gestational diabetes while low carb--Is the test wrong if I don't carb-load for days before?
- Thread starter plope132
- Start date
@jwilder9 It could be because your medical system is so messed up with everyone needing private insurance to get basic care without dept. Everything was free for me and i dont have insurance or need it.
That could account for different standards of care between providers/states. 1h test could be cheeper to run then the 2h test.
The 2h trst is standard in all states and territories in Australia.
That could account for different standards of care between providers/states. 1h test could be cheeper to run then the 2h test.
The 2h trst is standard in all states and territories in Australia.
katrina2017
New member
@cgi2099 In the US, the standard process is to do what’s called a “screening” or a “challenge” test as a first step.
You aren’t required to fast or do anything special before. You go into the doctors office, drink the glucola drink, and then after an hour you get a blood draw.
If that number is good, no further tests required.
If your numbers are not good, you then do the 3 hour test where I believe you fast for 12 hours, drink the glucola then get your blood drawn once an hour for three hours.
You aren’t required to fast or do anything special before. You go into the doctors office, drink the glucola drink, and then after an hour you get a blood draw.
If that number is good, no further tests required.
If your numbers are not good, you then do the 3 hour test where I believe you fast for 12 hours, drink the glucola then get your blood drawn once an hour for three hours.
hollyroller7
New member
@plope132 One question for you - does your OB’s office know that you only have 50-100 g of carbs a day?
I only ask because I have gestational diabetes, and I was told that it’s important to make sure I get enough carbs per day as it’s important for baby’s development. They made sure to emphasize that I don’t go too low on carbs. The recommendations I was given is 30-45 g per meal, and 15-30 g per snack (three meals and three snacks per day).
Just want to make sure you’re all good on that front!
Also, could you just take the 3 hour glucose test? That way you could be totally sure whether you have it or not
I only ask because I have gestational diabetes, and I was told that it’s important to make sure I get enough carbs per day as it’s important for baby’s development. They made sure to emphasize that I don’t go too low on carbs. The recommendations I was given is 30-45 g per meal, and 15-30 g per snack (three meals and three snacks per day).
Just want to make sure you’re all good on that front!
Also, could you just take the 3 hour glucose test? That way you could be totally sure whether you have it or not
biblefollower
New member
@hollyroller7 Honestly, that’s outdated advice. There’s nothing magical about non-fiber carbs. They quickly get digested and raise your blood sugar. Baby gets that blood sugar. Ideally you will get slow, steady, not too high raises in blood sugar for energy for you and the baby. But those raises have to be below a certain amount or they’re harmful. If someone eats 80 g of carbs a day and is getting the same average within range blood sugar levels as a non GD patient eating 200 g of carbs a day, then they aren’t hurting baby’s development. They’re getting the same blood sugar at a lower carb level.
It’s like the concept of A1C. It measures average blood sugar levels over time. Two people can have the same A1C eating very different levels of carbs. And there’s nothing inherently special about those (non fiber) carbs that the baby needs - the baby just needs adequate glucose levels (but not too much).
It’s like the concept of A1C. It measures average blood sugar levels over time. Two people can have the same A1C eating very different levels of carbs. And there’s nothing inherently special about those (non fiber) carbs that the baby needs - the baby just needs adequate glucose levels (but not too much).
hollyroller7
New member
@biblefollower I honestly have no idea if it’s outdated or not - I was just passing along the advice given by my OB and OB office dietician. So I have no real dog in the fight, but just wanted OP to check with their doctor to make sure that carb amount is safe for her and baby! I say there’s no harm by checking, right? 
I also found some sources that show pregnant women need a minimum number of carbs per day that I replied to another comment on my post. But I am no medical professional so I will leave it to the experts! Just making sure OP has covered all bases this way
I also found some sources that show pregnant women need a minimum number of carbs per day that I replied to another comment on my post. But I am no medical professional so I will leave it to the experts! Just making sure OP has covered all bases this way
biblefollower
New member
@hollyroller7 No worries. I just wanted to point out that they’re outdated, even if they’re still the government guidelines. Unsurprisingly, government dietary guidelines aren’t updated much and many are based on sparse or no science. As a pregnant woman with GD, I feel way better eating fewer carbs, knowing that I’m still getting plenty of glucose from the carbs I do eat and avoiding medication or insulin! (It’s funny that they want women to eat a ton of carbs and medicate/use insulin to get blood glucose down, instead of simply eating fewer carbs to keep blood glucose down.)
callousedhands
New member
@hollyroller7 This is such a weird logic. There's nothing harmful for the baby to be on low carb diet while a mom is having a diabetes. With diabetes there more sugar in the blood than in the non diabetic person, and the concern is too much sugar for the baby. You cannot deprive a baby from the sugar which you have too much of.
