Paleo Diet and Paleolithic Diet Questions & Answers

Question

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Docs are pressuring wifey to drink the koolaid.

Should she, or shouldn't she?

I remember finding a very astutely written article by none other than Dr Kurt Harris on his thoughts about how the glucose tests done to determine gestational diabetes are often woefully flawed from the starting gate.

Does anyone know the link to that article? Also, what are your thoughts on the test?

edited Oct 16 2011 at 18:20

Dragonfly
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asked Oct 16 2011 at 0:41

Jack Kronk
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sigh I did it twice because it was vehemently recommended by my midwives and I did not have the courage to say no. I ate pretty lowish carb, my glucose was 70-72 if I remember correctly. I thought that it was stupid since I exhibited no outward signs of problems. – none Oct 16 2011 at 0:48

ah the wonder of the mysterious downvote. is it because someone likes to secretly drink koolaid? is it because I mention Dr Harris? I gave zero opinions here, and asked a perfectly "Paleo" question. – Jack Kronk Oct 16 2011 at 17:31

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Glad you asked the question, Jack! I wish more parents would educate themselves rather than take their doctors recommendations at face-value. There are so many non-evidence-based practices in maternity care--it's pretty scary. – Dragonfly Oct 16 2011 at 18:30

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Downvote? I hate the anon. downvote. T"was not me. This is a great question. – none Oct 18 2011 at 3:02

Gazelle · Accepted Answer · 2011-10-16 13:41:03Z UTC

I'm facing the same dilemma. They won't let me give birth in the birthing center without passing the test. At first I wanted to fight it, but I can actually now see the liability issues, etc. that make it necessary. Gestational diabetes seems to be a legitimate risk factor.

I'm scared of the drink, but actually less scared than before I got pregnant. I think my paleo babby and body can handle it. I have been eating many more carbs (fruit, rice, starches) since pregnancy than before. I haven't done this intentionally but it seems to be what my body prefers, so I'm not "fat adapted" at this point and trust I can clear the 75g of glucose in 2 hours.

My decision is to do it. I don't think the drink will be harmful in the long run and I'm crossing my fingers that I pass with flying colors. If not, I hope I can use a bg monitor to prove that my post-prandial levels are fine over time on a daily basis...

sarah-ann · Answer 2 · 2011-10-16 13:56:52Z UTC

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First of all I'll be controversial and say that non-diabetic pregnant women should not be very low carbing (<25% energy), the area is not well studied and the few studies we do have are concerning. Sorry guys but it's totally experimental and pregnancy is not the time to be conducting these types of experiments.

Second of all where did the 2/3 false positive thing come from? From the Hyperglycemia and Adverse Pregnancy Outcomes study, we can see a linear effect in negative outcomes and failed OGTTs.

I would definitely do the test, if low carbing (which again I do not advise), carb up for a week before the test. If a positive test occurs, then how you handle that is up to you.

Bottom line is hyperglycemia is far more likely to happen during pregnancy due to an increase in certain hormones and it is something that needs to be tested for.

Just finished my thesis on GDM so if anyone needs more info/links to studies let me know.

answered Oct 16 2011 at 13:56

sarah-ann
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Agree with sarah-ann here. – Evelyn aka CarbSane Oct 16 2011 at 15:05

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Give me a break! I rather doubt that low carb during pregnancy is an "experiment" evolutionarily-speaking. Anecdotally speaking, the mamas I know professionally who have been low carb (not vlc) during pregnancy have had few if any pregnancy issues. Since when did pregnancy become an illness, anyway? GD testing has only been around a few decades. Somehow we survived & thrived without it. – Dragonfly Oct 16 2011 at 18:27

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Dragonfly, whereas intermittent ketosis was a distinct possibility waybackwhen, constant or intentional ketosis definitely wasn't. But we don't need to speculate all that much because any trials that have imposed VLC on pregnancy show an increased risk of having a small baby. I think CarbSane had some links to other studies too. People who got GDM prior to testing had far higher risk of macrosomic babies born with respiratory distress, neonatal jaundice or stillbirth. GDM is way more common today too due to larger women having babies at an older age eating far from a healthy diet. – sarah-ann Oct 16 2011 at 19:22

