Aug 032011
 

“If your blood sugar got too high, it could put you into a coma and kill both you and the baby!” – Certified Nurse Midwife to mother who refused the glucose tolerance test.

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  33 Responses to ““If Your Blood Sugar Got Too High, It Could…Kill You And The Baby!””

  1. “I’ll take the Dead Baby Card for five hundred, Alex.”
    **whoooo!**
    “And you’ve drawn the Daily Double, which also gives you the Dead Mother card!”

  2. Yeah so sign me up to chug a pint of sugar water after fasting. THAT won’t raise my blood sugar at all. If I don’t throw up from drinking that crap.

  3. It is REALLY rare that a mother with Gestational Diabetes (if that really exists) would elevate blood sugar levels to the point that a mother would go into a coma. WHAT kind of education did all these people that are quoted get?? Bad doesn’t begin to say it.

    • Yes, Gestational Diabetes DOES exist. I have had it with three of my six children (curiously only with the boys). I am an educated thinker who is very anti medicine so I know where you are trying to go with your thought process… but saying it simply doesn’t exist is like saying braxton hicks are all in your head or that Pre-Eclampsia doesn’t exist. I was not diagnosed through the syrup test. I was diagnosed through regularly elevated (high) blood sugar levels that I do NOT have when not pregnant. With my youngest child I was on insulin 4 times a day BEFORE 20 weeks. I was told there was NO WAY it was *only* GD and I *must* have had diabetes before the pregnancy and just not known about it (umm yea, high sugar makes me dizzy, palms itch, and other VERY noticeable symptoms that are VERY hard to miss… I would have known). By 34 weeks I was off of ALL insulin and diet controlled again (again something the doctors didn’t understand and said had never happened before and that I was just *wrong* about)…

      I can assure you that Gestational Diabetes DOES exist. Please, don’t be like the doctors and dismiss everything I and many other mother’s suffered through by questioning it’s existence… is it over-diagnosed? Yup… as is nearly everything else… but to dismiss it completely?? Please don’t!

      • You are right, Holly, and I apologize. I guess I was thinking of those mothers who are diagnosed with GD for blood sugars of 140. It does truly exist and is WAY over-diagnosed. Have you heard of anyone whose sugar has gone high enough to cause coma with GD? I haven’t, but that doesn’t mean it doesn’t happen.

        • I have heard of it being low enough to cause coma.. but not high enough.. usually I vomit if it gets too high so I suspect I would vomit enough to not have a high sugar anymore if I ate enough sugar to cause issues…

  4. because refusing the test increases your blood sugar, automatically.

  5. Uh… wait a minute. Going into a coma is more likely for people already on insulin or oral antidiabetics whose sugar goes too low. It does happen on the high end with conditions like DKA and HHNK, but you get so symptomatic before that stage that you have no trouble knowing something is wrong. The urine glucose tests at the OBs would pick it up before it got to that point.

    I really don’t like the GTT, and always wondered if doing that would harm the baby, since otherwise I was thinking every day, every hour, whether what I was putting in my mouth was good for the baby. (If I breathed in bus exhaust on the street for a moment I worried it would harm the baby. I stood way back from microwaves…) With the very excellent home blood glucose monitors available, why not write a prescription for one of those and have the mother do a fasting BS, a 2 hour post prandial after breakfast, and as many other times as they want. Wouldn’t this tell how the mother’s sugars run on her actual diet? There are also monitors in which a sensor can be inserted under the skin to give a continuous reading, but usually people wear these for three days and then the record is analyzed. This would be more expensive than the GTT, but it seems to me it would also be better for women and babies. I always worried that the huge blast of sugar could kick me into GD even if I hadn’t had it before. I have no idea if this could be true, but no one was able to explain to my why it couldn’t be true.

    • Henci Goer has written a couple of interesting articles about gestational diabetes-they’re available on her website and worth reading if you’re interested.

    • This is what my midwife has her clients do. She has a monitor, sends it home with the client and either provides test strips or has the client do so (the monitors are basically free, but the strips are pricey–but are nonprescription at the drugstore). She then has them eat a specific meal with a measured amount of sugar and do checks before and after.

  6. Hi, CNM! I’m glad to know that not only are you willing to be manipulative and cruel in the service of getting your patients to submit to you… you also are so ignorant of endocrinology that you’ve managed to confuse the sequelae of hyperglycemia with those of hypoglycemia! I feel so reassured that my safety and my child’s are in such hands! Surely I will now be willing to do everything you advise.

    (This is one of those where I find myself thinking, “I hope the OP was able to escape.”)

  7. Typically, people notice before it gets that bad. You feel really, really sick before you end up… oh, wait. An insulin coma is the opposite of what you just said. Hmm… How is my sugar being high going to put me in a coma? I know people who’ve had sugars of 300-400. They were feeling like shit, but no comas.

    • Before my hubby was my hubby he ended up in the hospital with a blood sugar of 1,200. He obviously has Type I. He nearly died from dehydration, but he never did slip into a coma.

      Since then he’s had a few times where he’s been 600+, but, once again, never a coma.

      • OMG! I didn’t know it was POSSIBLE to go that high! I’ve heard of 500-600, but that’s considered life-threatening O_O

        • Oh, it was not an ideal situation my any stretch of the imagination. He had been vomiting and his (stupid) roommates at the time kept giving him soda to drink. He would absorb the sugar into his system through his stomach lining and then vomit the liquid. The roommates were actually debating whether to take him to the hospital that night or wait until morning. Thankfully they decided on right away. The nurse that admitted my hubby said if they had waited until morning he would have died. So glad he didn’t, because he makes one heck of a husband.

      • I wonder what that would translate to in the numbers we use in Canada? When my husband was incredibly sick due to pancreatitis, we took him to the hospital and his numbers were about 63. He was also bright yellow, but that had nothing to do with his blood sugars.

