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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

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Original poster

GTT test reasonable?

40 replies

Rosie55 · 10/09/2010 11:30

I know tests for gestational diabetes have been discussed before, but would be grateful for opinions.

An appointment was made for me to have the fasting GTT because DD1 was 'big': 8lb 8oz. This is the only reason.

I've had no sugar in urine samples, though am only 21 weeks so far, no family history of diabetes, and my BMI before pregnancy was 20.

Do you think it's reasonable? I don't want to put the baby at risk, and DD1's birth was tricky: back-to-back, then head at the wrong angle leading to ventouse.

I'd rather not have a much bigger baby, but I don't want to be induced either, and DD1 wasn't over 4 kilos, which I'd understood to be the threshold.

Any thoughts? Thank you.

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loftyjen · 10/09/2010 11:35

Think it's reasonable, yes the test is annoying but really not invasive (apart from a couple of small pricks for blood). I've got GD and not had glucose in my urine at all.

While they talk of BMI putting you at higher risk of GD there are still plenty of skinny minnies I've met and seen in GD clinic.

If it is GD it can be managed well and your concerns regarding the birth can be addressed - if it isn't GD then hopefully the team caring for you can also help you to manage/plan for the best birth possible x

thisisyesterday · 10/09/2010 11:37

i do think it's unreasonable yes

i was booked in for one for the same reason. previous big baby (9lb 1)

however i met NONE of the criteria on the sheet they gave me, it said babies over 10lb previously, high BMI, over 35 and a few other things

i declined it

me23 · 10/09/2010 11:41

There is no reason for you do have a GTT your 1st child was not considered 'big' by nice guidelines, which state a previous baby weighing 4.5kg or more 8.8lbs is 4kg.
You also don't have any of the other risk factors.
Here is a link to to NICE antenatal guidelines www.nice.org.uk/nicemedia/live/11947/40145/40145.pdf obviously hospitals can choose not to follow them, but you have every right to refuse any test that you may feel is unreasonable.

Original poster

Rosie55 · 10/09/2010 13:45

Thanks for your replies, which are very helpful. It's great to have the NICE guidelines.

I'll think about it and maybe discuss it with the community MW (different from the hospital one who booked the test without consulting us).

OP posts:

emmab5 · 10/09/2010 14:15

Hi, I have GD and have never had any glucose in my urine in fact my GD was only detected by a GTT. My BMI was 20 pre pregnancy too.

The test itself isn't too invasive, just a couple of blood tests 2 hrs apart.

I was a little anxious once i'd been given my results but am very glad that I know so that my antenatal care can be planned appropriatley.

IMO it's probably worth having it done if just to rule anything out.

ArthurPewty · 10/09/2010 14:28

This reply has been deleted

Message withdrawn at poster's request.

emmyloulou · 10/09/2010 19:12

The whole idea of the GTT is not to see how you react to everyday circumstances, but it's a glucose stress test normal people can handle it, diabetics can't.

Your call really, if you have been offered it then I'd take it, I had a baby born to me when I had GD which went undiagnosed, he was severly ill after birth....

thisisyesterday · 10/09/2010 19:19

but the criteria for the test are there for a reason...

if you're just going to offer it round willy nilly then everyone should be offered it surely?

the OP meets NONE of the criteria for needing the test.,

thisisyesterday · 10/09/2010 19:21

in our area the way they do it is stupid too.
you have to buy your own lucozade and measure out a precise amounu

fast all night. drink the lucozade, then get to the hospital for your blood test which must be done 2 hours later.

they don't allow you to take a priority ticket, so if the phlebotomy dept is really busy and you miss the time slot it's tough luck. you have to do it all over again. each time you just have to hope you can time it right for the 2 hours

that in itself is ridiculous, but if they genuinely thought you may have GD then surely asking you to fast, take the lucozade and then get yourself to hospital is really fairly stupid?????

emmyloulou · 10/09/2010 19:23

I think some trusts do offer it now with no criterea as standard at 28 weeks as they do other screening tests, HIV, etc. Seems to be the thing at the moment in some areas, people are just being offered them as a screening test.

I never met any of the criterea when I first got GD.

thisisyesterday · 10/09/2010 19:25

neither did a friend of mine, and hers was picked up without the GTT as well (tho she did have that afterwards to confirm)

did you have any symptoms Emmy?

Northernlurker · 10/09/2010 19:31

I don't think it's a reasonable test at all. But I would say that as I've refused it twice. The test is not invasive as such - though it's not much fun. But like all tests it does lead to a greater medicalisation of your pregnancy. I think it is an over-used tool and may be used to limit your birth choices without necessarily improving the outcome for the baby. As others have posted there is no nationally recognised reason for you to even consider having it.

emmyloulou · 10/09/2010 19:33

Nope none at all. No symptoms at all. It was picked up first time as they did a random glucose, just because in routine tests which came back high, then I had a GTT. This time I have symptoms as it's quite bad and medicated but still no glucose in urine!

My last pregnancy GD was missed and it must have been quite mild as I was grade A criterea, previous GDD. Yet the GTT at 28 weeks came back fine, my glucose in my blood at random tests came back fine, no symptoms, no glucose in urine, nothing.

