Gestational Diabetes

Do I need to take the glucose tolerance test?

If I get a high score, do I need to take insulin?

For me the answer was no, and no! And here's the story:

• 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. I do not eat any processed foods, any chemicals, or any sugars processed out of foods. (As you may now ascertain, this means that I make almost every meal at home, from scratch.) 

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 (first) 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 adjust 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, 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.

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.