GTT/GDM Testing and alternatives

I've read so many times online about women throwing up from the GTT and it seemed to me that there had to be other alternatives (my friend Gato just went through that this week). I did a search and came across some interesting info that I thought might be helpful. Please feel free to add in any other options you may know about.

I have to take the glucose tolerance test and drink that awful sweet drink. I detoxed from sugar before pregnancy, are there any alternatives?

You may ask your doc to forgo the GTT unless you are actually spilling sugar into your urine. It does not have to be done routinely.

Here is another alternative from Helen.

At the beginning of December I wrote to you all asking about what I should do about the glucose test to see if I have gestational diabetes. I didn't want to drink the sugar drink because I know it would make me so sick. I mentioned it to my Doctor and he kind of murmured to bad but didn't give me any alternatives.

I decided to switch the midwifes at the office I go to so I can use the natural childbirth center. In the orientation they said all tests are up to me. So when I met with one of the midwifes I said I didn't want to take the glucose test that morning. She said instead of not taking it, she proposed a sugar sensitive friendly alternative. I'll pass it along in case it comes up with any of you.

She told me to fast starting at midnight. Go to the office first thing in the morning and have my fasting blood drawn. Then go out and have breakfast- protein and complex carb like I eat anyway. Then come back in 2 hours and have my blood taken again. She said that will tell her everything she needs to know. Now it is a bit of a pain because the test will take all morning instead of an hour, but I think it is worth it.

And one more suggestion from Julie

A few years ago (1999, I think) ACOG did a study that showed that 18 Brach's Jelly Beans (the small ones) had exactly 50 ml of glucose and was a valid alternative to the glucola for the gestation diabetes test. Women also tolerated the jelly beans much better with fewer side effects such as headache and nausea/vomiting. Maybe your care provider has heard of this and/or is willing to look into it to let you try it.
from: http://www.radiantrecovery.com/newsletter2/pregnancy.html

The American College of Obstetrics and Gynecologists (ACOG) said in a recent statement to the media that there is not one certain method to be used to effectively screen the pregnant population for gestational diabetes. They do not, however, know what screening is best or agree on when the screening should take place.

...

Testing for those women who have a positive screen for GDM can take many forms. The most common is a fasting glucose after a woman has been given a drink called glucola (concentrated sugar) and had her blood drawn. About four years ago some studies were done showing that ingesting 18 Brach's® jelly beans worked just as well as the glucola. The jelly bean test is a bit more pleasant and has few stomach side effects than the glucola for most women. It is also important to note that there is not one perfect time for testing for GDM and that this should be decided between the practitioner and the woman.

Jelly Bean Alternatives for Glucose Testing

Glucose Tolerance Testing

How, when, and why to test for gestational diabetes mellitus <-- great article

Miscarriage Testing

This was posted with permission from my friend ozgal who did a lot of info gathering. It's a list of all the different types of testing that you can get done. My ob/gyn today suggested that I just get the IgG and IgM tests done -- as they more common blood clotting disorders. I'll get the results in a few days time.

Here's a list of suggested post-m/c tests (with resources below):

• Toxoplasmosis


• Antinuclear Antibody Titre (ANA)


• Anti dsDNA Antibody


• Anti ENA screen (ELISA)


• APA – Antiphospholipid Antibodies (Anticardiolipin antibodies)


• Lupus Anticoagulant


• Thrombotic Assays (for clotting factors):

-- Antithrombin III Activity
-- Protein C Assay (functional)
-- Protein S Assay (free)
-- Plasminogen Assay
-- Activated Protein C Resistance (Factor V Leiden)

• Serum Immunoglobulins (IgG, IgA, IgM)


• Fertility hormones: Progesterone, HcG, Prolactin


• RIP (Reproductive Immunophenotype – natural killer (NK) cell)


• NKA (NK cell assay)


• Antihistone Antibody


• Coagulation Assay


• DQ alpha HLA antigen (male and female)


• LAD (Lymphocyte Antibody Detection) (male and female)


• TNF alpha (Tumor Necrosis Factor)


• Antibodies to neurotransmitters


• ETA (embryotoxicity assay)


• Ratio of TH1 to TH2


• Genetic/karyotyping of male/female blood


• DNA Integrity Assay (this requires sperm analysis)

Sources:
Dr. Jonathan Scher and Carol Dix, Preventing Miscarriage, the Good News. New York: Harper Collins, 2005.
Jon Cohen, Coming to Term: Uncovering the Truth About Miscarriage. New York: Houghton Mifflin, 2005.
http://www.repro-med.net/info/cat1-5.php
http://www.haveababy.com/rpl/basics.asp
http://www.illinoisivf.com/recurrent-pregnancy-loss/post-implantation.html
http://www.inciid.org/article.php?cat=immunology&id=374&pagenumber=1
http://www.asklenore.info/miscarriage/immune_testing.html
http://www.rialab.com/miscarriages_prevented.php
http://sharedjourney.com/loss.html
http://www.infertilitytutorials.com/miscarriage_members/hormonal.cfm
http://news.bbc.co.uk/2/hi/health/4002539.stm
http://www.gentlebirth.org/archives/miscrg.html#Prevention
http://www.sefertility.com/patinfo_progesterone.html

Please send her some prayers as thank you for sharing. She'll need them as she works on TTC post loss.

Low Iron Stores!

I knew there was something wrong with me. I just got my last test result, my ferritin level, which measures one's iron stores, was 10. The scale is 10-282 so I'm at the bottom of normal. Actually a gynecologist a couple years ago had me taking extra iron to get up around 30, so I've got a ways to go still.

I think the extra iron in my diet has helped to get my red blood cell count and hemeglobin back up to normal, largely drawing from my iron stores, or at the expense of them. I need to keep taking more iron to boost my stores.

Doctors don't often test for ferritin but its a good test for women, especially if you have heavy menstrual bleeding or have lost a lot of blood for other reasons.

Blood Draw Results

I'm going to celebrate today because my beta level came back at 12. Last summer it took until the end of October to get that low, and I miscarried/had my d&c in July (I had retained tissue remember).

My hematocrit is low but I can treat it with continued iron supplementation and eating iron rich foods. My acupuncturist also has me on a blood building herb formula.

We're still going to take a break until August so I can build up my reserves.

It's still hard though, I thouhgt I was doing well and then I went into Borders at lunch and passed by the wall of pregnancy books and it just made it a little harder to breathe. I remembered standing there a few weeks ago and hoping in my heart that I would have reason to need some of them. Maybe next time.