My wife is 29w pregnant. She just completed the routine OGGT 2 hour test.
Her results and reference ranges are as follows:
Fasting: her result 93
Reference range <92
1 hour: her result 145
Reference range <180
2 hour: her result 92
Reference range <153
I was happy as a clam to see those results. She is fit, she’s not overweight, even for being thus far along in pregnancy…
I was shocked to see the message from her HCP that because her fasting lab was 1 mg/dl above the reference range (a range I consider extremely tight) that they’re now considering her as having gestational diabetes.
I’m not all that concerned about the labs, frankly, I’m just not. We are both concerned about how this assesment/ diagnosis will shape the lens of how her third trimester healthcare and advice will go.
I’m really pretty frustrated with this. In my estimation, which in my estimation could be considered pretty expert; there’s absolutely nothing wrong…
But now based on this it could effect everything for the next two months
Would really like to hear from other moms about their experiences
Wow… now they’re saying that because in a week of home testing, on a home testing meter, because she’s had more than one fasting reading above 95 (which were like 97 and 99) (and we’re all aware of their accuracy parameters) that they’ll almost certainly be recommending insulin.
This is at one of the nations leading hospitals. I am so confused. Her hcp did try to explain how different GDM is than other types in its considerations. I’m so confused.
Additional context is that we are at what’s considered “advanced maternal age” and it’s her first pregnancy… but I have all sorts of confusion about what if anything any of that means in this context
Guidelines on the diagnostic criteria for gestational diabetes differ widely. It looks like your hospital follows the very strict IADPSG guidelines introduced in 2010. I guess that’s medically valid, but still arbitrary. Putting someone on insulin for having a reading slightly above 92 seems excessive to me.
At the time these guidelines were introduced it was already questioned whether it really made sense to double the number of diagnoses overnight, like one fifth of all pregnant women.
It does seem unreasonable and in your situation and that of your wife’s, I would not think it a good idea at all to be given insulin. Firstly, there seems to be no need at all and secondly, in my opinion it would interfere with her body’s assessment of the situation and compromise the working of the pancreas. I have brittle T1 diabetes and know what a very difficult tightrope it is to walk when using insulin.
Congratulations to you both and I hope this, as you say ‘unreasonable’ diagnosis will not spoil it too much for you both.
I’ve never been pregnant, but I would think with the accuracy of blood glucose monitoring as wild as it is (+/- 20% for meters or CGM etc), they would be a little more forgiving.
If I were in your shoes, I wouldn’t do insulin. The recommendation of NPH is absolutely mind-boggling. I was on that 30 years ago. For like 2 years. Then I got a pump, but better insulins came out soon after…
Apparently this is a thing though, internet is full of people talking about how they were immediately put on NPH in third trimester with a fasting of 95
I don’t know if that is the answer. Maybe just keep an eye on her BGs and see what happens. You’re probably taking better care of the baby that way, by routinely checking BG, than taking insulin willy-nilly, as many people probably do (and not monitoring BG as much).
They’ve explained quite a bit more about why they’re so worried about keeping blood sugars on the lower end of normal range in third trimester
Apparently by this point the baby is producing all of its own insulin— but if it’s being fed blood with even ever so slightly elevated levels (apparently this often presents as fasting levels instead of PP during pregnancy,) the baby’s newly formed organs are being overworked to keep them under control which can lead to many problems down the road.
Hell, who knows maybe that’s why some of us are here.
Apparently what we’re being told is all pretty standard, just incredibly new to me and quite a different lens to try to look through
