May 4, 2001
Gestational Diabetes
Question from Los Angeles, California, USA:
I am 30 weeks pregnant and my doctor says that I have gestational diabetes, but I do not agree with the diagnosis. I failed the one-hour glucose tolerance test with a value of 163 mg/dl [9.1 mmol/L] so I did the three-hour test and the results were 87 mg/dl [4.8 mmol/L] (should be less than 95 mg/dl [5.3 mmol/L]), 194 mg/dl [10.8 mmol/L] (should be less than180 mg/dl [10 mmol/L]), 158 mg/dl [8.8 mmol/L] (should be less than 155 mg/dl [8.6 mmol/L]), and 59 mg/dl [3.3 mmol/L] (should be less than 140mg/dl [7.8 mmol/L]). According to my HMO, two of these levels are elevated, therefore I have gestational diabetes. I think the cut off levels they are using are excessively conservative, and according to other cut off data I have found, only one of my numbers is elevated and only marginally.
It seems to me if I do have gestational diabetes I am a very borderline case, and I do not see the need to be classified as high risk and subjected to constant blood tests and monitoring as well as a diet I consider to be restrictive and completely unnecessary. I am very angry about this and especially upset about this meaning I am at great risk of developing diabetes later in life.
It is also making me have very negative feeling towards my doctor my pregnancy, and my baby. I am considering asking to be induced at the earliest opportunity.
Answer:
I understand that no one likes getting abnormal test results. According to the most recent recommendations (which is stricter then previous glucose values), you fulfill the criteria for gestational diabetes. I would agree that you have mildly elevated values and will probably do well on a diet, particularly since your fasting blood sugar is normal. The diet is important to prevent hyperglycemia which in term can lead to an overweight baby with potential complications at delivery and in the nursery. You are at increased risk of developing diabetes later in life, but this is not an absolute. In fact, you can minimize your risk with proper diet and exercise. Your doctor and baby have nothing to do with these test results, so do not be angry at them. Finally, there is no need at this point for any early delivery. You will do fine during this pregnancy with proper attention.
OWJ
