Anyone fail the one hour glucose miserably, and pass the 2 or 3 hour?

[Steph32]

Just curious. I'll actually be doing the new 2 hour test... where they get a fasting number, 1 hour and 2 hour numbers. I know for a fact I will pass the fasting but I WILL miserably fail the 1 hour draw. I prick myself at home just to see (I had GD with my first pregnancy) and the 1 hour is almost always above 140, sometimes even 190. But the 2 hour is always back to normal. I tend to spike fast and then come down pretty easily. And my fasting numbers are always fine too.

So I'm just wondering how accurate these tests really are at diagnosing GD. And how important the first hour number really is... seeing that my BG goes down pretty fast, which is more important in the diagnosis of GD - the 1 hour or 2 hour number?

 

[taterbean]

I had to take my first test at 11 weeks. I failed the 1-hour but passed the 3-hour. The 3-hour, like the 2-hour, is graded as a whole, not just but the blood levels at a certain point. When you take the 2-hour, it's generally the only test you take, so if you fail, you just start seeing a nutritionist rather than having to drink the nastiness again.

Since I failed my 1-hour the first time, when it came time to do it again, I told them to just give me the 3-hour so I could avoid having to come back to do it.

With the 2-hour GTT, you're not allowed to have any failing numbers. ADA standards say just one failing number gets you diagnosed with GD. With the 3-hour glucose test, you can fail 1 of the 4 blood draws and still be considered normal, but if you fail 2, you're diagnosed with GD.

If you Google 2-hour glucose test, the top search result will give you a lot of info on the ADA numbers for GD and diabetes testing.

 

[Steph32]

I know the standards and the rules for diagnosis for all the glucose challenge tests... I've done tons of research since being diagnosed last time. I was just wondering how common it really is to fail the 1 hour (in any test) and pass the subsequent hours (have a number below what is considered the cut off point). I also kind of question what is really "normal" ranges for a pregnant woman, and if I truly have GD if my fasting and my 2 hour numbers are fine. So I guess I'm just trying to look beyond all the standards and what the ADA says, and really ask, just what is really normal and acceptable for a pregnant woman... since our blood sugars tend to go up a bit anyway when pregnant.

 

[taterbean]

If you fail any part of your 2-hour test, they diagnose you with GD. It's very much possible to pass the fasting blood draw and the 2-hour blood draw and still fail the 1-hour blood draw. If it happens, they declare that you have GD in no uncertain terms. There are no other tests. Whether you choose to believe them or not is up to you. Whether you choose to follow their nutritional guidelines is up to you.

When you test your blood at home, it's different from a glucose test done by your doctor's office or a lab where they make you drink 75 or 100 g drink. The quality of your meals could impact your blood readings at home depending on the number of carbs or sugars in your meals.

If you fail your glucose test and disagree with it, you could take your charted numbers from home over the past several weeks in with your meal plan to see if that has an impact on how they treat you. If you aren't tracking this already, I would suggest doing so so that you can see what you're eating when your blood sugar after 1-hour is closer to 190.

Generally, though, people don't monitor with a blood glucose meter without being directed to by a doctor with an ideal range of numbers for each measurement period.

 

[happynewmom1]

Well...I had GD with my first and they never told me what the numbers were. I was just sent to a nutritionist and was put on a strict diet. With this baby, they had me take the 1 hour test at 10 weeks and I know I had a 138...and for some reason can't remember what the cut off number was. 130 or something like that? It wasn't super high but high enough so that I had to take the 3 hour. I took the 3 hour at 11 weeks and JUST passed it so had to take it again last week and passed. I don't really know what my numbers were for this one last week, but the one I took at 11 weeks I was ONE point away from being diagnosed with GD. lol Even now I still have to watch what I eat with this pregnancy as I didn't pass with flying colors, but I don't have to see a nutritionist, visit the high risk facility, monitor my blood sugar or any of that this time.

I'm sorry if this seems confusing! I just wanted to say that it IS possible to pass even after failing the 1 hour test. I agree with the above poster, though that taking your blood at home will come up differently than the tests you will get at the doctors as the drink they give you is LOADED with sugar so is meant to see what you can handle I guess. But if it IS coming up high with regular meals at home, there might be a good chance you have GD again with this pregnancy. From the sounds of it, if I were you, I might ask to take the 3 hour and bypass the 2 hour if you fail the 1 hour because you want to have every chance to pass and it doesn't sound like they give you much room for higher numbers with the 2 hour. But that is just what I would suggest.

GL! I hope you pass it all and not have to have that worry this pregnancy!

 

[taterbean]

I'm pretty sure the OP is talking about failing the 1-hour blood draw of the 2-hour glucose test, not the separate 1-hour glucose test. Generally, if you take the 2-hour glucose test, you don't take another test which is different from what you and I both went through, happynewmom1. If you fail any portion of the 2-hour glucose test, you are diagnosed with GD. You don't take another test for confirmation.

