Gestational Diabetes

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krazykat's picture
Joined: 08/11/07
Posts: 1143
Gestational Diabetes

Know your numbers!! I learned some stuff today that I thought I would share. I've heard of a lot of moms who were diagnosed with GD just based on the one hour test. ACOG does not recommend a diagnoses unless at least two of the thresholds from the 3-hour test were met or exceeded. Here is ACOG's current recommendation:

At this time, the Committee on Obstetric Practice continues to recommend the following:

1.All pregnant women should be screened for GDM, whether by patient history, clinical risk factors, or a 50-g, 1-hour loading test to determine blood glucose levels.

2.The diagnosis of GDM can be made based on the result of the 100-g, 3-hour oral glucose tolerance test, for which there is evidence that treatment improves outcome. Either the plasma or serum glucose level established by Carpenter and Coustan or the plasmalevel designated by the National Diabetes Data Group are appropriate to use (see Table 1). A positive diagnosis requires that two or more thresholds be met or exceeded.

3.Diagnosis of GDM based on the one-step screening and diagnosis test outlined in the International Association of Diabetes in Pregnancy Study Group guidelines is not recommended at this time because there is no evidence that diagnosis using these criteria leads to clinically significant improvements in maternal or newborn outcomes and it would lead to a significant increase in health care costs.

Here is the full ACOG Committee Opinion with a chart of the cut-off numbers: http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Obstetric_Practice/Screening_and_Diagnosis_of_Gestational_Diabetes_Mellitus.aspx

By the way, I PASSED!! No GD for me Biggrin

jolly11sd's picture
Joined: 02/02/05
Posts: 3327

Yay for passing!!! Good info abou the test.

KET_2010's picture
Joined: 08/13/11
Posts: 1737

Glad you passed! And thanks for the info! I'm hoping to find out my numbers tomorrow or the next day (I took my test for the 3 hour today...hope I passed!)

daria's picture
Joined: 07/22/03
Posts: 496

Interesting info. I found out my numbers from my 3 hour this morning. I failed 3 of the 4 draws. Failed the fasting, 1 hour, and 2 hour. I passed the 3 hour by a lot though...

KET_2010's picture
Joined: 08/13/11
Posts: 1737

"daria" wrote:

Interesting info. I found out my numbers from my 3 hour this morning. I failed 3 of the 4 draws. Failed the fasting, 1 hour, and 2 hour. I passed the 3 hour by a lot though...

That's weird...I didn't know you could fail the fasting part. At the Naval Hospital they won't even let you take the test if your numbers are too high for the fasting. They drew my blood and I had to wait while they got the numbers back for it before I could even have my drink. I'll find out soon if I passed or not. Hope I did.

krazykat's picture
Joined: 08/11/07
Posts: 1143

"KET_2010" wrote:

That's weird...I didn't know you could fail the fasting part. At the Naval Hospital they won't even let you take the test if your numbers are too high for the fasting. They drew my blood and I had to wait while they got the numbers back for it before I could even have my drink. I'll find out soon if I passed or not. Hope I did.

My OB doesn't even have you do the test fasting. He says that it is not a good indicator of how your body handles glucose if you starve it (on top of being pregnant) and then feed it a pound of sugar and sit still. Makes total sense to me!

And here is the full committe opinion from ACOG. It has a chart with the actual cut-off numbers at the bottom of the page. I'll update the OP as well.

http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Obstetric_Practice/Screening_and_Diagnosis_of_Gestational_Diabetes_Mellitus.aspx

KET_2010's picture
Joined: 08/13/11
Posts: 1737

Yeah when I did my 3 hour, for the first hour I was so jumpy I couldn't keep my legs still! There was another lady there doing a 1 hour and was in disbelief about having to possibly do a 3 hour lol. I told her I had barely failed and the other lady doing the 3 hour said her numbers were 140 exactly and they made her come do the 3 hour! I would hate that! But funny thing was, her bday is April 1st (my due date) and her due date was april 16th (my bday!!!)!!!

Anyway, I'm really hoping I pass or else this weekend I may have to go into a sugar shock and eat unhealthy things before making a diet plan LOL!

ShylahEQ's picture
Joined: 12/08/07
Posts: 1003

Glad to hear you passed Biggrin

Dixiemom1st's picture
Joined: 09/07/07
Posts: 620

When I had GD with DD it was my first morning blood test that I had problems with. My blood sugar was always high in the morning so I had to take insulin at night and then later also in the morning becuase of how my body reacted over night. So It is an important number.

krazykat's picture
Joined: 08/11/07
Posts: 1143

"Dixiemom1st" wrote:

When I had GD with DD it was my first morning blood test that I had problems with. My blood sugar was always high in the morning so I had to take insulin at night and then later also in the morning becuase of how my body reacted over night. So It is an important number.

I'd be willing to bet that if your sugars were high enough to need insulin that even if you had done the fasting test, your levels would have been high. Just a speculation though. I understand fasting before the 3 hour test because it is a more thorough and comprehensive test used to make or rule out an actual diagnosis. But the one hour is just a screening. I *think* around 20-25% of moms fail the one hour, but only between 2-5% are diagnosed with gestational diabetes.

There is also a multitude of ways to screen for GD rather than doing the glucola and one hour blood draw. There is a specific combination of foods you can eat that are equivalent to the glucola and then they can draw your blood after an hour or different intervals. But the glucola is the easiest most efficient way for a practitioner to administer the test especially if they have a heavy patient load. There are a lot of midwives who do the same gestational diabetes screening but in a more realistic manner. A lot of mamas don't know that there or other alternatives. And then there is not a consistent cut-off number used across the board. I just think it's good for people to know their options, know what is actually being screened, and know what the actual criteria are for diagnosis.

Whoa I got on a rant Biggrin My apologies Wink

Dixiemom1st's picture
Joined: 09/07/07
Posts: 620

I was only ever told to fast for the 2 hr test not the 1 hr test. Given that they did not draw blood at the beginning of the 1 hr test only at the beginning at the 2 hr test, fasting was not part of the 1 hr. With the 2 hr I failed the fast and 1 hr mark but passed on the 2 hr, which was exactly the results I would get when testing my blood after. I would be high in the morning but was most often fine 2 hrs after eating.

cuppycake77's picture
Joined: 08/09/11
Posts: 132

Congrats to you!

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