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Would you / should I decline the glucose tolerance test (GTT)?

(71 Posts)

I don't normally hold with saying no to medical tests etc. but this pregnancy I have been advised to have the GTT because my dad has just been diagnosed with type 2 diabetes. We know why he has diabetes - he has chronic pancreatitis. But this finding gives me a 'family history' so I've been sent an appointment letter.
My BMI is about 22 when pregnant (!), my last baby was very small for dates (5lb 1oz at 38 weeks, induced for lack of growth) and I've had no sugar in my urine so far. Oh, and my amniotic fluid looks normal (not excessive).
In these circumstances, would you stick your neck out and say no? I'm willing to frequently check my own urine for sugar (DH a GP so we can get some cheap NHS dip sticks) to make sure that i'm not endangering the baby in any way - DH says this is just as effective as the GTT.
I guess I feel like the test is unneccessary and, with my continued morning sickness, will definitely definitely have me throwing up all over the ob/gynae department since it involves fasting, drinking a sugary drink, then more fasting ... I give the sugary drink a maximum of 15 minutes before it reappears.
Anyhow, all this to ask - would I be reasonable vs irresponsible to say no to this test? Anyone got any experience of the GTT to share?

ChangeNameChangeLife Sat 03-Apr-10 22:03:22

Sorry but can I stress again that GD is not I repeat NOT about your weight. I saw several thin, some very thin women in the diabetes clinic. As I worry about my weight I asked the consultant did I have it because I might be overweight and she reassured me repeatedly that my weight had nothing to do with it. It is about your body reacting differently to sugars when pregnant.

Rockbird Sat 03-Apr-10 22:07:12

Oh bum. I'm hoping that your ID means you're on the other side of London to me! It's not so much the clinic that bothers me, just one particular nurse who was so horrible to me, she's bound to still be there hmm. I've resigned myself to having GD again, might as well prepare myself for it.

Thanks dizzydixies, would be interested to know what your experiences are.

dizzydixies Sat 03-Apr-10 22:10:29

if it helps when I went to the ANC on Tues I found that only one of the diabetic nurses is still there (2yrs later)

remember you should be dealing with the whole diabetic team and not just the midwife

becksydee Sat 03-Apr-10 22:10:48

don't know the answer to your question, rockbird, but just wanted to sympathise. mine was a late diagnosis too & i was put under huge pressure to have an induction, to the point of being bullied by my midwife & the diabetes midwife until i was sobbing inconsolably in front of them. luckily i had an amazing doula & other v well informed contacts & in the end i held out until 41+1 when i went into labour spontaneously. someone i know was coerced into a CS at 38 weeks & her baby was given formula because the midwives said her milk was 'no good' due to the GD

you have MN this time round, rockbird, you'll be fine

Rockbird Sat 03-Apr-10 22:14:16

That's the other thing bothering me becksy. The whole forcing you into formula feeding thing. DD was given formula, I wasn't encouraged to bf at all, in fact the mws took the mick at my uninformed attempts so DD never was bf. I'd like to think I could do it differently next time. With the full backing of MN wink

Sorry op...

dizzydixies Sat 03-Apr-10 22:14:57

to echo becksydee - I refused an induction and told them if I wanted to try a VBAC, the consultant agreed, in the end I had an elective but that was due to circumstances not including the GD

and I bf DD3 just the same as the other two - they checked her sugar levels once and that was it

LadyOfTheFlowers Sat 03-Apr-10 22:20:43

I did not have the test with DS1 - He was 9lb 9.

DS2 was 10lb 12 so I was advised to have the test with DS3.
DS3 was 8lb 12. I did not have GD.

I had the test this time with DC4 and again, I don't have it and baby is expected to be around the 8/9lbmark again.

DS2 appears to be a random one off. (He certainly is!!)

I have a needle phobia so was reluctant to have the test the last 2 times as it obviously involves 2 blood tests which for me is a complete nightmare but I had the tests done as I wanted to sort of 'prove' I didn't have GD. hmm

A tiny thought also stuck in my head 'what if you do develop it, have a huge baby and it could have been prevented/controlled with a simple test?'.

dizzydixies Sat 03-Apr-10 22:22:22

oh and DD3 was the smallest (with the GD) at only 9lb14 grin

becksydee Sat 03-Apr-10 22:23:54

oh no, that must have been really demoralising

you can do it differently next time round you'll know that colostrum is the best thing your baby can get to help it regulate its blood sugar, especially if you have GD, & you'll know to tell any mickey-taking midwives to either help or sod off!

