Early in the third trimester of the pregnancy of my third child, I was diagnosed with gestational diabetes. But the diagnosis was a sham.
Three days before my diagnosis, I had a cooking accident--I sliced my hand open on a can lid. It was determined that I had severed some major tendons, and would need microsurgery to mend them. I was given a tetanus shot because of the can (I was assured the shot was safe), hooked up to a fasting IV, wheeled to a ward, and proceeded to wait two days for my surgery.
Those days were terrible. I was in incredible pain from the accident; I was afraid; I was lonely for my children and worried about them needing me. I was ravenous, and I couldn't sleep at all. The stress was incredible. Finally my turn came. I was wheeled to OR and given a local anesthetic. Ironically, my family doctor phoned during the almost three hour surgery. She said my one hour glucose tolerance test result was high and I would need a three hour test. I told the surgeon to tell her I'd get one right away. I packed my bags and left soon after the surgery was done.
First thing I did when I got home was eat lots of burgers and fries, then sent my husband out for a big birthday cake (and lots of Coke).
I phoned the lab for instructions on how to take the test (my doctor had called them and said I'd be coming). They told me not to eat after 6 pm. Easy enough, so the morning after my surgery, I had a three hour glucose tolerance test. And no one even asked me why I had a cast on my arm! After the first three numbers were determined to be high (they weren't *that* high), I was said to have gestational diabetes.
In learned retrospect, the diagnosis was a joke: the stress, the fasting, the junk food gorging, maybe even the tetanus shot all contributed to my elevated blood sugar levels the day of the test. There can be no other answer, because I have no contributing risk factors, and in all my pregnancies before or since (seven), gestational diabetes has never been an issue.
I learned a lot from the experience, but the burden I carried because of that diagnosis still haunts me. I had been given a barrage of ultrasounds; I had to restrict food intake to the point that I lost weight, and ended the pregnancy nine pounds lighter than I started. I wasted precious time and resources constantly transporting to a vast number of diabetes clinic appointments (and to the hand clinic and my family MD too). The testing equipment was expensive, and taking my blood sugar up to seven times a day was painful and awkward. I was also considered very high risk in subsequent pregnancies and was obstetrically managed accordingly.
Gestational diabetes does indeed exist, but one has to wonder how many women are misdiagnosed and suffer because of it. I think if women were offered optimal nutritional counseling in pregnancy, positive test results would be very, very rare. But I suppose it's just quicker and easier for physicians to test for a condition rather than work toward its prevention.
Reprinted from Midwifery Today E-News (Vol 1 Issue 47, Nov 19, 1999)
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