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Refusing GTT

(48 Posts)
RobotHamster Wed 31-Jul-13 09:43:10

MW told me at booking in that due to my BMI I should have the glucose tolerance test. BMI is 31 atm (was just over 30 when I got pg).
I don't really want this test, but I don't like the tickbox attitude (if I'd been just a few pounds lighter I wouldn't have been offered it)
I didn't get GD when pg with DS, and I was heavier then. I've lost 2 stone before TTC this time and I feel like all the HCPs are focussing heavily on my weight (i had none of this with my first pg at all - the test wasn't even offered to me)

Can I just refuse to have it? What are the risks if I decide not to have it? I don't feel well informed enough to refuse itat the moment.. does anybody have more information they can give me?

Are certain people more at risk from GD (weight aside). I have no family history of diabetes at all, but don't know if this is relevant

superram Wed 31-Jul-13 09:47:11

My bmi was 30.5. I had the test as non invasive and why take the risk? You seem annoyed that they mentioned your weight but like me you are obese and they have to start somewhere (ie bmi over 30). Well done on losing the weight.

Only you know why you don't want it and along with that comes your decision. Just make sure you are saying no for the right reasons.

RobotHamster Wed 31-Jul-13 09:52:20

Ah I know, I know I'm too fat, and I really tried to get my BMI under 30 before I got pregnant but didn't quite manage it.
MW is OK, just matter of fact about it which is fine. I'd my weight is a factor then talk to me about it. All other HCPs have been v patronising about it, one couldnt stop going on about it in a very weird way. The sonographer told me I needed to have my 20 week scan at 22 weeks because there's 'so much of you' (yes I'm big, but my weight isn't on my belly, just everywhere else)
(i arranged it for 20 weeks anyway and all was fine)

RobotHamster Wed 31-Jul-13 09:55:26

I probably am a bit defensive about it. smile

I don't know why I'm thinking of refusing it really, and just trying to find out more about it, and the risks, to see if I can get away with not having it.

HaPPy8 Wed 31-Jul-13 10:00:03

The risk of not having the test is undiagnosed gestational diabetes. Risks of this include a large baby which can cause problems at delivery, and a baby that finds it difficult to regulate its own blood sugars amongst other things that a quick google will easily list for you. It is possible that other symptoms in the pregnancy might lead you to accept a test, for example, if you measure large for your dates or if you start to have sugar in your urine. It is true that with a BMI of 29 you probably woudlnt be offered it but the nhs need to have a cut off somewhere, and it happens to be 30. Good luck whatever your decide.

superram Wed 31-Jul-13 10:06:57

Hamster, have the test and don't worry about your weight until after the baby is born. I wouldn't be very happy with the sonographers comment though!

Just enjoy the rest of your pregnancy.

Drinking lucozade on an empty stomach is not the best experience of my life but it wasn't terrible.

Loobylou123 Wed 31-Jul-13 10:51:44

I had the test, also because of my BMI (32) - I don't really enjoy discussing my weight so once it's brought up by any health prof I tell them it is what it is, I know the score and don't want to discuss it further. That seems to put a stop to any further discussions!

The test is non invasive - just boring waiting between the control and results tests! I found the results reassuring though so was glad I had been.

I read up a bit beforehand as I was also thinking about not going - the risks seemed to be mainly a very large baby or baby whose blood sugar needs attention after birth - confirmed by midwife. I did read a few things about risk of stillbirth but I didn't ask my midwife to confirm that as the reports on it seemed a bit anecdotal rather than fact based. Would it be worth a call to your midwife to reassure you?

Stubbed Wed 31-Jul-13 10:55:39

A friend of a friend had undiagnosed GD and this resulted in a still born baby. I know it's rare but is it worth the risk?

3boys3dogshelp Wed 31-Jul-13 11:02:46

I have a family history of diabetes and was not offered a gtt with my first and third but was with my second (my weight was ok and same both times)! I had the test because like pp have said it's not invasive, just a bit of a boring morning, and the risks of undiagnosed gd are significant.
It must be frustrating when you want to be excited about your pregnancy and baby and me keeps banging on about your weight but don't put yourself and baby at risk unnecessarily.

sallysparrow157 Wed 31-Jul-13 11:06:05

Uncontrolled diabetes in pregnancy, gestational or otherwise, does increase to risk of stillbirth and heart problems ( both in the way the heart is built and in the way it functions in the first few days of life) as well as increasing the risk of having a big baby (so increased risk of a section or of the baby getting stuck on the way out) or a baby who is unable to regulate blood sugars (which can lead to fits and even brain damage)
I don't understand why anyone would refuse a GTT as it is such a simple non invasive test, you don't have breakfast, you have a blood test, you drink some lucozade, it your feet up for a bit then have another blood test, but it can pick up a problem that, if it is managed, can reduce the risk of lots of things that are harmful to the baby
People who are overweight are at much higher risk of gestational diabetes. If I was just on the cut off weight wise I would be glad I was being offered the test, you are still overweight and therefore at risk with a bmi of 29.9 but you won't get gestational diabetes picked up as early as you would have if you had eaten a big cake just before your booking in appt!

