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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?

ExpatAl Thu 28-Mar-13 18:23:38

You can have small babies with GD. They are not all whoppers.

SuffolkNWhat Thu 28-Mar-13 17:36:43

I'm due to have the GTT. DD was small, 6lb 7oz so it can only be due to my BMI (30 at booking but now 29 due to HG). Hacked off at being CLC as its scuppered my MLU dreams.

glossyflower Thu 28-Mar-13 08:19:16

... Oops posted too soon, fat fingers!
I was going to say if you are a smoker, have hypertension or hypercholestraemia etc.
Although its upto you if you have it, if it were me I'd probably have it but reluctantly so. At least you can be ruled out.
Plus I was always of the understanding that type II diabetes is not so much genetically linked as a type I. The reasonable explaination for many members of a family having type II is usually down to lifestyle choices.

glossyflower Thu 28-Mar-13 08:15:02

I must be honest I wondered why you'd refuse too until I read the whole post.
The rationale for you having the test is very weak. The fact your dad has type II diabetes is a little unreasonable as his was caused by pancreatic problems.
I would say unless you yourself have risk factors for diabetes, includiding other members of your family aside your dad that have diabetes, glucouria, overweight (yes skinny people can get diabetes but being overweight is a known modifiable risk factor), am

Rororowmeboat Wed 27-Mar-13 21:30:54

I really don't understand why you would refuse!

Teaandflapjacks Wed 27-Mar-13 21:09:35

ooops I meant to say a faff - spell check!

Teaandflapjacks Wed 27-Mar-13 21:08:45

Just thought I'd add, my BF had GD - she is as thin as a pin. It is a standard test in germany for everyone (where i live at the mo), they don't just offer to anyone who has a risk factor, and they strongly encourage everyone to have it here. But I was undecided until I saw a couple of posters and the devastating loss of still born births. I will certainly have the test now - thanks for helping me decided and sharing painful losses in the hope it helps others. My friend also mostly controlled with diet until final stages, and since before i was pg i mainly eat higher protein, higher green veg etc, low carb diet anyway, I would find that fairly easy to follow i think. I have read up on the reports and studies, and it is very much a mixed bag and conflicting messages. However, I would do anything to protect my little munchkin, and even if I have it, and it is a far, so what? Surely it is better to be over zealous and watch, than not. I have given up alcohol to zero etc too, and all the other stuff you are meant to follow- I just figure, it is 9 months... but I do respectfully see other peoples issues with this, and the conflicting pictures and evidence. I would think though, if you are overweight, then the other risk is a 26 fold higher risk of a larger baby, so if you add this with a GD risk - then maybe this is why they always look for it in people with high BMI? Good luck with everyones pregnancies!!!

ExpatAl Wed 27-Mar-13 20:52:52

Totally agree it's an important test and I think a lot of people don't want to take it because of the assumption that a postive result would reflect poorly on their lifestyles, which is the wrong way to look at it. A friend had a borderline test result so declined any futher testing and her ds really struggled when he was born. She hugely regrets not taking it seriously.

SherbertStraws Wed 27-Mar-13 20:51:10

My post was in reply to the OP not to you BabyH, I don't know why you thought it was to you. I get pissed off with people thinking you can only get diabetes, gestational or otherwise, if you are overweight. It is a myth perpetuated by the media.

slowblonde Wed 27-Mar-13 20:44:13

All I would say is that eating a large slice cake for example would then pose an equal risk to your health and you should be careful indeed!

Agree with midori regarding the other risks of undiagnosed / untreated GDM and for the vast majority of those in the high risk category an OGTT is an appropriate and very important test.

BabyHMummy Wed 27-Mar-13 20:21:05

i have a condition called hyperinsulineamia its linked to pcos.

Everyone is entitled to their opinion. I have discussed with a specialist and have made mine. Whether you or agree is not my concern. I am not "putting my baby at risk" as i test my sugar regularly thru the day and have agreed a plan with the specialist at my hospital.

midori1999 Wed 27-Mar-13 20:05:37

Cheese I am so sorry for the loss of your DD.

I agree that the risks of GD a very real and potentially fatal. The main risk is macrosomia, but there are also other risks such as placental abruption, IUGR, stillbirth and neonatal death. As well as serious and potentially incompatible with life congenital abnormalities if the GD starts early or diabetes was pre existing but undiagnosed.

MorganLeFey Wed 27-Mar-13 19:57:00

Agree with Slowblonde... as you've explained it so far the rationale doesn't really make sense, BabyHMummy? Does 'insulin resistant blood' mean you've been diagnosed as diabetic already..?

I pondered not having the mini-GTT (1 blood test after a bottle of lucozade - I suspect I've sugar loaded myself more than that with pudding smile ) because my random was normal & if I were booked in the department I had worked in I wouldn't have even been offered the mini-GTT as no additional risk factors...
However, where I'm booked offers it to everyone - so went ahead & it came back high - so went on to the full-GTT (more involved - 3 blood tests)!

Essexgirlupnorth Wed 27-Mar-13 19:27:51

I will need to have one as my Dad is type 2 diabetic. Had an appointment with my consultant on Monday and he said that everyone is on a curve and they just have a cut off. He said given my family history and the fact I have PCOS to just been careful not to eat two much sugar anyway.
Is up to you if you have the test or not though.

slowblonde Wed 27-Mar-13 19:04:04

As a specialist myself and having seen thousands of women undergo GTTs I am surprised you have been told the test itself could be a danger to your health. V strange indeed.

BabyHMummy Wed 27-Mar-13 18:56:19

not ill informed. Have discussed at length with the diabetes clinic who agree that it is a high risk for me. My decision is well informed thank you

SherbertStraws Wed 27-Mar-13 18:44:38

Are you aware that many people with low to normal body weight have diabetes. Don't be a fool and risk you and your baby's health by being so ill informed

slowblonde Wed 27-Mar-13 18:35:48

In fairness the GTT is just a glucose load (no different to a large bar of chocolate or bag of sweets) and does not pose any major risk to health no matter how insulin resistant you are. The higher the insulin resistance the more likely to have GDM and so a GTT is a very appropriate test.

Quilty Wed 27-Mar-13 18:33:03

In answer to ladyluck's question about the risks of gestational diabetes, one of the main concerns is if baby gets too big there is a much higher risk of shoulder dystocia (shoulders getting stuck during delivery) which can be fatal for baby. This is why they like to monitor babies growth closely for women with GD.

BabyHMummy Wed 27-Mar-13 16:38:29

As i have posted in my case the rest is imo too dangerous due to a pre existing issue. The test itself could kill me by putting me in hypoglycamic shock. As i test regularly i will pick up if there start to be an issue.

It is down to individual choice based on being informed and sensible.

FoxyRevenger Wed 27-Mar-13 16:21:37

After my friends son was stillborn due to undiagnosed GD I don't get why anyone would refuse something so simple but important?

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!

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

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

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.

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