Let me take you on a weird gestational-diabetes related journey.
I last saw my doctor over a month ago. She saw that I was testing my own blood in the mornings, so she said I could skip the glucose tolerance test. For information on what that is, see my previous post on prenatal tests by
CLICKING HERE.
At my next visit, I saw a nurse practitioner instead of my Ob/Gyn. I was not as fond of her. The next appointment, it was her again. This time there was sugar in my urine. She decided to recommend me to their endocrinologist (diabetes specialist). She also said I should 1, be keeping my blood sugar much lower than I was and 2, should start coming in ONCE A WEEK, and 3, start testing my blood 4 TIMES A DAY.
I asked for an A1C, which tests your average blood sugar over the previous 2-3 months. And I went in to see the endocrinologist.
So let me set the stage.
I have a little machine called a glucometer which test the levels of glucose in a drop of blood. Regular diabetics are told that their fasting levels, or "morning before breakfast" levels, should be between 90 and 130. One after after you eat a meal, the level should be under 200 and go down from there. Things that increase the levels of sugar in your blood include not just cake or candy but also fruit, bread, whole grains, and beans - entire wholesome groups of food. My average fasting level was 124 and my average after-meal level was about 180.
The A1C results are considered normal if the number is 7 or under. My mother has type 2 diabetes and take insulin. Her last A1C was 6.4, which is considered under control.
My A1C was 5.2 - perfectly normal.
Enter the endocrinologist.
He said that despite my excellent A1C results, it doesn't give any "current" information. He said a pregnant woman's fasting levels should be under 90 and after-meal levels should be 130. When I balked at this, he actually said "Don't you care about your baby?"
Nice try, jerk. I'm not a 21-year old first time mom. I'm 35 and I don't tolerate BS anymore.
I said "That is NOT fair. Of course I do. You're asking me to cut back on highly nutritious foods. I get to know why."
He laughed nervously and then put his "I'm the all-knowing doctor" pants back on and told me it was better to be safe than sorry, which seems to be common birth professional speech for "we love insane medical interventions that have minimal indication for actual necessity so that we keep our relevance."
He gave me a brand new glucometer, told me to test 4 times a day, set me up with an appointment for a Dietician, and told me to call his office in 4 days with my numbers, and if they aren't changing, I'll need to go on insulin.
The next morning, I had unsweetened oatmeal for breakfast and it shot my blood sugar to 237. For the heck of it, I tested again 2 seconds later, and the results were 180-something.
I spent the next 2 days testing twice at each sitting, sometimes more. One morning, 3 tests in a row went from 88 to 139.
I did not call the endocrinologist 4 days later. I did not go to my Dietician's appointment. I have not seen the NP ever week. I canceled every appointment, stopped testing my blood, and went back to fresh fruit for breakfast. I am not going to get babysitters twice a week for the next 3 months over "just in case" madness.
I reject this.
As I write this, I have seen no one in about a month and should probably call for a check up. I'll be asking for my actual ob/gyn and refusing to see NPs. I am happily eating pineapple, which is really high on the carbohydrate index, and organic granola cereal, and 2 pieces of bread with my BLT instead of 1.
I have also been online accessing full medical journals through Bryan's university account. Not just abstracts on PubMed - actual studies. No one can tell me why pregnant women have to be held to stricter blood sugar standards than actual diabetics, unless they had diabetes before they even became pregnant, because the potential for damage done to a fetus is during the first trimester. Gestational Diabetes shows up in the second half of the pregnancy, after the risks are primarily gone.
Insulin and other medications also have the risk of confusing the baby's body, and causing it to produce less of its own insulin as a result, which causes problems when the baby is born.
The American Diabetes Association says GD affects around 4% of pregnant women. Already, that's uncommon. It also says "Treatment for gestational diabetes aims to keep blood glucose levels equal to those of pregnant women who don't have gestational diabetes." Okay, so why are my birth professionals asking me to keep my blood sugar levels insanely LOWER than regular pregnant women? They also say "For you as the mother-to-be, treatment for gestational diabetes helps lower the risk of a cesarean section birth that very large babies may require." Big babies almost never require a c-section, just a doctor who actually knows what they are doing. This is an unnecessary fear tactic.
I found one study cited frequently to justify the lower levels called the "Hyperglycemia and Adverse Pregnancy Outcomes (HAPO)" stud, which stated that as maternal blood glucose levels increase, so do risks of c-section, pre-eclampsia, and babies born with stressed kidneys and low blood glucose levels. Bryan's university doesn't have online access to this study, so I haven't been able to determine exactly how much the risk changes. 5%? 50%? One review of the study said treatment has the potential to provide "with a 67% reduction in serious perinatal complications." But, it doesn't tell me how high those risks were in the first place. The results were all based on women given the one-time glucose tolerance test and then followed accordingly. None of them had results based on a glucometer that sometimes differs by 50mgs on the same blood sample.
I've decided the risks don't merit this insanity. My blood pressure keeps coming up normal, the baby is growing normal, I'm not cutting back on whole grains or taking a drug or coming in every week for 3 months. I'm taking a break, and then checking in with my Ob when I've detoxed emotionally.
