Some questions about the GD test.

I'm coming up to the time I need to do the GD test. There is a family history of diabetes (although it was self inflicted, poor lifestyle, not hereditary) so that's why I'm doing it. I'm a tad worried, I don't expect it to come back positive as I'm healthy, good weight etc, but if it does I'll be moved into caseload and lose our Homebirth, and I can't have that.

So. I was going to book it in for 24 weeks, or should I wait a bit longer? The timescale is 24-26 yeah? I made sure I got a referal for the 2 hour tolerance test and skipped the 1 hour challenge test altoghether, as I've heard all too often that the one hour one comes back high in many cases anyway, only for people to go on to have the 2 hour test and they are fine. I'd rather not have that stress :)

Also, my midwife suggested I have a lower GI diet before the test, less sugars, more whole grains etc. We have a pretty good diet anyway, but it could improve. How long before the test should we ramp up our diet in preparation? One week, two? I *think* the midwife said a couple of weeks, but I cannot remember.

I'm sooooo not the person to ask! My instructions every time have included a three-day carb binge before the test. Both for the two I did while pregnant and the two I did while not...

But I imagine it's not going to do any harm to change your diet in that way, so you could easily start with gradual changes now so that it becomes a normal thing and not just a change to prepare for the test that may become undone later.

BW

Haha well she actually said a carb diet was good! Potatoes, pasta, breads! So you're doin' it right according to my midwife :p I don't think I'll be keeping many of the changes, except less sugar. Less sugar is always good :)

i think the prime testing time is 24-28 weeks.

i think that a low GI diet is a good one to follow most of the time, so any time would be good to get onto that :) i was never told to eat a certain way before the test :dunno:

I had GD with the boys but not my DD... and she is middle child.. nothing you can do or change it.. I remember when i first found out i was devastated... To later find out its common and not a HUGE deal.. Lots of help, education etc.. so dont stress.

Good luck

With DS1 I had it at 27+6 weeks, the stupid Dr put me down for the 3hr test grr. I didn't have to go on any special diets or anything. With DS2 I just did the challenge test and it was done about 28 weeks too.

Good luck x

I've done the 2 hr test a few times. Low gi is the diet to follow for diabetes. However you have to have a high carb diet for the 3 days prior to the test. They should tell you that when you book in. Then u fast from
Midnight the night before, so book the test for early in the day, otherwise you'll be starving :).

I'm due to have mine at 26wks.

I've done it 3 times, at 28 weeks. Just the hour test, all came back fine.

I didn't follow a special diet either before testing.

This pregnancy I chose not to have the test.

I don't trust that test, a girlfriend of mine had it and came back positive - she is seriously THE most careful person with her diet, rides her horse every day, did everything textbook, and yet was diagnosed with GD. That just doesn't make sense to me ;)

Cathy Freeman has GD. That seemed weird to me lol. Unfortunately I need to do it or no HB :( I don't want to do it, I might look into not doing it if that's poss. Thanks ladies :D

GD is a funny one. Although diet and lifestyle help keep diabetes at bay, it can and does strike anyone. I've had a few friends who have been fine with their first babies and diagnosed with GD with their second babies. I don't believe there is a typical stereotype for GD at all. Two friends who had it only with their second babies are both fit, trim and healthy women. I just think it's one of those 'things', at least it seems to be in some cases! Cathy Freeman is a prime example of that.

I only had the hour test and it was fine. No special diet or instructions beforehand either. I'm little and generally very healthy but my diet and amount of exercise was far from ideal during my PG due to 24/7 nausea until 16ish weeks (I lived on icy poles!) then terrible back, pelvis and groin pain from around 20 weeks!

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GD is a funny one. Although diet and lifestyle help keep diabetes at bay, it can and does strike anyone. Cathy Freeman is a prime example of that.

