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Conference moira::parenting

Title:Parenting
Notice:Previous PARENTING version at MOIRA::PARENTING_V3
Moderator:GEMEVN::FAIMANY
Created:Thu Apr 09 1992
Last Modified:Fri Jun 06 1997
Last Successful Update:Fri Jun 06 1997
Number of topics:1292
Total number of notes:34837

94.0. "Screening for gestational diabetes" by FLAN::COZZENS () Tue May 05 1992 14:28

    I didn't see this question so I am hoping that someone can help me.  My
    doctor said that around the 24th week they do a diabetes screening. 
    Can someone tell me what this is all about and what is involved, just
    a blood?  Someone said that you have to drink something then they do
    the test.  The problem that I foresee, has anyone else had this
    problem, is that unless I eat first thing in the morning, I get sick -
    I vomit (still).  What happens if I am unable to keep this stuff down 
    before they do their tests?  Does anyone have any advise to offer?
    
    Thanks,
    Lisa Cozzens  
T.RTitleUserPersonal
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94.1Drink soda - wait - blood testDKAS::DKAS::GOODWINMalin GoodwinTue May 05 1992 14:4120
I had this test done a few weeks ago. Nothing was said at the time about not 
eating before the test, I had my usual breakfast before going to the doctors.

The procedure was quite simple. I was given a carbonated orange soda type drink.
It was cold and should be consumed within 5 minutes. After that it 
was just to wait for an hour (bring a good book). After the completed hour a 
blood test was taken.

(I was given the option to come by the lab, pick up the drink and bring it home,
drink it at home when connvenient and then show up at the lab for a blood test
an hour later.) 

I had no problems, the worst was to drink all that cold soda (10 oz I think) in
a short time, I usually prefer drinks that are not ice cold.


Hopes this helps

/Malin
94.2Cola, take homeEMDS::CUNNINGHAMTue May 05 1992 15:0114
    
    I was given the syrup (Cola flavored) to take home at my previous
    visit. Dont remember being told I couldn't eat (that would of been
    tough being my appt was at 4pm), but just told to drink the syrup
    (cold) 1 hour before my appt and nothing else (I brought it to work).
    
    Then they just took some blood and that was it.
    
    Everyone said the syrup would be AWFUL tasting, but I didn't think the
    Cola flavor was bad at all. Just tasted like flat coke. 
    
    Enjoy your pregnancy,
    Chris
    
94.3you can eatCRONIC::ORTHTue May 05 1992 15:1326
    For the initial diabetic screeining, which they do on virtually all
    pregnant women, you may, indeed, eat beforehand. Sometimes they will
    tell you to try not to go heavy on very sugary stuff, sometimes, not.
    You drink a glucose laden soda type drink, wait one hour, and they draw
    blood. That is all there is to it.
    
    If the results are not within normal range ( and sometimes, even if
    they are, if they're at the high end of normal), you go for a 3 hour
    test. This one is fasting (no food). Blood is drawn (if I remember
    correctly) right at first (a urine sample is collected then, too), then
    after one hour, two hours, and three hours. If you throw up during the
    3 hours, it botches it all up, and you'll have to do it agian.
    
    Usual time for the inital screeining is 28 weeks. I've not heard of it
    at 24.  My wife's endocrinologist said the reasom for this is, that if
    you are going to become gestationally diabetic, the usual time for it
    to really surge up (blood sugar will rise dramatically) is between 26
    and 28 weeks. To do it sooner, can mean missing this. My wifes' was
    detected the first pregnancy at this 28 week screening, though was
    probably present much earlier. In the subsequent pregnancy it showed
    up at 12 weeks. But at 28 weeks on the button, there was a dramatic
    jump in her blood sugar, and her need for increased insulin.
    
    She says one hour tests are a piece of cake!
    
    --dave--
94.4Just a warning...NEWPRT::NEWELL_JOLatine loqui coactus sumTue May 05 1992 15:485
    By the way, if you're on Brethine or Terbutaline for asthma or
    preterm labor, your sugar levels will most likely be high enough 
    for the doctor to require the 5-hour glucose test.
    
    Jodi-
94.5Is this standard?SSDEVO::HODGESTue May 05 1992 17:2613
   Hmmm...I've heard people talk about this test before, to the point that
   it sounds like it is fairly common practice. However, I NEVER had it
   done when I was pregnant. I had my daughter in the summer of 1990.
   Did they possibly make it "standard" after that? Anyone know why
   some pregnant women are not asked to take this test? I never had 
   any tests (not even an Ultra Sound), except when they drew
   blood and took a urine sample in my 1st trimester (?) to test iron count, 
   etc.. 