But even with no diabetes there will be no harm with low carb diet. Sugars are produced in our bodies, you don't need to eat those to supplement. Lots of people from other countries do not consume lots of carbs and are fine. Look at northern leaving people, traditionally they ate mostly animal derived products with minimal carbs during the summer.
But even with no diabetes there will be no harm with low carb diet. Sugars are produced in our bodies, you don't need to eat those to supplement. Lots of people from other countries do not consume lots of carbs and are fine. Look at northern leaving people, traditionally they ate mostly animal derived products with minimal carbs during the summer.
hollyroller7
New member
@callousedhands That is correct that you should lower the carbs in your diet with gestational diabetes - but it should not be too low carb. That was my concern with the diet OP is on (again, unless her medical team has okayed that). I’m not a medical professional, but am repeating what my OB and OB’s office dietician have told me about minimum number of carbs per day.
I don’t want to step out of my lane by giving medical advice, but here’s some evidence that backs up that you do need a minimum amount of carbs, even with gestational diabetes.
This is from the NIH stating that all pregnant women need at least 175g of carbs daily. Source here:
“Dietary carbohydrates (CHO) are an important energy source for both mother and fetus, and all pregnant women need at least 175 g of CHO, including 28 g of fiber per day [37]. However, for women with GDM [gestational diabetes], there is an additional need to pay careful attention to amount and type of CHO as it is well-established that dietary CHO have the greatest impact on blood glucose.”
This is from Yale Health from Yale University about their gestational diabetes treatment plan. Source here:
“Your target for will likely be 30-45 grams for meals and 15-30 grams for snacks.”
This is from the Australian Diabetes Educator Association’s quarterly publication. Source here:
“The American Diabetes Association stipulates that a low carbohydrate diet is not appropriate for pregnant or breastfeeding women. Further, the US A.N.D guidelines advises a minimum of 175 grams of carbohydrate (or 12 carbohydrate exchanges) per day.”
Again, not a medical professional or anything- just advising OP to talk to their doctor to make sure everything is all good with their diet as is
I don’t want to step out of my lane by giving medical advice, but here’s some evidence that backs up that you do need a minimum amount of carbs, even with gestational diabetes.
This is from the NIH stating that all pregnant women need at least 175g of carbs daily. Source here:
“Dietary carbohydrates (CHO) are an important energy source for both mother and fetus, and all pregnant women need at least 175 g of CHO, including 28 g of fiber per day [37]. However, for women with GDM [gestational diabetes], there is an additional need to pay careful attention to amount and type of CHO as it is well-established that dietary CHO have the greatest impact on blood glucose.”
This is from Yale Health from Yale University about their gestational diabetes treatment plan. Source here:
“Your target for will likely be 30-45 grams for meals and 15-30 grams for snacks.”
This is from the Australian Diabetes Educator Association’s quarterly publication. Source here:
“The American Diabetes Association stipulates that a low carbohydrate diet is not appropriate for pregnant or breastfeeding women. Further, the US A.N.D guidelines advises a minimum of 175 grams of carbohydrate (or 12 carbohydrate exchanges) per day.”
Again, not a medical professional or anything- just advising OP to talk to their doctor to make sure everything is all good with their diet as is
@hollyroller7 I appreciate your comments and links . I take the advice here as starting points for research and not medical advice so in my case I don't think your stepping out of your lane.
I am not really low carb because I watch my carbs/dieting etc., I do it because I get splitting headaches (like hangovers) when I do eat too many carbs. From my understanding it is because every sugar molecule needs some amount of water to keep the osmotic pressure right in your body, as you burn the sugar you need to change the amount of water to equalize the osmotic pressure. Same thing happens with a hang over, and eating sugar gives me the same damn headache! Similar to alcohol, I just "eat responsibly" to avoid the headaches and it turns out the cap on that is really around 75g/day mostly in fruit.