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Sarah-Ann~ No one has done a study on supremely well-nourished moms who were Paleo or Primal pre-conception AND sufficient in Vitamin D. Until there is such a study, I reckon all the current studies have far too many confounding factors to render them valid or useful to those of us who are eating a finely-tuned whole foods diet (with adequate supplementation) that is world's apart from the SAD or low-carb SAD. – Dragonfly Oct 16 2011 at 19:56

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And I'm not against GD testing when there are clear indications that the mom may be at risk. I am totally against universal, mandatory testing that doesn't take into account the mpm's current health status & diet. Moms who have been "diagnosed" with GD are often put on a low/lower carb diet anyway. – Dragonfly Oct 16 2011 at 20:00

show 2 more comments

thatonecrazylady · Answer 3 · 2011-10-16 01:13:45Z UTC

My unprofessional opinion- just do it. Only cause if she doesn't, they will always err on the side of caution as if she does.. so if your baby comes out over 9 pounds, they will worry the baby has sugar problems and your wife has been GD this whole time.
Yes, it's super sweet nasty drink- but if she passes it the first time, then that's it, case closed! Of course if she doesn't pass, then she will have to retest- but that would be something you want to be aware of and on top of. Good luck and congrats on your baby :)

JayJay · Answer 4 · 2011-10-16 01:14:27Z UTC

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I mean they say what 2/3 are false positives? So I guess its up to you. I would assume from some of your previous posts that you would treat it nutritionally anyhow. And if she is already eating well then whats the upside of taking the test? Can't make the decision for you, but I will say when push comes to shove we all have a right to decide. Don't be pressured into it if you decide against. Choice in all matters regarding whats put in or taken out of our bodies.

answered Oct 16 2011 at 1:14

JayJay
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yah. bummer is... midwives are telling her that in order to have the paleo babby in the home birthing center (natural), she is required to take it. – Jack Kronk Oct 16 2011 at 1:41

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Really? Must be a liability/insurance thing....which actually means it has absolutely no base in science or proper clinical judgment! That sucks. Well between taking that test and doing it naturally and not taking the test and having to go to the hospital guess I'd take it. But, I'd probably do some posing first to see how committed they were :) – JayJay Oct 16 2011 at 2:25

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I don't really know enough about this subject, but if I were you I would look into the "real" risks. I mean they claim something like 5% of women have this, but what percent of women who have a similar lifestyle to your wife have this is the real question. It could be 0% for all I know. Hope some people with more info on this subject chime in. – JayJay Oct 16 2011 at 2:30

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If they're pulling the "you can't deliver here" card, first see if they'll accept the A1c instead of the OGTT, it's more accurate anyway. And second, when she's in labor, just show up, they won't (can't) turn you away. Or just find more supportive midwives. Ours were awesome, once we told them our philosophy, they totally played along with our plans. – miked Oct 16 2011 at 4:22

sound good miked ... – JayJay Oct 16 2011 at 4:36

miked · Answer 5 · 2011-10-16 04:08:09Z UTC

No don't do it. If she's adapted to a lowish carb diet then she'll 1) get a false positive and 2) it'll make her sick. It's an insane amount of glucose they give you. Plus if she's a fat burner that sugar is going to stress the fetus too. We just had a Paleo baby a month ago and I know the fight you're facing. We actually dropped our original docs and went with midwives when they pulled out the "you don't love your baby" card when I tried to explain the biochemistry.

What people don't understand is that EVERY intervention has risks (even ultrasound) do you have to weigh the risks with the information you get from it. Don't let docs pressure you, they don't want to think they just want to follow protocol with out worrying about special cases. No matter the pressure, the choice is always yours.

Search RobbWolf's site, he had a great article on the OGTT and why you shouldn't do it.

Gestational Diabetes Glucose Test?

5 Answers