<shakes pom poms>

ArthurPewty Sat 03-Apr-10 22:35:53

"Sorry but can I stress again that GD is not I repeat NOT about your weight."

Yet that's why they tried to pressurise me the first pregnancy. I was 13 stone when i got pregnant, only 5'1, and they decided i was too fat and therefore must be a diabetic. Especially when my 10lb baby was first discovered to have been big (approx 36 weeks). I was blamed, personally, for refusing the GTT, accused of causing the mess, and told that the only solution was 'damage control.'

I was also told i would never be able to breastfeed her, and that her sugar would plummet within minutes of birth.

I BFed her exclusively until solids, and carried on until she was 3.5 YEARS old, nary a drop of formula.

They said the same thing about DD2, that i'd have to formula feed her, despite me refusing the GTT. I did no such thing - she was BFed from 45 minutes post birth, and she's still at it today, 18 months old. They insisted her trembly arms and legs on day 2 in hospital must be low blood sugar, so they did a heel stick, but she was at 3.8, so they had to stop the whole diabetes bullshit.

I'm with Henci Goer. Since mom's weight, baby's weight, and nothing else about GD is predictable or indeed consistent from one 'case' to the next, i refuse to believe it is a true disease by definition. Sorry, but that's how i feel.

I can tell you this - its a surefire way to instantly over-medicalise your pregnancy, the minute GD is suggested/accused/diagnosed ... it is one intervention to the next from there on out.

ArthurPewty Sat 03-Apr-10 22:38:40

and i want to reiterate that I did not have GD. I had a glucometer at home - none of my sugars, fasting or postprandial, were ever > 6.7, for either pregnancy. I did not have any sort of diabetes, just big babies which i am very proud of.

TotalChaos Sat 03-Apr-10 22:48:59

Personally I would not want GTT done unless I had abnormal blood sugar tests results.

btw - ladies with "naff veins" - I have them too - may be worth getting them to try your wrists instead of inside your elbow.

Shaz10 Sun 04-Apr-10 09:35:40

I once had holes in my hands, elbow and wrist from some 12 year old Doogie Howser trying to get blood out of me! I begged them to call someone from the blood clinic, in the end they did and she got something in 30 seconds hmm

My BMI was 35 at booking appointment so I went straight into the system for GTT. Initially I didn't want to have it but the midwife told me that glucose in the urine is a very late sign of diabetes.

My two reasons for not wanting it were that I would treated as high risk during labour and end up with a lot of intervention- which I have been assured will not be the case if the test is negative and that I am self-employed and will have to loose money to go to it for nothing.

I asked my midwife why obese women were more at risk and she couldn't tell me but the consultant explained that it's because you are considered to be raising your blood glucose levels above normal on a regular basis because of overeating/poor diet and this is the cause of type 2 diabetes if it happens too often. So weight is a factor although not the only one.

I can see tht the reason they are giving you freudianslips are very weak and I had the same thoughts about sickness but mine is at 24wks and at 19 now I'm feeling nearly normal.

fernie3 Sun 04-Apr-10 10:28:30

I had the GTT in my last pregnancy and will have it again (didnt have it in the first two) I had it because my bmi was 31 at booking and my mother had type one diabetes. It is more borign than anything waiting around but seems like a good idea to just get it done and over just in case.

4madboys Sun 04-Apr-10 12:24:06

ooh lots more replies, thanks ladies

i am thinking that i may ask just for a regular blood sugar level check and if that shows any problems then i will have the gtt test.

they are wanting me to have the test purely because ds4 was such a large baby.

i already have to argue against intervention because i go overdue by more than two weeks, so this will just be another stick for the consultant to use.

i guess will see how the pregnancy goes and if i have any signs of gd then i would have the test, i just hate the fact that having a large baby means i HAVE to have it. ds4 was large at almost 11lb but not fat at all, just very long and at just 2yrs he is the height of a three year old, his blood sugar was tested at birth and was FINE. so there were no problems.

with regard to crap veins, quite often they end up having to get blood out of the back of my hand, lots of wiggling the needle in and out etc and i end up with huge bruises, i am not bothered as i am used to it, but dont see the point in having it done unnecessarily and as i have NO risk factors then it doesnt seem necessary but i shall see how my pregnancy progresses.

pamplem0usse Sun 04-Apr-10 12:37:15

I'm refusing the GTT.

