for some things.

I don't always trust doctors though and I sure as hell won't go near a hospital to give birth ever again.

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Stephanie - posted on 04/07/2012

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I took the test and it gave me a result of 300, which is SUPER GD, they wouldn't give me the 3 hr because it was so high, so they sent me to a MFM doc who made me test my sugars for a week with no change in eating so he could decide about insulin, well, my sugarse were low 24/7 and I didn't have GD. They tagged my chart with it because of the test, and kept saying "oh this is a GD patient" when I had to go to the hospital,. but MFM said I didn't have it, I just can't handle that amt of sugar at once...so to me it was stupid....a test of 300 I would have been having symptoms, so you can have a false positive, be refused the 3hr because of a high #, and still have to jump through hoops even if you don't have it. Next pregnancy I'll refuse it, and ask to do the 2 weeks of checking sugars to rule it out.

Dianne - posted on 09/25/2011

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i dont plan on having this test done this pregnancy, my second, due to a couple reasons, that its not great for the baby to fast etc, i have an extremely good family history and my hubby is diabetic (with plenty of family history/experience), so i plan on taking a few random tests with his checker to keep an eye on my levels not to mention i felt so crap doing it with my first got nauseous etc that i want to avoid that, saying that however if i didnt have the ability to check my own levels id have it done just to be sure

Yalana - posted on 05/20/2011

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But I do agree with those of you who have stated that the fasting and sudden sugar rush does affect the baby. This is my 4th and final pregnancy, and I was scheduled for a u/s then the glucose test. I wasn't able to arrive early enough to have space between both and ended up getting my blood drawn while I was waiting for the u/s. During the u/s, the tech noticed that my daughter was extremely active for her age. She knew that I had my screening that day and said the sugar must really be affecting her. I didn't fast, but I was told to chug the drink within five minutes or less and then inform them of the time I had my last sip so they could draw my blood after an hour. I felt better than I had in a while afterward, but my daughter was on a super sugar rush!

Melissa - posted on 02/13/2009

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Actually, they have studies out on some midwife boards out there stating that the shock you put your body into when you fast and then drink the 50g sugar drink isn't good for baby. Also, I think there's a really high fail rate on those tests. My midwife has a great 50g carb breakfast that she has her patients take. I can link you if you'd like. I mean, really, if you have no reason to think that you might have GD and then continue with a healthy diet, I don't see a reason to take it. My diet has never been great while pregnant, so it's one of those things I really don't want to screw up.

Elizabeth - posted on 02/13/2009

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I would think (though I don't know) that the differences between the US and the UK and Canada on this issue may have something to do with the way we pay for health care. As far as I know there is no medical harm to the glucose test, but it obviously is expensive to test every woman. In the US, with our largely-insurance based system, insurers pay for it because of our extremely low tolerance to risk. In the UK and Canada, with nationalized health care and protection against litigation, that money is considered better spent elsewhere.

Just a guess, but when I lived in the UK, many tests we considered routine weren't routinely performed.

Crystal - posted on 02/05/2009

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Quoting Elliott:



Type 2 diabetes is easily diagnosable by taking a urine sample and checking it for sugars.






Which so far as I know EVERY pregnant lady gets fairly early on and throughout the pregnancy, unless their doctors are criminally negligent.





My doctors on post at Campbell never checked my urine.

Sabrina - posted on 02/05/2009

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In pregnancy it is common to get sugar in the urine even for non diabetic women because of the higher flow in the kidneys, and so this test is unreliable.

Mary - posted on 02/04/2009

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I personally am glad that I took the screening. We found out that I had dangerously low blood sugar, which would have been overlooked until it put me in the hospital bascially. Because the symptoms I was experiencing are also common pregnancy symptoms. Now, this is pretty rare of course, so I wouldn't say that everyone needs to do it for this reason, but I will be doing one with every pregnancy now.