. I take the advice here as starting points for research and not medical advice so in my case I don't think your stepping out of your lane. I am not really low carb because I watch my carbs/dieting etc., I do it because I get splitting headaches (like hangovers) when I do eat too many carbs. From my understanding it is because every sugar molecule needs some amount of water to keep the osmotic pressure right in your body, as you burn the sugar you need to change the amount of water to equalize the osmotic pressure. Same thing happens with a hang over, and eating sugar gives me the same damn headache! Similar to alcohol, I just "eat responsibly" to avoid the headaches and it turns out the cap on that is really around 75g/day mostly in fruit.
callousedhands
New member
@hollyroller7 I've heard those many times, and then I read Nicole's book and blog where she debunked all these recommendations for lots of carbs for diabetic pregnancies.
Personally I would not have been able to keep my blood sugars at check if I ate 175 g carbs a day. I was at around 90-100 and feeling fine, exercised every day. Again, some cultures still do not eat that many carbs and their pregnancies are fine, so i don't believe you need 175 g per day
Personally I would not have been able to keep my blood sugars at check if I ate 175 g carbs a day. I was at around 90-100 and feeling fine, exercised every day. Again, some cultures still do not eat that many carbs and their pregnancies are fine, so i don't believe you need 175 g per day
@hollyroller7 The 3 hour version is not being administered properly by the local diabeaties physicians (they do not tell you to go off specific meds nor do they tell you to eat at least 150g carbs before....I just called multiple to schedule one)...If they don't do the test right for low carb people, what else are they not doing right for low carb people?
My doctors all know I am low carb...I have had serious migraines from carbs since I was about 6...my pediatrician even did the big sugar test when I was small and it was negative. However, I think it gave me the worst headache of my life...even worse than that time I got drunk in college for 4 days.
My doctors all know I am low carb...I have had serious migraines from carbs since I was about 6...my pediatrician even did the big sugar test when I was small and it was negative. However, I think it gave me the worst headache of my life...even worse than that time I got drunk in college for 4 days
.hollyroller7
New member
suszettepresley
New member
@plope132 HbA1c is not used for testing GD, but blood sugar is.
March 7th level sounds really low.
They should draw blood at fasting (hour 0), then 1 hour after the 50g glucose (hour 1).
If you fail that one, they would repeat it as:
fasting blood draw (hour 0), then at hour 1, hour 2, and hour 3.
Each hour mark blood level has a set limit, and for the 3 hour test, I think you have to pass 3 out of the 4 readings.
And no, you're not supposed to change your diet, just for this test, so if you're on low carb, then stay on low carb. This is to get a glimpse of how your body digests sugar, bc it changes during pregnancy.
March 7th level sounds really low.
They should draw blood at fasting (hour 0), then 1 hour after the 50g glucose (hour 1).
If you fail that one, they would repeat it as:
fasting blood draw (hour 0), then at hour 1, hour 2, and hour 3.
Each hour mark blood level has a set limit, and for the 3 hour test, I think you have to pass 3 out of the 4 readings.
And no, you're not supposed to change your diet, just for this test, so if you're on low carb, then stay on low carb. This is to get a glimpse of how your body digests sugar, bc it changes during pregnancy.
reneelittledempsey
New member
@plope132 I would strongly recommend Lily Nichols website, as well as both of her her books Real Food for Gestational Diabetes and Real Food for Pregnancy. She has a ton of great information and a lot of evidence based info about low-carb diets and the blood glucose test. I also was eating a very healthy, low carb, high protein diet and got diagnosed with GD. I was able to manage with diet, but I definitely went through a period of anger/disappointment with the diagnosis. Lily Nichols books and website was a huge life/sanity-saver.
@reneelittledempsey Anger/disappointment are not the emotions at the top of my list--Alarm and deep concern about the health of my baby and myself are. Treating diabetes wrong is as dangerous as not treating it at all and after getting off the phone with multiple Diabeties clinics, it is clear that they are not doing any of the tests right in my area (I was a R+D test engineer at Roche so I professionally know things). They do not control base levels of carbs in the diet for any test nor do they tell you to go off specific medications. I am not an endocrinologist, but I worry that if I need to have the physician read the documentation for the test they are prescribing, they may need my help to medicate me too.