        I’m still amazed at the lack of logic from the drs/nurses. They freaked that he was drinking pop with blood sugar that high. Ummm..hello, his body isn’t making insulin, so none of that sugar is able to be used, which is why it’s high. It’s also why his body was screaming for him to eat high sugar food. His blood may have had lots of sugar, his organs did not.

        • Typically, if I recall correctly, you multiply or divide by 18 to convert back and forth between systems of measurement in different countries.

          If that 63 was really accurate (hard to believe but apparently possible) then your husband’s blood sugar was incredibly incredibly high. Over 1100, just like Krista’s husband’s blood sugar.

          Hope he recovered okay. That’s an amazing number.

          • It’s accurate. I might even be off & it was a bit higher (65). It was the highest number that hospital had ever seen. He’s mostly recovered now, thanks. It was a long year, the blood sugar was actually the least of his issues.

  8. Meanwhile, those of us who don’t intend to consume ten pounds of raw sugar on an empty stomach will do just fine, thanks…

    Good grief.

  9. My cnm with my first pregnancy told me, when I was refusing the GTT, that I could have a 12lb brain damaged baby, polyhydramnios, and cord prolapse. I just looked at her like she was crazy and asked, “wouldn’t you NOTICE long before it got that bad?” That was, obviously, the last I saw of her :D She then went on to tell me about a patient she’d had the month before who was “just like you, and her baby died!”.. mistake, midwife, mistake. I knew that woman, told her so, mentioned her name and, ohhh… the fact that her baby had a condition that was incompatible with life?! Must have been pretty embarassing to have me catch her in the middle of a completely BS story.

    • I think this pisses me off more than the original comment. How *dare* this woman demean what that other mother went through, and try to imply that it was her fault. Even though it was said to you, what are the odds that you know another patient that is going to the same place? Pretty good. Especially when a baby has *died.*

    • But the baby was totally fine until the moment the mom turned down the GTT, at which point the baby’s kidneys disappeared or her neural tube opened up again or she spontaneously picked up an extra chromosome. Because that orange drink is a magical potion that creates a field of health around itself, dinchaknow?

  10. Whaaaaaa? I’m, freaking HYPOglycemic here Doc. I process sugar TOO fast! I mean I suppose I could get diabetes, but explain that to me.

  11. Theoretically, sure… But that would be some incredibly high blood sugar. If the CNM fails to see ACTUAL signs of diabetes before the point of DKA-induced coma, the CNM isn’t a very good health care professional.

    My AVERAGE blood sugar, based on my A1c, was around 350 when I was diagnosed with type 1 diabetes (BEFORE pregnancy, thank goodness!). AVERAGE. That means it had been significantly higher than that on occasion, and I never went into a coma. (Not that it wasn’t horrible for me and wouldn’t pose a serious risk to an unborn baby.)

    (That said, I’m not against testing for insulin resistance in pregnancy. I just don’t think turning down said test deserves the dead baby card.)

  12. OP here

    The really crazy thing is that I wasn’t even against any sort of testing, just one that made me drink that awful beverage. I was avoiding sugar anyway and already eating healthy. I didn’t leave the entire practice, but I did not see this particular midwife again. With a different CNM, I did test my sugars at home, and kept track that way. Because I wouldn’t take the test, they decided to treat me as if I were actually diabetic. If I could have switched entirely to another practice, I would have in a heartbeat. The hospital was very focused on “health fads”.

  13. ya those things are awful i failed the 1 hour with my second… but my blood sugar drops so fast after the first hour i get hypoglycemic by the end of the second hour. and the test has always made me sick even when i had pre diabetes rather than hypoglycemia. seriously was close to passing out had i not eaten in the next 20 min. i cannot imagine how low my sugars got. it was seriously low at the last reading then it took me another 30 min or so to get orange juice to bring it back up. should have brought something with me, i thought i was going to die… gawd i hate that test.

    • I know a mom who’s blood sugar was dangerously low at the two hour mark (of the three hour test) and while I commend them stopping the test, I still cannot understand why they felt the need to reschedule.

    • This happened to me, as well. I dropped from 140 to 60 in less than an hour. I felt SO bad even before I knew the sugar level, I went to lie down, and that’s when they told me the results and gave me crackers and juice to keep it from dropping any lower.

  14. they didnt reschedual i did the 1 hour test that my sugars were high, so i was schedualed to do the three hour test. by hour two i was getting sick, by hour three my sugar was so low I almost passed out. i did have crackers and likely nuts with me now that i think about it but it wasnt enough, so i went over to a restaurant after and got juice, but it was another 20 min since leaving the lab before i got the juice.

    with my first babe i had pre diabeties even before i got pregnant.

    with my second i was prone to hypoglycemia even before i got pregnant with her, so really it wasn’t anything i didn’t know already, it was quite useless.

    If i have another I will skip it.

    i hope this clarifies it.

  15. DKA causes a coma with hyperglycemia. But this is only in Type I diabetics.

    Type II diabetics (and in theory GDM but unlikely) one can get hyperglycemic hyperosmolar nonketotic syndrome, which is similar to DKA and causes similar symptoms.

    So don’t crucify the OP – it is out there.

    But, unlikely to have a coma from hyperglycemia. Much more important if large for gestational age due to uncontrolled diabetes. This is a very big problem. Also, if undiagnosed, the baby can be hypoglycemic after birth and need attention.

    One more thing, the cutoffs for GDM are not completely arbitrary, they were chosen to have the best chance of catching diabetics, and not having false positives. Any good OB/CNM would not have a barely failed GDM on insulin – just a good healthy diet. So the pain of having GDM is eating properly – not such a bad thing!

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