# Unreasonable gestational D diagnosis
**URL:** https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994
**Category:** D & Pregnancy
**Created:** [November 12, 2024, 5:59am UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994 "2024-11-12T05:59:40Z")
**Posts on this page:** 15
**Page:** 1
### Author:  [@Sam](https://forum.fudiabetes.org/u/Sam)
#### Post date: [November 12, 2024, 5:59am UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/1 "2024-11-12T05:59:40Z")
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
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### Author:  [@Eric](https://forum.fudiabetes.org/u/Eric)
#### Post date: [November 12, 2024, 3:54pm UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/2 "2024-11-12T15:54:47Z")
Congrats again on the baby, @Sam!
I think @TiaG had a similar experience. Hopefully she will see the post.
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### Author:  [@jim26](https://forum.fudiabetes.org/u/jim26)
#### Post date: [November 12, 2024, 10:59pm UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/3 "2024-11-12T22:59:17Z")
Congrats!!
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### Author:  [@Sam](https://forum.fudiabetes.org/u/Sam)
#### Post date: [November 14, 2024, 10:51pm UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/4 "2024-11-14T22:51:50Z")
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
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### Author:  [@Sam](https://forum.fudiabetes.org/u/Sam)
#### Post date: [November 15, 2024, 9:21pm UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/5 "2024-11-15T21:21:41Z")
And they are talking about NPh… again this is like a leading hospital. I am so confused.
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### Author:  [@Boerenkool](https://forum.fudiabetes.org/u/Boerenkool)
#### Post date: [November 15, 2024, 11:22pm UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/6 "2024-11-15T23:22:53Z")
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.
> 
> Source: [Diagnosis of Gestational Diabetes Mellitus.](https://pure.rug.nl/ws/portalfiles/portal/789751108/978-3-030-89243-2.pdf) In Comprehensive Clinical Approach to Diabetes During Pregnancy (pp. 29-50). Springer International Publishing AG.
(5.1 mmol/l = 92 mg/dl; 10=180; 8.5 = 153)
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### Author:  [@Sam](https://forum.fudiabetes.org/u/Sam)
#### Post date: [November 15, 2024, 11:24pm UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/7 "2024-11-15T23:24:29Z")
It seems incredibly excessive to me… they’re describing that it’s all about the baby’s health…
Just such a foreign lens of a subject I thought I knew so well
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### Author:  [@Boerenkool](https://forum.fudiabetes.org/u/Boerenkool)
#### Post date: [November 15, 2024, 11:29pm UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/8 "2024-11-15T23:29:20Z")
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.
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### Author:  [@Sam](https://forum.fudiabetes.org/u/Sam)
#### Post date: [November 15, 2024, 11:30pm UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/9 "2024-11-15T23:30:04Z")
And many times more than that for women the age of my wife and i. Her hcp estimated its 80% for women in their early 40s
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### Author:  [@Boerenkool](https://forum.fudiabetes.org/u/Boerenkool)
#### Post date: [November 16, 2024, 12:04am UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/10 "2024-11-16T00:04:29Z")
That’s wild. Studies seem to suggest that these criteria lead to both more false positive AND false negative results.
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### Author:  [@jgordon5](https://forum.fudiabetes.org/u/jgordon5)
#### Post date: [November 16, 2024, 5:17pm UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/11 "2024-11-16T17:17:13Z")
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.
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### Author:  [@allison](https://forum.fudiabetes.org/u/allison)
#### Post date: [November 19, 2024, 3:08pm UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/12 "2024-11-19T15:08:40Z")
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…
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### Author:  [@Sam](https://forum.fudiabetes.org/u/Sam)
#### Post date: [November 19, 2024, 3:10pm UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/13 "2024-11-19T15:10:22Z")
Yeah it’s pretty hard to wrap my mind around….
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
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### Author:  [@allison](https://forum.fudiabetes.org/u/allison)
#### Post date: [November 19, 2024, 5:01pm UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/14 "2024-11-19T17:01:14Z")
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).
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### Author:  [@Sam](https://forum.fudiabetes.org/u/Sam)
#### Post date: [November 22, 2024, 7:51pm UTC](https://forum.fudiabetes.org/t/unreasonable-gestational-d-diagnosis/14994/15 "2024-11-22T19:51:07Z")
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