...I am also thinking to emotionally and not academically enough at the moment so hence the post
...I am also thinking to emotionally and not academically enough at the moment so hence the post
cookgokey_angel
New member
@plope132 Your emotions and worries are valid, but I think you might not understand what exactly goes into managing GD. It’s not like T1 where you’re put on insulin immediately or T2 where you’re given GLP-1 agonists etc. 99% of dealing with GD is … maintaining a low-carb diet. That’s it!!! You’re already doing it!!!
In some cases, GD gets more severe (it intensifies during pregnancy due to the placenta getting bigger & stronger) and you’ll be put on insulin or metformin. This DOES NOT HAPPEN IMMEDIATELY, and only happens if there’s EXTENSIVE demonstration that you need it. And if you do need it, that means you need it! Medication is a tool, not a failure.
You still haven’t taken the 3-hour test, so you might not even have GD. If you do, here’s what will happen right away once you have a confirmed diagnosis: You’ll be advised by your doctor to get a glucometer and start doing fingerprick tests 4 times a day: one immediately after waking up (that’s your “fasting number”), and the others 1 hour after your first bite of each meal (those are “postprandial numbers”).
If you’re keeping a low-carb diet, your postprandials should be a walk in the park. Your fasting number is the one that’s the hardest to control, and also the one that provides the most information about how your GD is progressing. If your fasting numbers are consistently high over the course of several weeks, you are a candidate for insulin or metformin.
The reason high fasting numbers require medication is because the most dangerous thing to the fetus is not consistently high blood sugar, but rather blood sugar that spikes and crashes. You can control this during waking hours by eating lots of small low-carb/high protein meals through the day. While sleeping, your body operates on its own. Even if you have the most perfect postprandial numbers in the world, untreated high fasting numbers can be dangerous to both the baby (their ability to regulate blood glucose can be severely affected; they can also develop macrosomia, which is to say they grow VERY large in utero) and to you (though the ONLY direct medical risk to you is delivering a potentially gigantic baby). (There is data showing that people with GD have a meaningfully higher likelihood of developing T2 later in life but it’s not clear if that’s causal or simply correlative.)
Again, GD is NOT like T1 or T2 diabetes, and people in this thread speaking from experience with those disorders aren’t being helpful.
In some cases, GD gets more severe (it intensifies during pregnancy due to the placenta getting bigger & stronger) and you’ll be put on insulin or metformin. This DOES NOT HAPPEN IMMEDIATELY, and only happens if there’s EXTENSIVE demonstration that you need it. And if you do need it, that means you need it! Medication is a tool, not a failure.
You still haven’t taken the 3-hour test, so you might not even have GD. If you do, here’s what will happen right away once you have a confirmed diagnosis: You’ll be advised by your doctor to get a glucometer and start doing fingerprick tests 4 times a day: one immediately after waking up (that’s your “fasting number”), and the others 1 hour after your first bite of each meal (those are “postprandial numbers”).
If you’re keeping a low-carb diet, your postprandials should be a walk in the park. Your fasting number is the one that’s the hardest to control, and also the one that provides the most information about how your GD is progressing. If your fasting numbers are consistently high over the course of several weeks, you are a candidate for insulin or metformin.
The reason high fasting numbers require medication is because the most dangerous thing to the fetus is not consistently high blood sugar, but rather blood sugar that spikes and crashes. You can control this during waking hours by eating lots of small low-carb/high protein meals through the day. While sleeping, your body operates on its own. Even if you have the most perfect postprandial numbers in the world, untreated high fasting numbers can be dangerous to both the baby (their ability to regulate blood glucose can be severely affected; they can also develop macrosomia, which is to say they grow VERY large in utero) and to you (though the ONLY direct medical risk to you is delivering a potentially gigantic baby). (There is data showing that people with GD have a meaningfully higher likelihood of developing T2 later in life but it’s not clear if that’s causal or simply correlative.)
Again, GD is NOT like T1 or T2 diabetes, and people in this thread speaking from experience with those disorders aren’t being helpful.
@plope132 I eat low carb for the most part and with my 2nd baby failed all the glucose test. From 26 weeks to the end of my pregnancy, despite meticulously tracking everything I ate, my gd got worse and worse. We just kept adding more and more insulin and yet my blood sugar numbers, especially fasting kept getting worse. I was on large doses of both fast and slow acting insulin by the end. Baby came out normal sized, his blood sugar was perfect and literally 12 hours after giving birth mine was back to normal with no insulin. I continued checking for about a week and it was never out of range, fasting numbers looked great. That placenta does really weird things some times.