There are three glucola-based glucose tests -- 1-hour, 2-hour and 3-hour. Many OB practices give the 1-hour to everyone and the 3-hour to those that fail the 1-hour test. The ADA has recommended just using a 2-hour test to diagnose GD rather than administering a second test to those that fail a 1-hour test. The 1-hour test is done with a 50 g glucose beverage and only has one blood drawn. The 2-hour test uses a 75 g glucose beverage and has a fasting, 1-hour and 2-hour blood draw, very similar to the 3-hour which uses a 100 g glucose beverage and has a fasting, 1-hour, 2-hour and 3-hour blood draw. You can fail one of the 4 blood draws in the 3-hour test and still not be diagnosed with GD, but if you fail any portion of the 2-hour test, you are diagnosed with GD. Failing the 1-hour test really just means you take a 3-hour test and doesn't diagnose you with anything.

OP is saying she's pretty sure she'll fail the 1-hour draw of her 2-hour test, and if that's the case, the doctor's office will do whatever they do next for patients with GD.

Honestly, though, there's no guarantee that you'll fail the test based on numbers at home. Glucola after fasting for 12 hours is different from your body's reaction to food intake. I wouldn't give up hope until your doctor's office calls and tells you that you have GD or not!

 

[Steph32]

Thanks. I forgot to add... when I took the 1 hour test with my first pregnancy, I failed so bad that my doctor and I decided to not even take the 3 hour test... they just automatically diagnosed me as GD. So I will never really know if I had it, by testing standards, because what if I actually ended up passing the 3 hour? Because when I test myself at 2 hour post-prandial, my numbers are always normal.

Another note, this time I am doing only the new 2 hour test... there is no separate 1 hour test that is done first... what they do is get your fasting number, and then drink a 75g glucose drink, then draw your blood at 1 hour and 2 hours. Like taterbean said, if you fail the first hour you are diagnosed GD. So the standards have gotten more strict. They are being ultra conservative to try to pick up all cases of even the mildest of GD. So... basically... I know I'm going to fail this test because when I eat just a semi-high carb meal at home my numbers can definitely reach 180-190 (and even allowing for home meter error, it is still high). And so with a 75g glucose drink that I have to down in 3 minutes, I'm sure it would be much higher.

I've been pricking my finger at home because my doctor advised me to, since the beginning of my pregnancy, since I had glucose issues last time. I also *try* to watch the carb intake of my meals (I saw a nutritionist last time, so I remember what to do) but I'm just wondering exactly how strict I would need to be-- even though they advise to stay under 140 one hour after meals or under 120 2 hours after... I wonder just how important that one hour number is. I have always had a tendency to be underweight and usually have trouble putting on lbs, so skimping too much is not something I can do, especially when pregnant.

 

[taterbean]

I don't mean to sound all preachy or anything, so I hope I'm not coming off as a total B, Steph.

With the additional info from your first pregnancy, yes, it's possible to really fail the 1-hour and pass a 3-hour test. And honestly, there are a lot of false positives with the glucose tests that can be based on regular diet. For example, high protein diets like what is recommended with the Bradley Method of child birth has a very high false positive rate on glucose tests. But like you said, you'll never know about your first pregnancy. With the 3-hour test, it's very possible to have an abnormal 1-hour number and still pass overall.

I've had to do numerous glucose tests, before I was pregnant and now that I am pregnant. My tests in 2008, my 1-hour numbers were well above normal, but the rest of my numbers on my 3-hour test were great. The endocrinologist I was seeing still treated me for pre-diabetes, had me meet with a nutritionist who saw nothing wrong with my diet, and then tested me again 6 months later with no significant change in results. I lost only about 10 pounds since then, but my numbers during my first GD test at 11 weeks were SIGNIFICANTLY lower than my 2008 numbers. On one of my tests, my 1-hour number was 185 and my 2-hour was 127.

The different amounts of glucose in the glucola can have an impact on how your body reacts to it as well. And that much straight glucose in one sitting is completely unnatural to our bodies, just like sitting still for 3 hours after drinking it is! In truth, even if we're mostly sedentary after meals, we're still likely to be more active at home or work than we are in the doctor's office during a glucose test.

In your situation, I would make sure to discuss your home test results and your glucose test results together with your doctor when discussing how to approach the rest of your pregnancy. If you're not rapidly gaining weight, do your best to limit your carbs and consume more of the things that are less likely to make your blood sugar sky rocket and you're getting enough calories to support your baby, then you're doing the best you can possibly do. Starving yourself for the sake of GD obviously isn't an option. I'd also consider your first child's weight at birth since high birth weight is the biggest risk/complication of GD. If your first child wasn't a giganti-baby and you try to follow the guidelines you've created with your doctor, then a blood sugar spike at 1-hour might not be as awful for you as for other people.

 

[Steph32]

Thanks for all the info taterbean. And no, you are not coming off as a B! I like all the specific information. I think I just don't do too good of a job at explaining my thoughts and clarifying my questions!

I was diagnosed around 30 weeks with my first, so I really only followed the diet for 10 weeks. He was actually born naturally, normal weight @ 6lbs 15 oz! So, that's also why I doubt that it was "truly" a problem for me.

