Is it right for a doctor to treat me for gestational diabetes just because I couldnt keep the drink down?
Mommy 2 Be asked:
I took my one hour gb test and failed. I threw up shortly after I left the doc’s office. I went back for my 3 hour gb test but couldnt hold the drink down long enough for them to take my next blood sample. I know that this still doesnt mean that I have gb. My doctor claimed that there is no other method for them to find out if I have gb so she’ll have to treat me like I do by putting me on a diet and having me test my blood sugar. I dont mind all of the dieting and testing but is this right for her just to say that i must be treated for it since I couldnt hold the drink down?
Kansieo.com
I took my one hour gb test and failed. I threw up shortly after I left the doc’s office. I went back for my 3 hour gb test but couldnt hold the drink down long enough for them to take my next blood sample. I know that this still doesnt mean that I have gb. My doctor claimed that there is no other method for them to find out if I have gb so she’ll have to treat me like I do by putting me on a diet and having me test my blood sugar. I dont mind all of the dieting and testing but is this right for her just to say that i must be treated for it since I couldnt hold the drink down?
Kansieo.com
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that is not a basis for determing GD. that sugary drink can be hard for some women to keep down, especially if you suffer from nausea or heartburn.
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Please see the web pages for more details on Gestational diabetes.
Diet and caloric intake are individualized and monitored to prevent weight gain of > 9 kg. Obese patients are discouraged from daytime snacks. Moderate exercise after meals is recommended. Insulin therapy is reserved for persistent hyperglycemia (fasting plasma glucose > 95 mg/dL or 2-h postprandial plasma glucose > 120
mg/dL) despite a trial of dietary therapy for ? 2 wk.
The amount and type of insulin should be individualized. For
obese patients, regular insulin is taken before each meal. For nonobese patients, 2?3 of total dose (60% NPH, 40% regular) is taken in the AM; 1?3 (50% NPH, 50% regular) is taken in the PM. Fetal monitoring with nonstress tests, biophysical profiles, and kick counts should be done beginning at
32–34 wk (or earlier if indicated) and continuing until delivery for patients who require insulin.
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I did an internship with a midwife who used jelly beans for the OGTT. I found a research article in my medical library which backs it up.
Maybe you could print this and show it to your doctor:
American Journal of Obstetrics & Gynecology. 181(5 Pt 1):1154-7, 1999 Nov.
Abstract OBJECTIVE: This study tested the hypothesis that a standardized dose of jelly beans could be used as an alternative sugar source to the 50-g glucose beverage to screen for gestational diabetes mellitus. STUDY DESIGN: One hundred sixty pregnant women at 24 to 28 weeks’ gestation were recruited for a prospective study to compare 2 sugar sources for serum glucose response, side effects, preference, and ability to detect gestational diabetes mellitus. Patients were randomly assigned to consume 50-g glucose beverage or 28 jelly beans (50 g simple carbohydrate). Serum glucose values were determined 1 hour later. The test was later repeated with the other sugar source. Finally, a 100-g 3-hour oral glucose tolerance test was performed. Participants completed a questionnaire recording subjective outcome variables. American Diabetes Association criteria were used to interpret all test results. RESULTS: Among 136 participants completing the study no significant differences were found between 1-hour serum glucose values (116.5 +/- 27 mg/dL with 50-g glucose beverage, 116.9 +/- 23.6 mg/dL with jelly beans; P =.84), frequency of discrepant results (P =.47), sensitivity, specificity, or predictive value. Jelly beans yielded fewer side effects (38% with 50-g glucose beverage, 20% with jelly beans; P
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It seems reasonable to me. All the evidence the doctor has says that you have high blood sugar/GD. You probably tested high in the doctor’s office which is why they sent your for the 3hr GTT. You tested high after one hour and then couldn’t complete it. Unless you wanted to try the 3hr test again, what else could she do?
Ask her if you can test your sugar for a few days at home before starting the diet. If your sugars are consistently normal before and after eating, that would be evidence that you *don’t* have GD and she should be ok with you continuing to eat normally (and not have to test).
diabetes testing
There are 2 mistakes the doctor can make…
1)Treat you as if you had gestaional diabetes when you don’t
or
2) Not treat you for gestaional diabetes when you really have it.
If the doctor is going to make a mistake, it will fall in one of those 2 catagories. I would choose the first mistake for two reasons. The first reason is is better to monitor your blood sugar and give you a diet than to risk complications to yourself AND your baby. The second is people like to sue doctors these days and it is much harder to defend yourself (as a doctor) from the second mistake than it is the first.
You always have the option of finding a new doctor (maybe an endocrinologist) if you don’t like the treatment you are getting from this doctor.
To answer your question, people will argue with me, but I think it is right for your doctor to treat you. I don’t think the doctor is treating you only because you didn’t keep the drink down, but because the proper thing to do is to treat you as if you had GD until a test shows that you don’t.
Best wishes for you and your child.
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It’s a little too generalizing to treat you anyhow, but do you have any other symptoms? Had a previous baby bigger than nine pounds? Are overweight yourself? I see by your avatar that you are black. There’s a much higher incidence of diabetes in black women. – a sucky genetic thing
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The good news is, the diet won’t hurt you in the least and will help you have a healthier pregnancy by reducing the weight you’ll gain and reducing the baby’s size. (having a healthy 6 or 7 pound baby versus a ten pounder)
Have a great pregnancy and pop anyone in the mouth who babbles about you “being able to eat for two.”
Kansieo.com
I think it’s probably a good thing. The diet will be good for you and keeping up with your blood sugar will be good, too. I wouldn’t stress about it.