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Can diagnosis of gestational diabetes be wrong?
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An_202704 posted:
I was diagnosed with gestational diabetes 3 weeks ago. I went to a diabetes class and from then on have monitored my blood sugar levels 4 times daily; fasting and 2 hours after a meal. My levels have been consistently in the 70s-80s with 3 occurrences where it went to the 100s. My dietitian said that because I am kind of on the low side, she wanted me to add more carbs to my meals but making sure my levels stay under 120. Tonight I had a huge meal, definitely over 100g of carbs yet when I checked my blood two hours after starting my meal, it was 111. This is the highest my blood level has gotten since I've started self-monitoring. The past few days I have been eating about 60 - 75g of carbs per meal (not snacks) and have gotten levels in the 80s-90s after 2 hours. My dietitian is confused as to why this is and we are both wondering if I am truly diabetic because my blood levels indicate otherwise. When I did the 3 hour test, my 1 hour level was over 200 and 2 hour level was 155. My fasting and 3 hour level were under the target range. Is it possible that somehow the testing got messed up or that perhaps I was diabetic at the time of testing and now I am not?
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phototaker responded:
It's hard to tell, but you sound diabetic to me, if you're getting 155 after 2 hours. It's usually under 140. You're probably just eating pretty healthy right now. Continue to test yourself.
Of course, if it's just because you're pregnant, that might mean you are pre-diabetic, or will go back to normal after the baby is born. You still need to be careful and eat properly after the baby is born, as you are more likely to get diabetes. I know someone who became diabetic when pregnant, but eats very carefully, and never has shown signs of it again. My mom had three big babies, and ended up getting diabetes afterward.
She was an emotional eater, so sometimes ate too much bread or other carbs.

I'm not on medicine. If I eat properly, my levels test out pretty well. If I overload on carbs, my levels go up. I'm definitely diabetic.
 
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krhudson responded:
I am thinking that the 200 level is a little high after the first hour of a meal for a non diabetic. Also,155 is high 2 hours after the meal. 3 hours is good to be under the target. The key is how long it takes to get there. For non Diabetic the blood sugars can be up to 180 2 hours after a meal according to ADA but that is off in my opinion for a non Diabetic.

I am a type 1 Diabetic and I stick to 85 to 95 fasting and try for no higher than 140 2 hours after the meal and down back to 120 by the third hour. Also, I really try to never exceed 180 1 hour after a meal.

The carbs sound high for each meal but for 2 they may want it that way. I stay at about 30 carbs per meal and 10 to 15 for snacks. I only eat lean protein and veggies and some fruit in moderation, a low sugar yogurt, nuts and low fat/sodium cheese. My grams per day never exceed 100 total and they have you on 180 for the day? That is a lot and if you are eating white fluffy carbs those will spike such as white rice, potatoes unless they are baby reds, pizza, breads and pasta. If you have a little pasta or bread make sure the pasta is wheat and the bread is whole grains, not whole wheat.

Careful of the fresh fruits, some will spike the blood sugars so keep testing often.

Seems to me their may be a special diet not only for the Gestational Diabetes but also for feeding 2?

Also, check with the one that made the Diagnosis. I know they would take caution for the health of you and baby.

Everybody is different. Keep going to classes. I think the Dietitian is taking perfect numbers in the in the 80s and piling on more carbs to find a balance to keep you out of the 70s for blood sugars. Rather than pile on carbs would she/he let you have 1/2 yogurt and fruit around the times it is low rather than always assuming it will be to low. Blood sugars in the 80s is perfect. Now, they may see thoughs 70s as hypoglycemia possibilities did anyone mention what may be causing the lower numbers when you get them and determine why? You may have been way low on eating enough complex carbs? Also have to make sure to eat enough.

Let us know what the Dr. says that Diagnosed it. He/She may have seen a higher A1C 90 day average test over 5.50 and is being cautious. Make sure the Dr. knows what the Dietitian is recommending you do so everyone is in sink on this.

Keep asking the questions and keep testing often and logging in the 1, 2 and 3 hour tests. I did that for 8 weeks and it really helped me get the best control.

I am not a Dr. or Dietitian, we just share thoughts and ideas here, always confirm everything with your Dr.

krhudson
 
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Manoj_in_Bangalore responded:
You can confirm whether you have diabetes or not by testing your fasting insulin and fasting glucose levels from the same blood sample and then using the HOMA calculator.
 