I do suspect though, that I may have pre-diabetes. Even when not pregnant, I think I get insulin spikes. This may not be a GD related thing at all. The high spikes, even though they don't last long, should not be happening. From what I read, in a normal non-diabetic person, their blood sugar rarely exceeds 140 at any time.

So it may just be a situation that I have to monitor and just make sure that my numbers don't get exceedingly high. I will watch what a eat but not deprive myself, of course. That's the thing, I love to eat... I just don't gain a lot of weight, no matter what I eat ... although during my pregnancies, both this one and last, it's never been an issue really... I gain the necessary 1 lb a week just fine. However, if I cut back on the carbs even a little, starting this early, I just don't know how that will affect my weight gain.

 

[taterbean]

You could have some issues with insulin resistance. That's what they said I had all those years ago when they were treating me for pre-diabetes while saying I wasn't pre-diabetic! It might be worth making an appointment with an endocrinologist or your regular doctor after your baby is born to discuss your blood sugar spikes.

Since you had a small/normal sized baby last time, you'll most likely be fine this time around too, I'd suspect. I had my 3-hour glucose test this morning, but I'm not worried about failing since I'm not rapidly gaining weight and baby girl is still on the small side. If you're gaining weight normally, I'm sure you don't have too much to worry about.

Some GD signs include rapid weight gain for you or the baby, extreme fatigue (beyond normal pregnancy), excessive hunger or thirst, and multiple yeast infections. These can also be symptoms outside of pregnancy as well. The yeast infections can actually occur anywhere that can trap moist air including your panty line, belly button, and underarms, so it's not just limited to vaginal infections. If you've had any of these issues outside of pregnancy, that's another reason to consider talking to a doctor about it after you deliver.

I believe it's also possible for the spikes you have to point to other issues that aren't related to diabetes.

Fortunately for you, you don't have the weight issues like many other people with similar insulin issues, assuming of course you have an issue outside of pregnancy. Many women with insulin resistance and high glucose numbers also have PCOS and irregular periods which make it difficult to lose weight and to conceive a child. I notice that you lost two babies last year, though, which is another issue many women with insulin issues have. I'm sorry for your losses. I actually lost one of my own last summer which is part of why I was tested for GD at 11 weeks.

Like I said before, with everything you've said about what you've been through with glucose tests, the size of your previous child, you weight gain and all of that, you should be fine regardless of if they say you have GD or not. I'd also ask for an extra u/s at 32 to 34 weeks to monitor the baby's size if you are diagnosed with GD, just to make sure they don't think he's getting to big too quickly or anything. Other than that, feed your baby and take care of your body.

 

[Steph32]

Taterbean- Regarding my losses, I actually did suspect high blood sugar could have been a factor in my missed m/c... before I knew I had miscarried (I was supposed to be around 11 weeks) I tested after a meal and it was 200. A few days later I found out I miscarried at 9 weeks, and I always wondered if my high blood sugars had anything to do with it. Of course, many things go through your mind at that point. Sorry for your previous loss as well.

Thanks for the advice

 

[Dusey]

I am new to this forum but wanted to post my recent experience for any women going through something similar. This is my first pregnancy so I am experiencing everything for the first time. I had my 1 hr glucose test Friday morning (3/9/12). I got my results later that day-and was told my level was high at 160 and the cutoff is 135. I was too scared to eat anything before the test so I know it was nothing I ate that could have caused the high levels. I was terrified!! I went first thing Monday morning for the 3 hr test a nervous wreck after fasting for 12 hrs. My doctor called me the following day to let me know I passed!! My level at fasting was 83, 1 hr was 164, 2nd hr was 124, 3rd hr was 100. So it is possible to fail the 1 hr and pass the 3 hr

 

[courtney89]

I failed my 1hr glucose test so badly with my first little girl that they didn't even do the 3 hour one! So yea.. pretty bad I would say lol.

 

[Steph32]

I am new to this forum but wanted to post my recent experience for any women going through something similar. This is my first pregnancy so I am experiencing everything for the first time. I had my 1 hr glucose test Friday morning (3/9/12). I got my results later that day-and was told my level was high at 160 and the cutoff is 135. I was too scared to eat anything before the test so I know it was nothing I ate that could have caused the high levels. I was terrified!! I went first thing Monday morning for the 3 hr test a nervous wreck after fasting for 12 hrs. My doctor called me the following day to let me know I passed!! My level at fasting was 83, 1 hr was 164, 2nd hr was 124, 3rd hr was 100. So it is possible to fail the 1 hr and pass the 3 hr

Welcome to the forum! 160 for the 1st hour is actually not so bad or uncommon. With many women the number comes down by the 2nd hour anyway. I had 200 at the 1st hour with my last pregnancy, so because it was so high, they automatically diagnosed me as GD. Didn't have to do the 3 hour. But I wonder if it would have come down enough by the 2nd hour... I'll never know. Still, being at 200 is NOT good.

 

[Steph32]

I failed my 1hr glucose test so badly with my first little girl that they didn't even do the 3 hour one! So yea.. pretty bad I would say lol.

Me too... what was your number?