Received by NAG [Nutrition Action Group] May 18, 1989
May 8, 1989
Dear Dr. Brewer,
I'm writing to you because I spoke to you by phone in January regarding gestational diabetes. You asked me to let you know
how things turned out. In my 32nd week of pregnancy, I was diagnosed as a gestational diabetic, and put on a 1900 calorie
ADA diet. I was instructed to go weekly for tests to determine if there was a need for insulin. I was told my baby could
die, particularly in the 37th week, or have brain damage, if I did not follow these instructions. I was assured these tests
were absolutely reliable, and my baby could be helped.
Also around this time, my sister in Arizona read the article on gestational diabetes in "Mothering" magazine. She knew the
tests described were the ones I had been given, and she sent me a copy. After reading it, I was sure I was misdiagnosed,
and was extremely angry I had been told these tests were reliable. (I was tested "routinely" without having any symptoms,
no sugar in the urine, no diabetic history.)
I tried to get a second opinion, but could not even get past the receptionist because I was near the end of my pregnancy.
Each one told me that they also routinely test for gestational diabetes, and I should accept my doctor's advice. It was then
I decided to call you. I read you my test results and briefly described my situation. You said my test results did not indicate
diabetes, and the diet I was on was dangerous. You felt, too, that I was misinformed by my doctor. At this point
I had been on this diet for 2 weeks. You were so right! In this 2 weeks I lost 5 1/2 pounds. The last day I became
weak, chilled, but sweaty, and fell asleep for nearly 14 hours. When the doctor saw I lost weight, he wanted to schedule
an ultrasound in the hospital. He was taken aback when he realized I had aquired information on these tests and had questions
and objections regarding his diagnosis. He would lay claim to following "internationally accepted procedure;" and he excused
himself from the room frequently. He left the room so many times during this conversation, I felt he was retreating to his
office to refer to books, or deliberately trying to interrupt my trend of thought. He referred to my pregnancy as "high risk"
(another label that would adversely affect myself and my baby). When I asked what foundation he had for this, he denied using
the term, although it had been said in front of my husband as well. He was either unable or unwilling to answer our questions
and suggested we take our questions to a perinatal specialist for a consultation. I later learned he made arrangements withe
the specialist and then dropped me as his patient. I never kept the appointment with the specialist. I felt the arrangement
was made to suit the doctor and the specialist would support him in whatever he claimed. I was worried about how my baby
would be treated because of his diagnosis and I had no control over the situation. Although my decision frightened my husband,
I decided when I went into labor, I would go to emergency at the hospital where my pediatrician worked and claim to have had
no prenatal care or doctor. In this way, my baby could be cared for by someone I trusted.
Within the same week, my friend, a mother of five, suggested I speak to her doctor. She was sure he was a fair man and would
at least speak to me. I went to see him and became his patient. Like you, he felt I was not a diabetic and should not follow
the diet. He was able to answer all my questions and felt I had been overtested and worried needlessly.
I finished my pregnancy normally, including the dreaded "37th week," without any mishap. During my 39th week, after a short
4 1/2 hour labor and without medication, I gave birth to a 7 lb. 9 oz. girl. She is perfect from head to toe with no indication
of brain damage, Down's syndrome, or any other affliction suggested to me during my pregnancy. We came home 36 hours later,
and at 9 days old she was described as being in "excellent" health by my own pediatrician.
I am convinced that my original doctor did not know anything about diabetes. Here is a man who has done nothing but deliver
babies for 20 years; when the College of Obstetricians imposes guidelines as to the routine testing of pregnant women for
gestational diabetes, shouldn't he be required to return to the classroom so that he may have some genuine understanding of
what he is doing? And shouldn't he be required to understand and study the nutritional needs of a pregnant woman rather than
prescribe a standardized diet more suited to a non-pregnant true diabetic?
Our conversation gave me the courage and support I needed to make decisions. "Thank you" for your support and encouragement.
"Thank you" for having the courage to speak out. May you know that I will forever hold you in the highest esteem for helping
Tom's note to me in the margins:
May 20, 1989
Hi! Joy, I've had over 100 responses from your "G.D." article in Mothering. This letter is esp. good. Educated women
will eventually correct this whole rotten mess but not soon! TPI, TJFI, CSVI have so much money! Hope you and your family
are well. Love, Tom
See "Gestational Diabetes: Myth or Metabolism?" at the end of the "Gestational Diabetes" page.