A short while ago I was asked my opinion on the GD testing.. I am finally back to blog it out...
OK - the wonderful 'drink this concentrated sugar solution and come to have your finger pricked to see if you have high blood sugars' test.
Well, can you tell my bias simply from that statement.
How the test is done- This test can be done fasting or non-fasting, with blood drawn from finger sticks or from your veins. You are made to either drink a special sugar enhanced drink called Glucola (the sugar concentrate) or eat jelly beans. Then, a short time later, your blood will be tested for the level of glucose. They usually ask you to not eat for 12 hours before, but not always. And they ALWAYS tell you not to workout much after the Glucola consumption.
When the test is done - It is done to most women around 28 weeks gestation. However, if you have a family history of diabetes or had gestational diabetes in a previous pregnancy they may test you earlier. There are also guidelines that say not everyone needs to be tested for gestational diabetes, though it is routine in many places.
How the results are given- 140 and below are considered not gestational diabetics, anything above this reading will usually be sent for further testing.
Problems with this test... MY GOODNESS, don't get me started.
Most women are told to lay off the physical activity and often are told to take the drink first thing in the morning after a 12 hour fast through the night... OK... (duh) - First off, who actually takes in that amount of sugar after a 12 hour fast? Many MANY women have SOME variation of blood sugar anomalies even when not pregnant - this type of body abuse will most assuredly be skewed in such circumstances.
I tell you, as a borderline hypoglycemic, I SURE would be bouncing sugar out of every pore after doing something as idiotic as that. Not to mention the health risk to someone such as I? Ei, Ei, Ei. In fact, in a study titled "Hypoglycemia during the 100-g oral glucose tolerance test: incidence and perinatal significance", they found that many women (6.3%) who don't have hypoglycemia have reactive hypoglycemia to the oral glucose tolerance test... and they have significantly lower incidences of gestational diabetes. (Weissman A, Solt I, Zloczower M, Jakobi P.Obstet Gynecol. 2005 Jun;105(6):1424-8.)
They 'say' there are no side effects... I took the GD test one time... once! What happened to me? I was sweating, shaking, my heart was racing so fast I thought it was going to fly out of my chest, I got a horrible headache, I felt like I was going to puke, and the room was spinning. I have spoken to many MANY women who reflect similar experiences - some even pass out... don't TELL me there are no side-effects...
Another issue is that if you are sick (a cold, the flu, a tummy bug, not enough sleep, etc...) ALL of those things can inhibit correct (and normal when healthy) glucose metabolism.
A third issue is that, if a woman is NORMALLY small of frame (95-115lbs PREpregnancy) - a normal adult dose of this sugar solution will render inaccurate results.
What do the studies say?
The cochrane review states: There are insufficient data for any reliable conclusions about the effects of treatments for impaired glucose tolerance on perinatal outcome. So... Testing and "treatment" doesn't improve outcomes??
So WHY ARE WE DOING THIS?
The ACOG recommends only screening those women who are either 30 ears old or older OR who are at an increase risk for GD from personal or familial history.
Why not simply universally advocate healthier diet, exercise, cinnamon as a natural blood sugar assimilator (yes cinnamon), and education? Rather than this UNPROVEN, UNHEALTHY, INEFFECTIVE screening, diagnosis, and treatment?
So - no real help from me, I know. But you asked my thoughts. My thoughts are the misdiagnoses, stress on the maternal body, and the unsubstantiated practice of this routine test is not enough to get me to keep my baby from nourishment for 12 hours, sit on my lazy butt for as long a time, chug sugar solution, and then let someone stick a needle under my skin just to tell me that my sugars are high. Sigh. I am being moody today, I know. :o)