   Just curious...

   Julia
94.6NEWPRT::NEWELL_JOLatine loqui coactus sumTue May 05 1992 18:3911
    RE: .5
    
    Most likely, oversight.
    
    I was a high-risk patient and at 35 weeks I asked my OB
    about the test because of some discussion going on in this 
    notes conference.  She was embarrassed to admit that she had
    overlooked the fact that the test wasn't ordered.  I did, 
    however, receive every *other* test in the book :^) 
    
    Jodi-
94.7pretty standard in northeast U.S., at leastCRONIC::ORTHTue May 05 1992 18:4619
    I'd agree probably an oversight.
    
    What area of the country do you live in? It's pretty well standard
    procedure in the northeast U.S., anyway. My wife had it done routinely
    for all 4 kids, starting in 1985.
    
    Just a note... ultrasounds are *not* routine, at least not for most
    dr.s.  There are some who do do them routinely, but the A.C.O.G.
    (American College of Obstretrics and Gynecology) does not recommend
    this. I think those who recommend it routinely are trying to cover
    their tails, in case something goes wrong, that the parents cannot
    later come back and say, "If you'd done an ultrasound, you would have
    detected this". My wife had one with the first cause they suspected a
    possibility of twins. The second pregnancy she had one done because the
    first one had been premature. The third and fourth she was
    gestationally diabetic, and had umpteen ultrasounds (I believe a total
    of 19 with the last child!). 
    
    --dave-- 
94.8A1VAX::DISMUKESay you saw it in NOTES...Wed May 06 1992 10:438
    The blood sugar levels can be tested with urine (which they ask for at
    every visit, right).  They may be doing the ol' litmus test and if you
    are borderline they will ask for a more accurate test.  I don't recall
    having the diabetes test done on me with either, but then that was a
    long time ago (heh - 5 years)
    
    -sandy
    
94.9additional warningKAOFS::M_FETTalias Mrs.BarneyWed May 06 1992 10:5126
    As far as I know the glucose tolerance test is standard procedure
    in Canada too. I had it for both pregnancies, and had the 3 hour
    one done inbetween the two, just to rule out sugar problems as 
    a reason why the first did not survive to term. 
    
    In all cases I drank about 10 - 12 oz of stuff that looked like
    syrup of Orange Crush. While I did not get too much nausea,  I did 
    experience a great sleepiness near the end, When I commented about this 
    to the lab staff they said it was a very common reaction. So sleepy
    in fact, (during the 3 hour one) that it made it difficult to drive
    home.
    For the 3 hour one I had blood drawn 6 times. I don't have a phobia 
    about needles, but I have very small veins -- I was quite sore after
    the test! 
    
    On Ultrasounds: As far as I know, in Quebec, every expectant Mother
    gets, routinely, an ultrasound at 18-20 weeks and another at 28-30
    weeks. In Ontario only the first is routinely ordered by doctors.
    I have been getting one a week, just as a precaution, and as I have
    mentioned elsewhere, this is done by an OB and not a regular
    technician. The OB scores the baby (much like the apgar at birth) 
    for such things as "breathing practice", state of the placenta,
    position, etc. (Gosh and I always hated tests as a kid and here my
    child is being tested and scored even before its born!)
    
    Monica 
94.10not standard here?SSDEVO::HODGESWed May 06 1992 13:1324
                        <<< Note 94.7 by CRONIC::ORTH >>>
                -< pretty standard in northeast U.S., at least >-

>    I'd agree probably an oversight.

    Actually, after reading later replies, I do remember supplying a urine
    sample at almost (or all) visits. And as later stated, maybe they measure
    the level and do a test only if it is suspcious??  I think that this
    is probably why I didn't get one.
    
>   What area of the country do you live in? It's pretty well standard
    procedure in the northeast U.S., anyway.
    
    I live in the Mid-west (Colorado). I'd say about 50% of my friends
    have had the test and 50% haven't.

>   Just a note... ultrasounds are *not* routine, at least not for most
    dr.s.  

    Agreed - my doctor doesn't do them unless he suspects problems or
    needs to reassess the due date. I guess my point was that since he
    didn't suspect any problems along these lines, maybe that's why he 
    didn't have a gluecose test done??

94.11test, test, test!9886::CLENDENINWed May 06 1992 13:1615
    
    The glucose tolerance test is done at 28 weeks generally.  Like
    everyone has said it realy is a very easy test.  
    
    The ultra sound is done differently by ever doctor, some do it between
    14 and 18 weeks just to check due dates,  I had 4 done with my first
    pregnancy.  The first was to check my due date, the 2nd the tech did 
    not get the pictures the doctor wanted, and the last 2 I had because
    my daughter was 15 days late and they just wanted to make sure
    everything was ok.
    