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there are certain groups more prone to GD - indigenous people are one of them. and then there's other factors like age on top of lifestyle & hereditary ones. but i agree that there are definitely people who seem to get it for no apparent reason!!

as an aside, i was interested to see cathy freeman being talked about as having type 2 diabetes. when GD isn't quite the same. i thought it would have been a great time to raise awareness in general about GD.

Hi PZ

I failed my glucose challenge, so had to have the GTT. I was terrified of being diagnosed - because then the Obs start freaking out about huge babies, induction at 38 weeks etc and I didn't want any of that nonsense. I completely understand how you feel wanting to pass the test, because there are all sorts of consequences for the birth if you're even a tiny bit over the limits they set.

I scheduled the GTT for a week after I found out my GC results, then really cut back on the carbs, ate no high GI carbs whatsoever and started swimming every day. My instructions were to have no less than 150g of carbs per day, I didn't check whether I did this or not. They certainly didn't say to binge on carbs to me!

I also made sure I had some low GI carbs with every meal - but v small amounts - 1/3 cup pasta etc with a meal that contained mostly protein and veg. And I had low GI carb snacks during the day - a vita wheat with a slice of cheese, an apple etc. I didn't touch anything sweet for that week. Passed the GTT with flying colours, and am sticking to the low GI diet now, but not quite as obsessively strictly.

Oh, I recommend the Burgen wholemeal and seeds bread - it's v low GI - lowest I've found, so I eat that in small quantities - a couple of slices a day.

Good luck with your GTT!!

I would just go with whatever you are doing, I am not sure about changing your diet to try and change a blood test result like GD?
I would rather do I what I would normally do and the if it came up positive, then have a plan of action.
Changing your diet prior to the blood test will possibly not change the result at all.
I would think it would be better just to think about having a correct diet all the way through your pregnancy, then if the test comes up possible GD and subsequent tests show you have it, then it would be easier to mangage if you have already made those dietary adjustments.
Good luck with the tests.

I have to go with Heather, it's better to get true test results and deal with the gd if it comes back positive rather than trying to adjust the results.

I had gd with dd2 but not ds or dd1.

Hope it goes ok.

The only thing I would say about doing a special diet is that it can take a while to get the hang of it. So if you want to have a low GI diet before your test, best to start now.

PZ - I agree with Heather. Stick to your normal diet. You're eating healthily anyway. I know you're afraid of losing the homebirth, but try not to focus on that.

I did my 2 hour test at 26 weeks and was fine. I was eating healthily, but didn't have a perfect diet. A friend did it at the same time. It's suspected she should have done it at 28 weeks, as it's likely she developed late GD.

Her bub came 3-4 weeks early, was very big with poor blood sugars and slow response and ended up in the nursery for 10 days. He did not look well in his photos. They realised his mum probably had GD.

I know it's not the case for all GD bubs, but there's a good reason for them to be born in a hospital and close to a SCU/NICU. Some of them can be very sick.

I don't mean to scare you. I just want you to focus on keeping your diet healthy. Don't try to 'trick' the test. You really do want to know for bub's sake if you have GD or not.

btw - I have family with Type 2 diabetes and i was fine despite being overweight.

hon I am overweight and my OB always makes me do the 3 hour test every time, This time we are doing it earlier at 26 weeks. My frist two pregnances didnt have GD, havent had the test this time yet. My pathology always gives me a diet to follow for 3 days before the test on what to eat, it maybe different in different states. I have to ring up and book the test and thats when they give me the diet over over the phone or if I see them personally before the test.