Recent medical research has shown that a positive diagnoses of GD has been shown to have no different outcome re: baby and mother's health, versus not knowing.

I was marginally over the guidelines on BMI for having the test, but they b*lloxed up the fact that I was 13 weeks pregnant by the time they were doing the calculation and that I'm pretty heavily muscled (I'm 5"11 and pretty fit).

At 20 weeks into my pregnancy if I don't eat when I first get up I proceed to vomit everywhere. Seriously, I'm pretty sure I wouldn't even be able to keep the lucozade down.

My midwife has failed to give me any explanation of what the test involves.

Oh and on my booking in bloods it took an hour and a half and five different medical staff to get my blood. Not a pleasant experience, especially given I'm afraid of needles!

LilyBolero Sun 04-Apr-10 12:50:08

With my current pregnancy (dc4) my mw wanted me to see a consultant, so made an appt at my booking in appointment. Her reasons were that my previous 3 babies were big (9lb12, 10lb0 and 10lb2). She thought the consultant would recommend a GTT, a late growth scan, and probably a hospital birth (although ds1 was born in hospital, dd and ds2 were both home births, I was at the time undecided about this one).

So I dutifully saw the consultant at 12 weeks. he said I was 'fantastically healthy', had had 3 consistently sized babies, born with no complications, would probably have a 4th around the same weight, and that he didn't want to do any more tests because there was no clinical indication that this was necessary. And he also said if he was advising me, he would go for another home birth! Which I am planning now.

Am currently 35 wks, baby measuring spot on for dates. I think the size of the previous babies is partly that I grow good sized babies, and partly that I have long pregnancies - they were 12, 14 and 8 days overdue, so had a bit of extra 'cooking' time.

4madboys Sun 04-Apr-10 13:18:42

lily you sound the same as me, i grow good size babies and also go overdue, 14days with ds1 an dds2, 18 or23 days (depending on which due date you took) for ds3 and 15days for ds4. i have laboured easily and had normal vaginal deliveries, ds4 was born in a birth pool, laboured for less than an hour and he was born without me having to push at all, no problems at all.

yay for seeing a reasonable consultant lily, i am down to see one, so hope that mine is as good as yours

LilyBolero Sun 04-Apr-10 17:00:21

4madboys - I was really relieved at how utterly reasonable he was! Dd and ds2 were both born at home with no pain relief or stitches, and weren't too big for me - and for me that's the crux of it - that my 'normal' is different from the next person's 'normal' and as such, growth scans/GTT etc may 'flag up' problems that aren't problems iyswim.

merlin8878 Tue 06-Apr-10 14:18:56

I'm 16 weeks with DC3 and have been booked to have a GTT at 26 weeks.

As I have a family history of diabetes and 'big' babies, my consultant thinks that in my previous pregnancies GD has been missed so she thinks it is a good idea for me to be tested.

I don't mind having to be tested, but I hate needles and blood!

I'm also worried about getting to the hospital without keeling over! I have to fast from 10pm the night before and be at hospital for 9am. I start going woozey if I get up and get DD1 ready for school without having something to eat or drink!

ladyluck12 Wed 27-Mar-13 10:00:44

Where's the actual evidence of complications with GD?
I asked my mw and she said basically its the 'big baby' thing.
It doesn't cause major or long term problems because it ends after the 9 months.

BabyHMummy Wed 27-Mar-13 14:19:07

I am in process of arguing with Amy hospital about GTT. I have insulin resistant blood so GTT holds a wealth of camera for me and baby. I have spoken to the diabetic clinic and there opinion was that as i monitor closely it should be ok as long as the second my sugar aren't normal i get my ass to hospital.

I would suggest you ring your hospital and ask to speak to the gestational diabetic nurse and ask them but as your dp is a Gp then can't see the issue buy ultimately the choice is yours

BabyHMummy Wed 27-Mar-13 14:20:39

Apologies on phone and autocorrret is a swine! Should say GTT holds a wealth of danger lol

Dd2 was still born at 37 weeks and everything pointed to undiagnosed GD, this was two years ago. Started testing blood sugar with finger prick at new hospital with dd3 at 12 weeks and was on insulin a week later. She was induced at 33+ weeks due to GD complications. I'm thankful she's alive.

I guess my dd didn't die though as it didn't exist and dd3 wasn't prem and in nicu either. She's 13 months now and I'm still breastfeeding.

Currently 6 weeks pregnant and starting testing at 12 weeks again as it's likely to happen again. I don't fit the GD profile either, every time I went in they would tell me that too!

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