NooMyx Wed 31-Jul-13 11:15:56

My only worry with this test is that the amount of sugar you have to drink is enormous. More than three times my normal daily intake; so I worry how well it's going to represent what normally goes on with my blood sugar on a daily basis...

I wonder if it would be an acceptable alternative to simply keep a track of blood sugar at home for a period of time? (Not that anyone's told me I need the test at the moment; I'm just worrying).

sallysparrow157 Wed 31-Jul-13 11:29:51

It isn't meant to represent your normal sugar intake, it is meant to see how your body responds to a large amount of sugar, putting your blood sugar up after a sugar load (normally the body is so good at regulating glucose levels that even after far more sugar than usual the blood sugar would still be normal) is a very early sign of diabetes so it means gestational diabetes can be picked up before it has even really started, it would be picked up a fair bit later by just checking your blood sugar at home

RobotHamster Wed 31-Jul-13 11:35:25

Thanks all for taking the time to reply. I know nothing about GD, so thank you for telling me what the risks are.

One of the reasons I'm moaning about it is the fasting and then the huge amount of sugar I'll then need to drink (i really don't eat sweet things and my sugar intake is low) and the migraine I'm likely to get a few hours later as a result, but if I take it easy hopefully i'll avoid that as obviously I can't take my normal meds in pg.

I know I'm being a bit daft. I just find it odd that nothing at all was mentioned about it last time and nobody was at all concerned, despite me weighing well over 100kg by the time I got to my due date - I'm significantly lighter this time and only into the at risk weight, and its all people seem to be interested in.

You're right though, its non invasive and apart from it being annoying (and I bloody hate lucozade) there is no real reason not to have it.

Grumble.

Mythreeknights Wed 31-Jul-13 11:37:31
UnderwaterBasketWeaving Wed 31-Jul-13 11:43:18

My BMI is 18, I had a GTT. It's one test. Your weight does put you at statistically greater risk of some things, therefore you should accept the tests and treatments that are provided to minimise these.

Why would you knowingly put yourself at risk by refusing this? It's not a personal attack on your appearance.

RobotHamster Wed 31-Jul-13 11:44:36

Underwater - perhaps read my more recent post.

UnderwaterBasketWeaving Wed 31-Jul-13 11:50:04

Sorry mate, don't mean to upset you. Hope it's all clear.

RobotHamster Wed 31-Jul-13 11:54:10

grin

Sorry, I'm being snarky

anklebitersmum Wed 31-Jul-13 11:56:31

I had a GTT with pregnancy 4. Just on 30bmi and was also lied to told it was 'like lucozade' and was a simple, risk free, potentially life saving test.

I was ill beyond belief. In bed in a darkened room for 3 days following swallowing that gloop a cross between a fibre drink and lucozade . My migraines kicked in like they were trying to win an Oscar..full blown colours, tunnel vision, searing pain and sickness. Suprising enough there was no issue and I point blank refused the follow up.

May I suggest having a good long chat with your midwife/doctor and discussing your weight and medical history before making a decision either way, including how they intend to help you handle any repercussions.

UnderwaterBasketWeaving Wed 31-Jul-13 12:01:05

I had to bring my own lucozade.

CheeseFondueRocks Wed 31-Jul-13 12:01:11

Stillbirth is indeed one of the risks of having undiagnosed GD.

I have declined all routine screening tests for chromosomal abnormalities because I will carry my child to the end either way. I cannot change if there is something wrong or not.

However, I can't see why you would decline the GTT if you are at increased risk. This means that you are potentially putting your child into a life threatening situation when you don't have to.

I had the GTT in my last pregnancy with a normal BMI because my sugars were found to be high in a blood test. This was because I had had a massive glass of fruit juice just before my blood test. I did the GTT and it was clear so your result won't be wrong because you are drinking a lot of sugar. The fasting isn't a big deal. Have dinner as normal, then just water, sleep, get up, have test, eat as much as you want. No big deal. Honestly.

RobotHamster Wed 31-Jul-13 12:05:33

anklebiters - that's exactly what I'm worried about - thank you for posting.