It's just what my midwife recommend, she does that for all people apparently, not to alter the results at all. I will be shocked if I have it, I'm young and healthy and definitely not overweight. My aim is not to alter results, I doubt it is my midwives either, it's just what she recommends (and it looks like a few other people have been told to eat more carbs, exercise and less sugar too). Thanks for all the info and advice ladies. Our diet and my exercise are pretty great right now so I will just keep doing that, with the alteration of cutting down on my sugars :) But eek, I reread my post and I can't see how I was implying I'd be tricking the test, no no no. From what I've read my middie is okay in saying about the carbs, as it helps when testing time comes, as your body has had a break from excess sugars and then boom, hello sugar :)

Carbs break down into the body as sugar so you need to have some of them but not to many. It is not just a matter of stopping eating sweet stuff. My GTT came back positive this time round and I have never had GD before in any of the previous 5 pregnancies. I think it is just a luck of the draw situation. Hope yours come back fine

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It's just what my midwife recommend, she does that for all people apparently, not to alter the results at all. I will be shocked if I have it, I'm young and healthy and definitely not overweight. My aim is not to alter results, I doubt it is my midwives either, it's just what she recommends (and it looks like a few other people have been told to eat more carbs, exercise and less sugar too). Thanks for all the info and advice ladies. Our diet and my exercise are pretty great right now so I will just keep doing that, with the alteration of cutting down on my sugars :) But eek, I reread my post and I can't see how I was implying I'd be tricking the test, no no no. From what I've read my middie is okay in saying about the carbs, as it helps when testing time comes, as your body has had a break from excess sugars and then boom, hello sugar :)

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Your middie is not quite correct if that is what she said. A low GI diet is great if you are wanting to avoid or treat any form of diabetes but in will in fact trick the test if it is not a diet that you follow everyday. The test is trying to see how your pancreas handles stress which is why most labs get you to go on a carb loading diet for the few days beforehand...they are trying to see how your pancreas handles the stress and how insulin resisitant you have become. By going easy on the carbs for the few days beforehand and resting your pancreas you actually put it in better position to handle the glucose load of the GTT.

So your pancreas would actually give a better result than if you had followed your normal diet or the carb load diet in the few days before and used up the insulin stores. That is why they carb load you...to tip the pancreas over the edge....

Having said that I wouldn't stress too much about it.....you will either have it or you won't....gestational diabetes unlike type 2 is not realy diet related, it is very much hormone driven. your placenta is producing a whole heap of growth hormones that make you insulin resistant at this stage of the pregnancy...This places extra demand on the pancreas to produce extra insulin to do the same job it normally would.....most people's pancreas' can keep up with the extra workload, for some it is too much and they show signs of high blood sugars or GD. As a guide your body has to produce 2-3 sometimes 4 times as much insulin as when you are not pregnant to metabolise the same amount of food. Some people need twice as much and cope well, some need four times as much and get GD.....it is mostly a result of the hormones and nothing whatsoever to do with weight, diet, lifestyle etc.....

And having said all that...we should all follow a low GI diet all the time then we would all have nice stable blood sugars and no sugar cravings or related mood swings....imagine how much happier the world would be?!!! LOL

Oh jeez, having read some of these replies, now I'm worried I've mucked up the test. I told my Ob before I did the GTT that I had cut back on high GI carbs and was exercising, and he just said 'good' and passed no further comment, so I figured what I was doing was fine. I'm continuting my low GI diet for the rest of the pg. I guess I will have to check with him again when I see him in a couple of weeks. I wasn't trying to trick the test, I was trying to change my diet for the rest of the pg because I was worried my body wasn't coping with the amount of carbs I was eating, hence the slightly raised GCT results. Hopefully it is OK.

Honeybee - I wouldn't worry too much. Eating healthier can only benefit you and bub.

I should have mentioned by friend who had the GD baby really couldn't stop scoffing lollies. We can't be perfect. I know I had maccas too many times. Just do the best you can.

Did you get the GTT result?

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Your middie is not quite correct if that is what she said. A low GI diet is great if you are wanting to avoid or treat any form of diabetes but in will in fact trick the test if it is not a diet that you follow everyday. The test is trying to see how your pancreas handles stress which is why most labs get you to go on a carb loading diet for the few days beforehand...they are trying to see how your pancreas handles the stress and how insulin resisitant you have become. By going easy on the carbs for the few days beforehand and resting your pancreas you actually put it in better position to handle the glucose load of the GTT.