    Enjoy the pregnancy.
    
    Lisa
    
94.1212 hour fast beforehandVMSSG::KILLORANWed May 06 1992 14:5133
    
    I was told to fast 12 hours before the test.  They did both
    blood and urine.    I flunked and had to go in for the 5
    hour test.   They took blood first to get my fasting glucose
    count.  Then they made me drink the horrible orange drink.
    The Lab Tech gave me a glass of water afterwards to take the
    taste away.  She told me that I could have as much water as
    I wanted.  Then repeated the test by taking blood and a urine
    sample every hour.
    
    I thought what a horrible thing to do to a pregnant women. 
    Plus I had the worst heartburn and they wouldn't let me take
    any Tums.  
    
    Unfortunately I was diagnosed with GD.  They put me on a special
    diet for the rest of my pregnancy.  The good thing is I didn't
    gain any weight.
                    
    It was a very frightening thing.   This notefile explained alot
    about GD.  It made me feel like I was not alone, and that was
    very comforting.  If you are diagnosed with it, you will have it for
    every pregnancy.   Now I know what to expect next time. 
       
    
    Jeanne
    
    
                                                 
    
     
    
    
    
94.13commentsCRONIC::ORTHWed May 06 1992 17:4128
    Some points to clear up....
    
    The urine test done at every visit can test for sugar in the urine, but
    that is not what they are checking for! They are checking for protein
    in the urine (sign of toxemia). They usually do check for sugar
    too, but if your blood sugar is high enough to register in your urine,
    you are in trouble! Blood sugar must be 180 or above to show in urine,
    and it should *never* be allowed to get anywhere near that high in GD.
    
    reply .12 mentioned fasting for 12 hours. This cannot have been for the
    one hour test, cna it? Very unusual if it was! Your comment about
    muliple blood samples leads me to think you meant the three hour test.
    Is that right?
    
    On the comment in previous reply (sorry, can't recall which one) that
    they maybe didn't test cause they had no reason to suspect anything. GD
    is a "silent" problem, usually. You usually never would even suspect it
    was there. When my wife went back for her 6 week postpartum check after
    her first GD pregnancy, her dr. asked if she felt normal and
    "un-diabetic". She replied she never had "felt" diabetic, so she wasn't
    sure!  They checked her blood sugar and it was normal.
    
    "Regular" diabetics have more symptoms than GD's. Blood sugar is kept
    under *much* tighter rein with GD's than non-pregnant "regular"
    diabetics.
    
    --dave--
    
94.14fasting for just 1 blood sampleTARKIN::TRIOLOVictoria TrioloWed May 06 1992 18:028
    
    I had a twelve hour fast for 1 blood sample.  I was told to drank the
    horrible orange soda and wait 1 hour and then have them take a blood sample.
    At the forty-five minute mark, I proceeded to almost faint so
    they made me lay down, ordered breakfast for me and took the blood
    sample.
    
    This was done at St. Vincent's hospital in Worcester, MA.
94.15VMSSG::KILLORANThu May 07 1992 12:0343
    
    .13
    
    Dave,
    
    I was told to fast before the 1 hour and the 3 hour tests.
    When I arrived at St. Joes Hospital in Nashua they asked
    me if I had eaten anything in the past twelve hours.  If
    I had, they would have rescheduled my test.
    
    My glucose count was at 260 after drinking the orange drink.
    I believe that normally your readings should be 60 to 100.
    They would like to see it around 80.    I was able to get
    it under control by diet and then number went down to the
    70's.  What a relief.  Another thing was I had to check my
    urine every morning for Ketones.  
    
    An easy way to explain what Ketones are is:  After a person's
    body has burned up all the calories/enzymes in their food - then they
    start burning Ketones - Ketones are like a waste and bad for the 
    baby's system.   They can be past over to the infant.   The
    diabetic educator at the hospital used an example of a fire
    place with logs - you burn the logs and are left with ashes.
    The ashes are the Ketones.  
    
    The biggest worry is that if a woman is diagnosed with GD,
    she can develop diabetes later on in life (from age 40).
    Your chances of fighting it are a well balanced diet, 
    exercise and to keep your weight down.  
    
    Another thing if this goes undetected, after the baby is
    born it can go into shock.  It's glucose levels can be
    out of wack.  It's pancreas may be in overdrive.  When
    I was in labor everyone at the hospital was allerted 
    that I had GD.  Fortunately things turned out fine and
    the baby was okay.  Sometimes they have to give the
    baby an IV, or give it sugar water to get the levels
    right.
    