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DavidHueben replied to Manoj_in_Bangalore's response:
Manoj:

Perhaps you missed these quotes from Dr. Dansinger from a few months ago:

"All endocrinologists are familiar with the HOMA, however they generally view that as a research tool and most do not use it with individual patients or realize that the calculator is on the internet. I'd guess 1 percent are aware that the HOMA calculator is available on line.

I believe more endocrinologists and other clinicians caring for such patients will use the HOMA calculator more routinely in the future. Not to diagnose diabetes, but rather to gain insight into the relative contributions of beta cell dysfunction and insulin resistance in folks with elevated A1c."
Red meat is not bad for you. Now blue-green meat, that is bad for you! -Tommy Smothers
 
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Manoj_in_Bangalore replied to DavidHueben's response:
HOMA is not used extensively, but is the most advanced diagnostic tool.

I suspect you have fully realized the significance and utility of HOMA and hence your comments.

There are also vested interests from the pharma companies to supress the use of HOMA because it will reveal the truth and they do not have any drug available that can directly lower fasting insulin levels.

I would encourage you to spend time to understand the whole concept, rather than pouncing on quotations.
 
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rebitzman replied to Manoj_in_Bangalore's response:
There are also vested interests from the pharma companies to supress the use of HOMA because it will reveal the truth and they do not have any drug available that can directly lower fasting insulin levels.


Actually - there are any number of drugs used to lower insulin levels.
 
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rebitzman responded:
Gestational diabetes is not exactly the same as other forms of diabetes, and SHOULD (no guarantees) clear up after you give birth.

Frankly - you are controlling it for your baby - not you.
 
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rebitzman replied to Manoj_in_Bangalore's response:
I suspect you have fully realized the significance and utility of HOMA and hence your comments.

Won't comment either way on David's REAL feelings, but he was quoting Dr. Dansinger - not expressing his own opinion.

He pulled it from a post you openly disagreed with by the way.
 
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Manoj_in_Bangalore replied to rebitzman's response:
Actually - there are any number of drugs used to lower insulin levels.

I haven't yet heard of any drug on the surface of our Earth than can lower fasting insulin levels as a direct effect.

If you believe such drugs exist, I would be interested in knowing the name of the drugs and the manufacturer.
 
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An_202705 replied to phototaker's response:
What I was trying to get at was that even though my test indicate that I am diabetic, my monitoring says otherwise. When I was tested, I had to drink about 75g of carbs and the results were high. But when I ate over 100g of carbs that one meal, my results were within the normal range. Plus the diet that my dietitian put me on was a standard one for diabetics and after I told her how low my results have been, she told me to try to eat more carbs to bring up the numbers. When I told her how much I had to eat to bring the numbers up to 90 she was very shocked because normally that would cause her other patients' levels to sky rocket but mine are well within the normal range. So this is why I'm asking if it's possible for me to be diagnosed a diabetic weeks ago but now my body is able to produce enough insulin for my meals? Since I'm pregnant and hormones are always fluctuating...

You're right about how I should continue to be careful after the baby's born because I will probably get it due to my family.
 
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An_202706 replied to krhudson's response:
I talked to my doctor today and she said the test indicates I am a diabetic but when I told her how much carbs I was taking in compared to my numbers, she just said to keep doing what I'm doing because the numbers are great. My numbers have never exceeded 120 after two hours. I find it very strange. I had a big breakfast the other day (about 75g of carbs) and had to check after one hour because I wasn't going to be able to in 2 hours, which is when the dietitian recommended me to check, and I was at 114. That's the highest number I've gotten in 2 weeks. Also my dietitian looked at my food journals and said I was eating a good variety of food and to keep it up.
 
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An_202707 replied to rebitzman's response:
I know I am controlling it for my baby but because my numbers were low when I started I was very concerned because I've fainted from hypoglycemia before and based on the diet I was given, I was dipping close to hypoglycemia. But yes my Dr. also says it should clear up after I deliver. (But I'm thinking it has already cleared up). I'll still be monitoring my blood levels of course to make sure that it's always within the normal range.
 
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rebitzman replied to Manoj_in_Bangalore's response:
I would be interested in knowing the name of the drugs and the manufacturer.

I'd be happy to provide you the list over lunch - next time you're in Green Bay
 
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krhudson replied to Manoj_in_Bangalore's response:
Manoj, take him up on the offer, Green Bay is a great town!

krhudson


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