Grumble, grumble, whine

[Sashahomeschoolmama]

So I went ahead to the backup doctor appointment today. I was just going to skip it but I realized that I need refills for my asthma prescriptions.

He is Unhappy that I never did the 3-hour gestational diabetes test. He is Unhappy that my fasting blood sugar is around 98. He says that pregnant women with that fbs need insulin.

So he is pushing for me to schedule the 3-hour. He also wants to see me again in 2 weeks, when I'm 38 weeks, even though he normally only sees homebirthers once per trimester.

He also said that my urine looks "funky" so, depending on what they find crawling in it, they might call me tomorrow.

Grumble, moan, groan. I absolutely am not into the 3 hour test but obviously he's not going to let the issue drop. I think the only thing I have going for me is that he did external palpation and didn't think that the baby seemed unusually large. And I've only gained about 20 lbs.

[Ilovemonkeys]

I ran 98 when I was pg but I also had high sugar "GD" and follwed the GD diet.

Maybe you should cut back on sugars and carbs?

[xobehs]

I ran 98 when I was pg but I also had high sugar "GD" and follwed the GD diet.

Maybe you should cut back on sugars and carbs?
This and my GBS was diagnosed when I got a UTI late in PG.

[MrsGinCamarillo]

What does your midwife recommend? Do you have to return in two weeks?

[Sashahomeschoolmama]

I see my midwife tomorrow and I'll talk to her about it then. She told me last time, when I told her that he wanted me to do the 3-hour, that he had been blamed for a woman who ended up giving birth to a baby with shoulder dystocia (I don't know the entire story but she had undiagnosed and untreated GD, gave birth to a big baby, and he took a lot of heat for it) so he is uber-sensitive on the issue.

[Wolverine]

I hope all is well. I know that the 3 hour glucose can be a PITA. But, it seems *fairly* non-invasive as far as testing goes and it's probably better to be safe now than in a bad position down the road.

[Sashahomeschoolmama]

I ran 98 when I was pg but I also had high sugar "GD" and follwed the GD diet.

Maybe you should cut back on sugars and carbs?

Looking around online, it looks like I naturally eat a GD-friendly diet anyway. The only thing that I *don't* already do is drink low-fat or skim milk, which isn't an option right now for me anyway.

[Amy_G_]

sasha,
if you eat a GD-friendly diet anyways, and your fasting blood sugar is 98, I would be more concerned than if you ate a regular diet and your fasting blood sugar was that high.

I would get the testing done. Even if it means your baby isn't larger than normal, the excess blood ssugar floating around in YOUR system is bad for YOU.

what is your blood sugar after a meal, and how quickly does it go down after you are done eating?

[3girls2luv]

ITA with Amy, fbs of 98 is not good for you or the baby.

[Elizabethdaisy]

I hope everything goes well for you. good luck.

[cream_city]

I thought 100-125 was "prediabetes" -- you're below that, thus you are in the okay range, albeit on the higher end. I wouldn't want to take the insulin, given that your levels don't actually warrant it. Couldn't the extra insulin be bad for you if you don't need it?

You also haven't gained much weight, and the baby looks the right size. It does sound like he's being overly cautious.

Will he not serve as a backup doctor if you refuse the 3-hour test? I would actually be curious about the urine results, since they looked funky a week or two ago, didn't they?

[JudyJudyJudy]

Sasha, I hope everything works out well for you. Take care of yourself.

[Amy_G_]

several places I've seen online don't really mention fasting blood sugar in a pregnant lady, because they assume you've done a 1 or 3 hour glucose test.

http://www.nichd.nih.gov/publications/pubs/gest_diabetes/sub4.cfm

Fasting glucose level No higher than 95
One hour after eating No higher than 140
Two hours after eating No higher than 120

I did find other places that say fasting glucose level is normal below 98 or 99, and cause for concern if >100.

the key thing I think to keep in mind is that 95, 98, 99 well those are all awfully close to 100, and cause for concern and further testing.

[Amy_G_]

http://www.diabetes.org/pre-diabetes/pre-diabetes-symptoms.jsp

the little chart says for non-pregnant people
normal is below 99,
pre-diabetic is 100-126
diabetic is >126

[still_me]

You are in my thoughts. Let us know how it all goes.

[NickNAK]

98 isn't that bad at all it's just 3 points over the cut off.

Check your blood sugars around 3 am and see if they are really low.

What happens sometimes is called the dawn phenomenon. It's where your blood sugar gets so low at night that your liver starts spilling out glucose to get it back up.

You can counteract that by eating a protein/carb snack right before bed to help hold your sugars stable overnight.

[Sleepdeprived]

NickNAK I've never heard it called that but I have dawn phenomenon every night. (I'm officially a type 2 diabetic now) I like to have a name for it! The snack works for me if I'll get my lazy arse out of bed at 7 a.m. and eat breakfast. If I sleep late I'm screwed.

I had GD in my 4th pregnancy and my doc prescribed fbs goal was 110. It was regularly at 110 or in the teens and was still considered ok for diet control. I never had insulin and we had a really good outcome with a detached birthing center birth in under 2 hours, no complications.

Baby's bs was fine and she was large, but not macrosomial (like my 2 older dds who at 8 & 5 are overweight and show signs of metabolic syndrome. My OB & CNM think I developed GD during those pregnancies after the routine testing.) I guess my point is that even if the birth goes fine, mom having uncontrolled high blood sugar can have a lasting, extremely negative affect on the child. I went through several OBs who wanted to do an automatic c/s at 37 weeks when they heard my history before I found the OB and CNM that would work with me. It seems to me like your OB is being overcautious, but maybe the recommended bs numbers have changed in the past couple of years since I gave birth.