He was born and was very, very ill, turns out I was diabetic but it was not being monitored so had caused loads of issues.

But it's starting to creep into some trusts now that it's just a screening test they will do for all women at 28 weeks, it depends on the trust and some a lucozade tests, some a breakfast tests, it's all trust dependant.

emmab5 · 10/09/2010 19:33

I had my GTT done at my GP surgery. Yes I had to fast and take a bottle of lucozade but small price to pay for health of baby and me.

If you didn't fast the blood results wouldn't be accurate which is also why you need 2 hours between 1st and 2nd test.

EmmyLouLou so sorry to hear about your experience. How is your DS now?

thisisyesterday · 10/09/2010 19:39

i wasn't complaining about having to buy the lucozade per se, nor the fasting, nor the time you have to wait.

it was more the fact that they didn't enable you to ahve the bloods taken in 2 hours. and i think it's pretty stupid to get someone who potentially has diabetes to get themsevels to a hospital after doing it!!!
if they genuinely suspect it they should be doing it supervised in hospital.

if i'd had GD i could have died getting myself to hospital after doing that

emmyloulou · 10/09/2010 19:42

Yeah well I had to do the same kind of, I had to eat a breakfast this time, a set one and then drive to the dr's for my blood test 2 hours later.

Crazy really, although in my last trust it was supervised from start to finish.

emmyloulou · 10/09/2010 19:44

Emma, he is fine now, but he was born at 37 weeks v. small, lots of fluid and need a vent even at that gest.

Turns out it was all from complications with his sugars, my placenta etc, which they would have know about if they'd have been watching me as diabteic, so don't worry in all my pregnancies where I have been diagnosed, I had extra scans etc and healthy babies

thisisyesterday · 10/09/2010 19:45

my friend who they were pretty sure had GD (baby was mahoooooooosive on her 20 week scan) had hers done in hospital, totally supervised

unfortuantely tehy made her drink this really vile drink and she puked it all up lol, so had to drink it all again (well, a new one obviously)

makes you wonder doesn't it. this was in the same trust. i figured they must not really think i had it or else they'd send me to hosp to be tested too!

emmab5 · 10/09/2010 19:57

emmyLouLou glad your DS made a full recovery.

It's scary how procedures vary from trust to trust - I was lucky enough to be able to have GTT at my Gp surgery and they wouldn't let us leave between tests, we were supervised the whole time. I wouldn't have wanted to have travelled to hospital for it

emmyloulou · 10/09/2010 19:58

Weird isn't it, they pretty much expected a + for me as this will be the 4th time now.

So they expected me to load up with sugar the drive to get my bloods done! Good job it was not as bad as it is now, it tends to get worse in most cases the later you get, I'd have blacked out!

sillysow · 10/09/2010 21:11

ditto emmylous sentiments. My GD wasnt spotted until 2 days before spontaneous labour, although symptoms AND results had been there for 3 months. As such I was poorly immediately prior to labour, and I think it made it a much harder experience. For the sake of 2 needles I would do it. Far better for it to be managed than not in my experience.

saoirse86 · 10/09/2010 23:09

I was given a GTT as well, despite my only risk factor being that I have coeliac disease. I just went for it. I just thought that even though I knew it would be fine, there was no harm in taking one morning off work and feeling a bit hungry for a few hours. I'd have been more annoyed if I'd refused and found out later that I did have it.
Even if you do have GD, you surely wouldn't be forced into being induced. Presumably it's still your choice what to do later.

Original poster

Rosie55 · 11/09/2010 15:25

I've read all the posts with interest, and was sorry to hear about your DS's illness, emmyloulou.

I'm not put off by the test being unpleasant, but by the possibility that a positive result could lead to more medicalisation of the pregnancy without a proven better outcome for the baby.

That being said, DH and I are quite cautious by nature so I'll probably have the test.

Thanks again.

OP posts:

heidipi · 11/09/2010 16:34

Hi all - I've just been referred for a GTT test next week because at my 28 weeks scan (which I had due to high BP before I was pregnant, as apparently that can result in a large baby) the baby measured fine but the fluid level was a bit high (21.5cm when the expected highest level is 20cm I believe).

I'm 41 so they seem to be being cautious, which is fine as my BP is an issue, but I hadn't really thought about GD before so I'm a bit worried about it. This is my first pg and my BMI was 23 before I was pregnant so I think my age and the increased fluid are the risk factors.

We'll see anyway, but it's useful to hear about other experiences. I have to turn up at 8am have a fasting blood test, then the glucose drink, wait for 2 hrs then test again. Apparently I get a biscuit afterwards too - hurrah!

CardiCorgi · 11/09/2010 16:49

Well I'm not in the UK, so things are different here but my doctor does the test with every single patient. Her reasoning - it's cheap, easy, not excessively invasive for the patient and gives important information. If you have GD it really should be monitored and kept under control.
For what its worth, I was fine but an equally slim sporty colleage had GD for each of her pregnancies although neither her age or weight would have put her in a high risk category.

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