    Jeanne
    
    
    
94.16some fasting:KAOFS::M_FETTalias Mrs.BarneyThu May 07 1992 13:175
    I only had to fast for the 3 hour test - I checked with
    them specifically the first time for the 1 hour; they said I 
    did not have to.
    
    Monica
94.17no eating OR drinking\ASABET::CARTERMon May 11 1992 16:099
    When I had this test done my appointment was made for 9:00am and I was
    instructed not to eat OR drink anything from midnight on.  This test is
    done in my Dr's office in Framingham and needless to say I hit
    Friendly's immeadiately after the test.
    
    My Dr also told me the test needed to be done between 26-28 weeks for
    best accuracy.
    
    ..Tracy
94.18interesting...BSLOPE::BOURQUARDDebMon May 11 1992 19:429
I had the "O'Sullivan screening" last week or so (around 28 weeks).  My
appointment was at 4pm, and they recommended that I eat a snack (though
not a hot fudge sundae) prior to the test.  I ate a pear.  Drank my "margarita"
and had my finger pricked an hour later.

Mostly I'm surprised that some doctors require fasting.

My results were within normal ranges, so lunch and the pear did not raise
my glucose levels sufficiently...
94.19CIVIC::MACFAWNTraining to be tall and blondeTue May 12 1992 14:465
    Being a "real" diabetic, I can say that GD sounds a lot simpler than
    the real thing.  I went through two pregnancies, which was a nightmare,
    but was well worth it in the long run.
    
    Gail
94.20Only had to drink 1/2 the bottleWYNDE::TILLERYWed May 13 1992 10:485
    I had the test done yesterday, and I'm 26 weeks.  I only had to drink
    half the bottle of liquid, and they wrote on my slip that I could eat.
    Easy test, blood was drawn an hour after I drank the liquid.  
    
    Sue
94.21flunked 1 hr., passed 3 hr.WYNDE::TILLERYFri May 22 1992 12:176
    Just an update to my previous reply.  I didn't pass the screening
    for diabetes, so I had to do the 3 hour diabetes test, but I passed
    that with flying colors.  I wasn't even close to being on the high
    side.  Who can figure...  don't know why I didn't pass the screening.
    
    Sue
94.22A1VAX::DISMUKESay you saw it in NOTES...Fri May 22 1992 12:326
    My sister always flunked the 1 hr test, but passed the 3 hr test. 
    Seems when she ingested sugar it took longer to process than usual so
    her tests were way off.  Helps not to eat Snickers for breakfast!! 
    
    -sandy
    
94.23How is a "real" diabetic pregnancy worse???CRONIC::ORTHFri Jul 10 1992 20:3221
    Gail, 
    
    Don't know what it is like for a "real" diabetic, but can't imagine
    it's any worse than what my wife went through! By pregnancy's end, she
    was testing her blood 4x daily, taking 80 units of NPH at 8 pm, and 15
    units regular before each meal. She was being seen weekly for OB visit,
    ultrasound, and non-stress test. They delivered her 2.5 weeks early for
    fear of extreme fetal size (Jake only weighed 7lbs. 6 oz! Daniel
    weighed 8 lbs. 15 oz. with our first GD pregnancy).
    
    Her diet requirements were extremely rigid, and her endocrinologist
    conferred with her by phone every other day the last 6 weeks, to insure
    proper insulin regulation.
    
    How is a "real" diabetic pregnancy different? Or worse? Doctor expects
    her to become a "real" diabetic sometime in the future. Could be any
    time, actually, she needs to be tested yearly now. 
    
    Just curious!
    
    --dave--
94.24DECWIN::JACKIEJackie FergusonTue Jul 14 1992 16:4427
I just had the three hour test this morning, slightly different procedure
than some of the earlier notes I read here.  I had the short test done last
week at 28.5 weeks, this one was done at 29.5 weeks.

I had the test done at 8:45 in the morning, and was told to fast from midnight.
When I first got to the lab, they did a urine sample and blood.  The 
technician said that she wanted to do all the blood samples in the same 
vein, unless it started to get sore.  Then I got to drink the whole cola drink. 
When I did the shorter test, I only had to drink half the bottle, this time I 
had to drink the whole bottle.  Then I had to do urine and blood at the 
following times- half hour past the initial drink, one hour, two hours, and 
three hours, for a total of five drainings.  At the one and two hour drainings, 
I was allowed to have one glass of ice water, that was it.

The worst part was giving the urine samples at the half and one hour mark,
without having anything to eat or drink since dinner the night before.  I could
have prepared better for this if I had known :-)  Fortunately, I was able to
come up with the very small amount that they need.

