Gestational Diabetes: A Sampling of the Research
Are you concerned about gestational diabetes (GD) or the glucose tolerance test (GTT) used to screen for GD? There are a couple of paths you can follow in the research on this subject. We hope this post will help you get started.
One research path looks at lab results and suggests that the standard method of screening is inaccurate and/or unrealistic. After all, even the least health-wise pregnant woman is unlikely to fast for 12 hours (overnight or otherwise), then have nothing but a large sugary drink on an empty stomach, and then wait another 3 hours before eating anything. In fact, to do so on any normal day would be considered taking very poor care of her health. The Cochrane Review of GD testing methods suggests that at the very least, testing after a meal or even a candy bar gets the same lab results, with fewer side effects. Some care providers may also offer (or accept) the option of testing blood sugar at home each day for several days, two or three hours after a meal.
Another research path looks at outcomes such as birth weights and maternal and infant health. This path suggests that the concept of GD as a disease is faulty in itself. Not that blood sugar during pregnancy should be ignored (for example, urine can be tested for sugar as well as other markers at every prenatal appointment), but that “the practical advice one can give to women carrying the label of ‘gestational diabetes’ should be given to all pregnant women, another reason to question the practical benefits of such a diagnosis. This advice concerns lifestyle, particularly nutrition and physical activity.” (Michel Odent)
Dr. Michel Odent, the French researcher quoted above, famously calls GD “a diagnosis looking for a disease.” Odent’s article was published originally in The Journal of Prenatal & Perinatal Psychology and Health.
Henci Goer (Author of The Thinking Woman’s Guide to a Better Birth) offers some pros and cons of being screened for GD, as well as detailed options for following up a GD diagnosis.
She also offers a detailed history of the GD diagnosis and its validity.
As you should already know, we are not physicians or midwives, and this blog is not intended as medical advice. As always, the decision of what tests and screenings to perform during pregnancy, and what to do with the results, is yours.
We at BirthNetwork believe that
- Pregnancy and birth are normal, healthy processes, not illnesses or diseases.
- Maternity care should be evidence-based and woman-centered.
- Women are entitled to complete and accurate information on their full range of options for pregnancy, birth, post-partum and breastfeeding.
- Women have a right to make health care decisions for themselves and their babies. That right includes Informed Consent as well as Informed Refusal.
- By making informed choices and having confidence in the process, families can experience safe and satisfying pregnancy and childbirth.