So your pancreas would actually give a better result than if you had followed your normal diet or the carb load diet in the few days before and used up the insulin stores. That is why they carb load you...to tip the pancreas over the edge....

Having said that I wouldn't stress too much about it.....you will either have it or you won't....gestational diabetes unlike type 2 is not realy diet related, it is very much hormone driven. your placenta is producing a whole heap of growth hormones that make you insulin resistant at this stage of the pregnancy...This places extra demand on the pancreas to produce extra insulin to do the same job it normally would.....most people's pancreas' can keep up with the extra workload, for some it is too much and they show signs of high blood sugars or GD. As a guide your body has to produce 2-3 sometimes 4 times as much insulin as when you are not pregnant to metabolise the same amount of food. Some people need twice as much and cope well, some need four times as much and get GD.....it is mostly a result of the hormones and nothing whatsoever to do with weight, diet, lifestyle etc.....

And having said all that...we should all follow a low GI diet all the time then we would all have nice stable blood sugars and no sugar cravings or related mood swings....imagine how much happier the world would be?!!! LOL

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Thanks so much for the info! I actually spoke to my gp about this yesterday and he said the same as you! So I called my midwife, and I kid you not, I got: "Well yes technically it may trick the test a little, but that's what we want, isn't it? You won't have it anyway so there's no harm."

:o Um NO I said. I want accurate results. I want good care. Yep I want a Homebirth but at what cost, to compromise test results, no. If I did have GD (soooo unlikely) I would probably hire an IM and still have my HB. I was a little shocked actually.

God I am so uninformed ATM lol. Not like me. So if I had a crappy diet would that sway the results too? (I don't!)

Wow what a strange response from a midwife!! I much rather my midwife who doesn't insist you have the test, at least thats better than doing the test, tricking the result and maybe not getting good care? My midwife offers the use of a finger pr!ck test for a few days to test your sugar levels instead of doing the test, if she thinks that you are showing symptoms of GD in the first place. Surely that would be a better option than to tell your patients to "trick" the test?

Everyone else has given great advice, so I will just say I am praying it comes back negative and you get the homebirth you want!!!!!

Good luck XXX

If you had a crappy diet all it would do would be to amplify GD symptoms such as high blood sugars because your pancreas would be over stressed......but the biggest factor in that will be the hormones which impede the effectiveness of the insulin. To put it another way, you have an overweight, crappy diet, biggest loser candidate type person, they will have insulin resistance as the fat cells impede the movement and effectiveness of the insulin cells. If you have a pregnant woman with hormones you have increased insulin resistance. Put the two together and you have a higher likelihood of tipping that particular pancreas over the edge into GD territory. But it doesn't automatically follow that it will occur...it all depends on how much resistance is occuring and how effective that particular pancreas is at picking up the slack.

As a type 1 diabetic my pancreas produces NO insulin of its own so you can see clearly in my body how a pregnancy affects insulin resistance. While I was pregnant I also suffered insulin resistance, EVERY pregnant woman does. My injected doses doubled over time from about 24 weeks till 37 weeks when Bubs was born. I have a friend who is also type 1 and about my size (healthy weight range) and her doses tripled...obviously her hormones affected her more than me....so you can see every person will react differently and I believe differently from one pregnancy to the next.....you can just cannot predict exactly who will and will not be affected by it.

Honeybee.....I wouldn't worry......the fact that you have gone low GI for the rest of the pregnancy will be a good thing and I am sure you and bubs will be fine.....If you are really worried about it the best way to monitor things would be to grab a finger stick blood test machine from the chemist and do a few tests over a few days, both fasting and about 2 hours after meals. These tests over a few days give a far more accurate indication of true GD than a one off blood test can, unfortunately it is not practical or affordable for the medical profession to make all pregnant women do this......compliance with that idea would also be an issue. I am sure you are just fine!

I agree with Taurean!!! GD is a funny thing. I had it with my first but didnt with my second on third so we'll see soon how this time goes. :)