I have had my glucose levels tested (not fasting levels though) already this pregnancy, and all came back fine.

So - its not lucozade then? I think I'll ring the surgery and find out what it is I'll have to drink.

RobotHamster Wed 31-Jul-13 12:06:34

Should say its not the fasting I'm worried about - its thefasting followed by the high amount of glucose- migraine trigger.

GoodMorningMoon Wed 31-Jul-13 12:08:31

The risks do outweigh the draws. I was misdiagnosed with GD by my GP because I only had the 1 hr GTT and didn't know you can have a 2nd 2 hr test.

Having said that, I ate very well, have a healthy baby girl and have a better grip on my weight and diet now. I don't regret it for a minute.

ExpatAl Wed 31-Jul-13 12:09:19

I am very prone to migraine but had no problems with the test. I had some food ready to take straight after the test and drank pints and pints of water.

RobotHamster Wed 31-Jul-13 12:11:11

Thanks - yes, I think plenty of water and something healthy to eat as soon as the test is over is a good idea.

CheeseFondueRocks Wed 31-Jul-13 12:11:41

It was Lucozade at my hospital. Normal glucose blood tests will also not give you a diagnosis for GD.

Is it really worth the risk? I'm sure if you speak to the hospital about the migraine issue they can give you a very early morning appointment so you don't have to fast as long. It really isn't that much Lucozade either. I jst hated it because I had never had LUcozade before and thought it tasted vile.

DinoSnores Wed 31-Jul-13 12:18:05

Although the NICE guidelines say that we should only do GTTs on 'at risk' people, we miss about 40% of GDM that way and many diabetes specialists believe we should test every pregnant woman. The potential risks, as others have said, are so serious and very treatable.

It is pretty grim stuff to drink, but take a snack to have straight afterwards that has a bit of long acting carbohydrate and some protein (like a ham sandwich). I felt completely fine after mine.

RobotHamster Wed 31-Jul-13 13:24:53

Very useful, thank you. I've already booked my appointment - did it weeks ago. I've got an 8am one, so will be done by 10am.

Ah it'll be fine.

I'm so sick of having blood taken

TarkaTheOtter Wed 31-Jul-13 15:13:00

It's a tedious test but in some ways we're lucky that it can be tested for and if treated you have no higher risk then anyone else. It's undiagnosed gd that's dangerous. Increased risk of heart problems, macrosomia, shoulder dystocia, still birth, perinatal death. It's serious. Diagnosed and controlled - no increased risk.

For some reason gd has a stigma attached. It shouldn't. It's hormonal and whilst bmi seems to correlate with increased risk it is not caused by diet or weight. It's hormonal. In the US they do a 1hr screening GTT on everybody.

If you think the GTT will lead to a high likelihood of migraine, you could ask if they will let you do a food diary and blood sugar testing for a week or so instead. It's a lot of extra work for them and you so you would need to make your case effectively.

Teaandflapjacks Wed 31-Jul-13 15:50:41

Just a bit of food for thought - i also had the test (2 hour one), my BMI was 23 at BFP. I live in Germany where this test is considered standard for everyone, regardless of history, weight etc etc. There is absolutely no stigma attached to it here and you would be considered very odd by docs here if you refused - like saying 'no I wont have my blood checked for iron levels' etc. I had it, and was fine. A very good friend had it - she is slim, I guess BMI 21 when she got preg. - and she ended up having GD. The reason the NHS (I firmly believe) screen people with just a higher BMI or a risk in family is purely a funding issue - ideally everyone would be given it - due to the risks of having GD, as other posters have said, outweighing the issues of the test.

Yes the sugar drink was vile - but the most tiring bit was waiting for bloods to be taken - so take a good mag/book. grin

RobotHamster Wed 31-Jul-13 15:59:09

Ahhh thanks for talking some sense into me. Sounds like its something every pregnant woman should have tbh!

Mythreeknights Wed 31-Jul-13 16:02:36

I agree, every pregnant woman should be tested and it's a cost cutting issue whereby they just use parameters such as familial diabetes and BMI to set the benchmarks for those most 'at risk'. They don't tell you the gender of your baby in my area at the 20 week scan as they want to save money by spending less time in the ultrasound room...so, I guess if you are offered the GTT, you could almost consider yourself lucky!

Teaandflapjacks Wed 31-Jul-13 16:06:46

No worries - TBH I think, like me, you just get fed up of all these tests and being fiddled about with!!! xx

Teaandflapjacks Wed 31-Jul-13 16:08:54

@ Mythreeknights - that was my take on it too - felt lucky I was able to have it done and could rule it out.