I felt a little upset around the one hour mark, but having the water helped
to get the cola taste out of my mouth.  I also felt a bit dizzy as I wolfed
down my lunch when I got back to work.

They say the results will be back in one to two days.  My initial test was
slightly high (so the nurse told me) so I'm hoping I passed this one.

Jackie
94.25VMSSG::KILLORANWed Jul 15 1992 17:1042
    
    
    Hi Jackie,
    
    If you felt dizzy or tired, it might mean that you have
    GD.  I was told that it is a side effect.  Then again,
    it may have mean't nothing at all.
    
    When I was diagnosed with GD last summer, I thought it
    was the end to the world.   But next time I know what to
    expect and am not bothered by it.   
    
    The OB/GYN had me meet with the Diabetic Educator at the 
    hospital.  She explained what caused GD, and watched a 
    little film.  She also explained how to check my glucose
    levels (I had the nurse do it in Health Services because
    I am too much of a baby to prick my finger myself).  Then
    she gave me a booklet with instructions and a chart to
    keep track of the levels.  Once they knew I was following
    the diet and my levels were under control, I only had to
    have my blood tested once per week.  Also every morning
    I had to check my urine for Ketones.  
    
    The diet was very easy.  In the morning for breakfast I
    was not allowed to have fruit.  I could have tea and toast
    with butter and an egg, or a bowl of cereal (cherios, or
    corn flakes for example - not cereal with sugar added).
    Morning snack a piece of fruit and some cheese - or milk.
    Lunch - I had a sandwich with meat and cheese, I could have
    a potato chips if I wanted and a something to drink (milk,
    water something sugar free no juice).   Afternoon snack
    was yogurt.  Then dinner meat or fish, vegies rice or potato.
    I had to have a snack around bedtime - since I was not a 
    big milk drinker they recommended that I have a bowl of 
    cereal.  This is to help prevent Ketones in the morning
    urine.
     
    Good luck, 
    
    Jeanne
    
    
94.26test turned out ok.DECWIN::JACKIEJackie FergusonWed Jul 22 1992 15:2613
I got the results of the test today at my regular visit.

The 1 hour test had had a reading of 167, and my doctor said that they wanted
it to be under 140.

On the three hour test, they look for it to be under 160, and three of the five
readings must be above that to fail the test.  Only the reading at the one hour
mark was high, at 164.  The initial reading before having the drink was around
70, I think, which she said was very good.

So, it looks like the 1 hour and 3 hour showed the same thing.

Jackie
94.27Great newsVMSSG::KILLORANThu Jul 23 1992 10:5812
    
    
    Great news Jackie.  It's good to hear that you are fine.  
    
    My readings were 92 before the drink, 1st hour 245, 2nd hour 228,
    and the 3rd hour 222.  They gave me one week to get the glucose
    count down and under control by diet.    
    
    
    Jeanne
    
    
94.28fail 1 hr; pass 3 hrCRLVMS::HALBERTmail to CRL::HALBERTWed Sep 23 1992 18:5610
    Just to reassure others who might be worried between tests:
    
    My wife also did not pass the initial one-hour diabetes screening test,
    which gave a reading of 168, and started worrying about the possibility
    of GD. But she passed the three-hour test with no trouble. Based on
    notes in this conference and its previous versions, and asking around
    among friends, it's apparently quite common to fail the first test and
    pass the second. I wish we could have seen some statistics.
    
    Dan
94.29We flunked the 1hr. test.NUPE::hampButtonflyed!Tue Oct 19 1993 14:4611
Reading these replies have made me feel better and I hope to pass on
those good feeling to Tam.  She got a call today telling her that she
flunk her 1 hr test. (She was boarderline).  Soooo, she's schedule for
the 3 hr. next week.  This is our second pregnancy.  No such problems
with our first.  She has been ill lately with a cold and a sinus 
infection for which she has been taking antibiotics.  Would that have
any affect?  They also told her that she needs to start taking iron 
supplements.  She did take those the first time around.


Hamp
94.30no big dealKAOFS::M_BARNEYDance with a Moonlit KnightTue Oct 19 1993 15:298
    a borderline result is not uncommon, and in my experience they
    will easily ask that one performs the 3 hour test. I passed my
    1 hour with flying colours the first time, but after I lost the 
    baby late in the pregnancy they decided to give me the 3 hour
    just as a precaution. Lots of nausea later, they said I was okay.
    (Actually the most surprising side effect was the sleepiness)..,
    
    Monica
94.31GOOEY::ROLLMANTue Oct 19 1993 15:448

I failed the one hour test, but passed the
3 hour test easily, only 1 week later.

go figure...

Pat