Friday, July 12, 2013

Prenatal Glucose Test: Is it Necessary?

•50 grams of glucose •tap water •artificial flavor

     That's not what you'd expect to find on a “recommended” list for pregnant mothers, but those are the ingredients of the drink a pregnant woman must consume if she follows doctors orders for glucose tolerance screening.

    Women who are discerning with the things they consume during pregnancy--or at any time in their life--are not likely going to drink the glucose test beverage without, at least, asking: “Is this really necessary?”

    When pregnant,
    I told my OB-GYN that I wanted to do only the most urgent testing and screening necessary, and only those about which one can do something to improve the situation—in other words, no tests that involved a higher percentage of risk in the test than in the problem tested for, and nothing about which the only solution offered would be an abortion.

    She appeared to listen to my request. She said there were only about 5 tests that I should absolutely take, that I would need to fast for 12 hours, and they would draw a few vials of blood. At the lab the next day they drew my blood and then handed me a beverage to drink within 5 minutes (which was ice cold. Those with some knowledge of TCM and Ayurveda know that it is not advisable to consume any extremely cold food or beverage). My doctor hadn't mentioned a test involving a drink.

    I looked at the ingredient list and was shocked. I said there must be some mistake—this couldn't be a beverage for a pregnant woman. I wouldn't drink it at any time, much less expose my baby to those ingredients.

    The lab tech insisted that it was extremely important for the baby and that my doctor said I needed it. In hindsight I am disappointed that I was susceptible to this influence, but I forgave myself, understanding that pregnant women are especially sensitive to suggestions that are offered “to protect” their baby.

    I drank the liquid and immediately felt ill. 

    I've neither slammed a freezing drink like that, nor consumed 50g of glucose in my life, even on a full stomach.

    My test score came back high, a border-line “failure”, and I was advised that I would need to go the hospital to take the next step, a 100g glucose test. (My thought was, of course—it's like giving someone who never drinks alcohol 2 freezing cold beers to down in 5 minutes and asking them how they feel an hour later). I was advised that I would need to stay in the hospital for several hours, in case I went into a coma during the test!

    All the alarms went off that time, and I believed there was (at least for me) something very wrong about this approach to testing glucose levels and exposing unborn babies to that experience.

    I asked my doctor if I could simply continue to eat whole foods which do not cause glucose spikes, regularly test my own blood sugar levels with a home-test kit, and if the numbers were good, then there was indeed no problem and no need for further testing. She simply said: “No. If you want your insurance to pay, you have to take the second test.”

    I researched online and found hundreds of women all with the same questions and concerns, but none clear on what to do about it.

    I called my midwife, and she confirmed that I would need to take the second test.

    That day I did not figure out the next step in dealing with the glucose test, but I did know that it was time to find a new doctor and a new midwife.

    Finally, I decided to go it alone. I bought the test kit, ate meals I normally ate, and tested my glucose levels. They all fell in the normal range.

    When I finally found a doctor who seemed to genuinely care for and respected my approach to pregnancy and nutrition, I showed him my glucose level test log. His exact words were: “My patients, even the ones who aren't pregnant, would kill for these numbers.” My new midwife: ditto.

    So I had confirmation for what I already knew and wish I'd never doubted.

    My new doctor did go on to explain that the industry felt that many people would “cheat” or “lie” about their numbers if they were left to their own devices and testing, so they had to encourage these lab tests. When women failed the tests, they were generally not trusted to change their eating habits, so to protect the mother and baby, doctors would then recommend insulin.

    Fair enough.

    But for mothers who are willing to control what they eat, who do not want to expose their baby to glucose rushes and chemicals, and do not want to take insulin, and whose diet indeed maintains proper glucose levels (not always the case), there is an answer—or at least there was for me.

    My approach may not be the correct approach for all, but at least along with all the confusion and questions about the test one finds in the “pregnant community”, there is an answer from someone who experienced it, found a different answer, and at 42-years old, gave birth at home to a healthy 7lb 14 oz baby.