ExpatAl Wed 31-Jul-13 16:26:57

Completely agree Tarka. We all have to have it in Germany too. I appreciate the extra screening we get here.

ExpatAl Wed 31-Jul-13 16:27:37

...I mean we all have to have the test in Belgium too.

mejypoo Wed 31-Jul-13 18:05:24

I thought GTT was a standard test for all in the NHS. Maybe it will be catchment area/local authority. I am 22 weeks and have a bmi of 27 so will defo have one

maggiethemagpie Wed 31-Jul-13 19:53:45

Why would you not want to have the GTT? Even if is a tiny chance that you have it, if you do and it was missed and your baby was ill or worst case scenario stillborn, how would you feel?
We are pretty lucky to have free medical care in this country, a lot of places you'd have to pay for a test like this, or if you could not afford it go without.
I know you are concerned about getting a migraine but surely it is worth it to know if you have GD or not?
I haven't had the GTT as I already have diabetes, but I had the whooping cough jab on Monday to avoid the risk of my LO getting an illness in their early weeks, my arm was really sore and itchy for two days and hurt like hell, but I am putting my child's welfare before my own comfort so don't really see it as a big deal/

Blankiefan Wed 31-Jul-13 19:55:18

Can I hijack the thread to ask some GTT questions? I have one booked in for 14 August - will they get in touch before then to tell me more about it or should I chase it up? Also, the midwife said ages ago that you drink some "unpleasant gunk" - looks like they use Lucozade elsewhere (a much better thought). Can I take some along and get them to use this instead? Thanks.

TarkaTheOtter Wed 31-Jul-13 20:00:16

blankie have you had a letter about your appt? You will need to fast from 10pm/midnight of the night before. Water only, no breakfast. They'll take your bloods when you arrive, then you drink the drink, then they take blood again 2hrs later. Take a large snack to have once its over. If you have GD they'll let you know within a day or two.

I doubt they will let you use lucozade if they don't generally as they would need to know the correct measurement etc.
It's really not that bad as you don't have to drink that much of it.

RobotHamster Wed 31-Jul-13 20:04:49

Maggie - read the thread. I've said I'm having the test. I was in two mind when I started this thread and got all the info I needed.

Blankie - hijack away. MW told me I needed to fast for 12 hours before the test, so I've got one booked for early AM. I'd contact the surgery/hospital just to double check I think.

Emigrated Thu 01-Aug-13 02:25:23

Just wanted to add in my part of Australia all women have a glucose screen test at 26 weeks. If 1hr after a sugar drink levels are not below 7.9mmol then you have the 3hr test. 30% of women end up having it and 10% get gd diagnosis. The risk factors of certain ethnicities and family history are also pointed out on leaflets etc. refusing this test is not on the conversation radar, all my pregnancy friends are keen to know, as was I. I sailed through the screen despite a high bmi and fwiw the only people in my peer group to get it are all skinny. It makes me irritated to read the guilt put on larger women when it's an important test in all pregnancies.

Tortoiseonthehalfshell Thu 01-Aug-13 03:10:26

In Australia, it's given to everyone now (although of course you can refuse it). I was diagnosed positive for GD with my first despite having NO risk factors. My BMI was 23 or so, I was only just 30, I have no family history of diabetes, nothing. So in the UK it wouldn't have been picked up, and who knows how things would have gone?

For my second daughter, I did refuse the test BUT, and this is key, I did so because I already knew how to treat GD and I put myself on the GD diet and monitored my sugars thrice-daily. Which is what I would have done with a positive diagnosis anyway.

bigkidsdidit Thu 01-Aug-13 03:50:25

At my hospital (Chelsea and Westmjnster) we a got it too as standard. It's fine Op, good luck smile

RobotHamster Thu 01-Aug-13 08:23:32

Emigrated - that's how I feel too. Its not like I can do much about my weight at the moment us it (though am trying to maintain my weight, rather than put any on).

Glad to hear its standard for all women in some areas too.

Emigrated Thu 01-Aug-13 17:00:47

yep. Good luck with it.

PetraBaelish Thu 01-Aug-13 17:29:56

Well done Hamster on making an informed decision. IMO the pros by far outweigh the cons with this test!
I have to have it too despite BMI being 21; but my mum had GD when pg with me so I'm high risk. I didn't get it with my previous two pregnancies so I hope I'll be ok again this time!

I won't lie to you it's a horrible, nasty "drink", but you are allowed to have water afterwards so bring a big bottle! At least that will get the taste out of your mouth a bit.

Good luck with the test and I hope you won't develop GD.

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