I think that part of the problem here in the US is that doctors have a tendency to scare us, by making us think that things are more common than they really are. My FIL and hubby are statisticians and specialize in the medical field. And it is amazing how docs word things to scare ppl.. For example...(disclosure: these are not real statistics!) your doc could tell you that 95% pf pg women take one hour GD test. And 45% of those women take the 3 hr test. And 20% have GD. This is VERY misleading. It is not 20% of all women, it 20% of 45% of 95%. Which is closer to 8% of the original number. But we are trained to think that doctors know all and can fix all so we follow them and do as they say without questioning because we think that they have given us all of the info.



So anyway, I would say that the GD test is not bad so if your doc wants you too, go ahead, but don't be that way with everything.

Brenda - posted on 02/04/2009

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Interesting indeed.  I am glad to hear from so many varied areas about this stuff!  It is interesting to see how things have changed in thinking just since my first pregnancy, and some of these things will no doubt influence testing in future pregnancies world wide.  GD is such a difficult thing to diagnose and deal with.  I think no matter what, most the times the docs are good intentioned, just some things are a mystery even to them.  :)

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Type 2 diabetes is easily diagnosable by taking a urine sample and checking it for sugars.



Which so far as I know EVERY pregnant lady gets fairly early on and throughout the pregnancy, unless their doctors are criminally negligent.

Sabrina - posted on 02/04/2009

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Screening for GDM is contraversial even in the medical community and practice differs from country to country. It is ethically difficult to design trials to test the safety of NOT screening and hence most professionals do it on a common sense basis. In the UK, the national guidelines (which is put together by a multi disciplinary group and supposedly based an whatever evidence is available) suggests that we use 2h OGTTs, and so screen only women with risk factors.
Even if you argue that the risk of GDM is not that great in comparison to the amount of intervention that ensues, there is a growing number of women of childbearing age with undiagnosed Type 2 Diabetes, who first present in pregnancy (with an older and more overweight maternal population nowadays). And Type 2 Diabetes definitely has a bad effect on pregnancy, and the earlier you diagnose it the better - i.e. if you wait for symptoms most of the damage may be done!

Brenda - posted on 02/04/2009

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Interesting.  I honestly have never heard that view before.  I know that on average, of women who take the 3 hour test, only 15 % fail to pass, which considering that is dwindled down by the amount that passed the one hour test, I don't know the statistics on those that fail both as related to all women to start with.  It at least sheds light on the reason.  I was quite confused because I had never known anyone who didn't take it.... :)  Thanks for the input!

Brenda - posted on 01/31/2009

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Hehe, this is where I so fit into the "non extreme" part.  I had another lady that said there's no reason to test for something if you have no symptoms...  Considering GD rarely has symptoms...  oh well.  Most of that group I am finding I don't see eye to eye with...  The whole not seeing a medical professional while pregnant just bothers me because of my past problems.  Those what ifs scare the crap out of me, and I don't know why they don't scare other momstobe too!  I guess I'm not all that "natural" in that respect!

Crystal - posted on 01/30/2009

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I can understand that if they have it the doctors may want to induce early, but you can always insist on an ultrasound to measure the baby beforehand and you can decide to induce or not. I'd rather make sure that I don't have it though.

Brenda - posted on 01/30/2009

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I had a lady respond in another group about this.  She said the reason was because it is often inaccurate and there is a chance of being diagnosed GD and not having it.  I thought that was the reason for the 3 hour test..  Personally I'd rather eat like a diabetic for a couple months and ensure me and my baby are safe than the possiblitity of severe illness and not knowing it....but you know.

Brenda - posted on 01/30/2009

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I just don't get it.  I can at least wrap my head around the vaccine issue I posted about.  There I can see the reasoning, though I disagree with it, I get why people delay and don't vaccinate.  But gestational diabetes can kill mother and baby if it gets bad enough, and it is a little blood to tell for sure and syrupy drink.  I wouldn't have amniocentriecis done myself (recently had a lady on my babyzone board lose her baby because of amnio), but that is an optional test that doesn't test for something that could kill me or the baby.  I had Pre Eclampsia with my first, mild as it was, but to me not getting glucose screening would be like not having them check my blood pressure or proteins each appointment...

Ally - posted on 01/30/2009

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i'm with you....that seems very silly to me...it seems to me that not knowing puts everyone at an increased risk???

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