    A few tips I found important in meal preparation:

    • include protein and a small handful of nuts when eating complex carbs
    • simple carbs will cause spikes
    • flour and pasta—even whole grain—will cause higher numbers. Ideally stick to eating whole grains rather than those processed in any way
    • eat smaller more frequent meals
    • if you do eat whole grain flour products, you can help by adding whole grains to the mix (i.e. whole wheat bread with cooked amaranth, quinoa, whole oats, or millet, etc.)
    • brown rice, yams, cherries, and berries are some of the top carb sources

    I appreciate that gestational diabetes can be a serious matter and must be tended to.  There are instances where changes in diet are not sufficient and medication is required. But just as with birth choices, there are different answers for different people. No matter what the situation, if you do not feel comfortable, ask and ask again. Because just one person saying “you must”, “urgent”, or “for your baby's protection” doesn't necessarily mean it is so. 


    "This is my body, my baby, and my birth.
    I choose to birth in an atmosphere of mutual respect. 
    My body and my baby are handled with love."


    UPDATE: MAY 29, 2014

    FURTHER READING ON GLUCOSE TESTING: I read an excellent article just posted on this subject that is one in a series by Aviva Romm.  For those interested in learning more detailed information about the harmful ingredients in many glucose test drinks and alternatives, click hear to read Aviva's article. 

    ALLIE CHEE After earning a BA in literature and a 2nd degree black belt in Korean martial arts, 20 years traveling in 50 countries, working in numerous entrepreneurial ventures, and serving as co-publisher of a leading financial industry magazine, Allie Chee lives in Silicon Valley with her husband and daughter and is a student at Stanford.

    Her articles have appeared in: 
    •  The Well Being Journal
    •  The Holistic Networker
    •  The Birthing Site
    •  Natural Mother Magazine 
    •  MidwiferyToday

    Her published titles are: New Mother, Free Love, & Go, Jane!


    Anonymous said...

    I thought this was very thought provoking and good advice for those who choose to eat as naturally as you do (which I would think many of your readers do). For those who don't, the glucose test may indeed be very important to assess the health of both the baby and mother. You do offer disclaimers throughout that state what you did was best for you. It also suggests women should ask the question "is this really necessary". There are plenty of times I advocated for patients not to do a test. However,I think with the state of our changing healthcare system, we will see a lot of re-evaluating to decrease waste and contain cost. That is a good thing, I just hope the pendulum doesn't swing too far and things get tragically overlooked....

    Anonymous said...

    I have just been diagnosed with GD after taking the 100 g glucose test after having elevated levels on the 50g glucose test. My primary concern in believing the results of this test are my size and my weight. I have no other risk factors, I am shorter than average and on the very low end of the weight scale for people my height, yet my body is supposed to process the same amount of glucose as someone twice my weight in order for me to test "normal". At the very least there should be some adjustments to the amount of glucose based on weight. I will do home tests as you have done before I even consider insilin.

    Anonymous said...

    I've been told I have "Gestational diabetes". After having an abnormally high sugar level ( 5 hours after stuffing myself with cookies and other such sugary/high carb goods) I had to go back for the 3 hour test. After drinking the freaking 100 g crap I felt entirely ill. I felt almost as if I'd been forced to consume an entire 2 liter of mountain dew in 10 minutes. This is after fasting for over 12 hours. I have never ever had that much sugar in my body at once. It was more sugar then I take in in a normal 3 day period. Now...I'm being forced to stab my fingers 4 times a day. After childhood traumas of getting my fingers lanced once every 3 months cause my mom got WIC for me and my brother. Only chance I have to cut that down is if I can prove that dieting alone can keep my glucose levels down. If I can't do it with dieting and exercise I have to get either oral meds, or in extreme cases, insulin.

    I still think that they should've let me fast for another 50 g test (seeing as how I ate sugary stuff so close to the first one) before shocking me with the 100g test....probably would have had normal blood sugar.

    Pharmaceutical Research said...

    U.S. glucose testing is undergoing a significant transition, driven by new analytical technologies and developments in diabetes treatment. Although the blood glucose testing segment of the in vitro diagnostics (IVD) industry is mature, several segments of the market, such as home testing devices for diabetes management and point of care (POC) instruments for use in professional settings, will exhibit strong growth. Direct access testing has emerged as a strong force in the blood glucose testing segment, and non-invasive and minimally-invasive testing now represent major new areas for the application of IVD. U.S. Glucose Testing Market

    J. Bascom said...

    I agree completely regarding the suggestion that not all people require all tests. I wonder just how many tests are done to how many women that are unnecessary for their situation.

    Thanks for encouraging mothers to study, explore, to ASK questions, and take responsibility for their health.