GTT test reasonable?

[Rosie55]

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.

Leonie, firstly women with GD should not feel guilty it's not their fault.

Secondly do not underestimate the risks to the baby with uncontrolled GD, been there done that in my last pregnancy when it wasn't spotted until too late, and my son nearly died due to complications and it was my most unmedicated pregnancy to date as they never knew I had it until just before they delivered.

When my diabetes has been monitored my babies have been fine, so please don't make wild ranting posts like that when you haven't actually been on the receiving end of GD and it's complications, as you have never had it.

Oh and it's common for babies born to diabetic mothers to have problems with low sugar, as they are used to receiving high sugar from the mum and it takes them a while to adjust their over production of insulin.

Secondly a failing placenta can be caused by uncontrolled diabetes.

So again to point out the innaccuraccies in your posts, you can't blame the medication in your friends case, they are risks of GD anyway, NOT insulin, hence why it's important to monitor it.

Coming from a mum whos son nearly died at birth, who had low blood sugar, was very small due to a degraded placenta, depriving him of nutrition, breathing issues, etc. I had diabetes which went unmedicated as it wasn't spotted.

So please don't scaremonger those who wish to have the GTT to rule it out, it's important. The issues your friend had are side affects of GDD anyway, not insulin.

Our trust offer GTT as standard. My SiL is completely average and she had it, picked up GD when she was pregnant with DS2. She was glad for the additional care, she was treated at a different hospital to me, but still in the same trust. I am going in for a GTT at 28 weeks [mid october], I just have to fast before hand head to the unit and take a dose of sweet stuff, two hours wait at the Community Unit or at Home, our choice. The tests are offered on a Monday, so there will be other M2B there as well, I plan on waiting around. I feel that I am informed of what to expect and don't feel scaremongered into taking the test, it was my decision to do it and it's my first and want the best possible care for LO.

Hi

Can someone explain to me why you WOULDN'T have the GTT test (fast, blood, glucose, blood). Is there any danger to the baby?

I just had mine at 28 weeks. But I am currently coping with my pregnancy in Chile, where I probably only understand about 75% of what the docs say to me. They told me to take the test, so I did.

I have a normal, slightly low BMI, no diabetes in the family and this is my first baby.

Thanks

Victoria

Leonie you may be right and I'm sorry for your experience but I don't think your posting style is particularly helpful to the OP.

I had GD in my first pregnancy but it was very slight and well controlled with diet. However I did feel it made the birth over-medicalised (induced early) and trying to breastfeed afterwards with ward staff threatening to make me give the baby formula if I couldn't do it (I did have problems and mix fed for a bit but eventually managed to stop the formula) was really horrible and, I now realise, unnecessary.

But I had DD in a famously bad labour/maternity ward so yours may be fine.

I'm now pregnant again and was in two minds about the test but decided to take it again because I felt I could be more assertive about refusing induction (as long as I was keeping my blood sugar under control) and the possibility of the baby being really ill when born was enough to make me have it. I seem to have escaped it this time (32 weeks and no sign so far)!

I recently decided not to have the GTT. The only category of risk I am in is borderline BMI. My BMI was fine up until 6 months before falling pregnant, I gave up smoking and piled on the pounds. Drs advised to stick to not smoking and not try to tackle the weight gain which I did.

So a few months later I am pregnant with a borderline BMI and am told to attend the GTT. I stress told, because no one advised me that I could decline if I wanted to. After much research and speaking to my birthing class tutor I declined the test due mainly to the very real threat, that the GTT is just another way to unnecessarily intervene medically in my pregnancy and birth. I believe I have no symptoms of diabetes, and I have very much been on the lookout. If I develop any symptoms or problems I will of course seek medical help immediately. But, I will not allow the overbearing medical profession to ram road me into induction, cesarean and god knows what else. I am practicing hypnobirthing and am aiming for a happy health and NATURAL home birth. If I had the test I forsee that none of my wishes for that kind of birth would be respected and it is not a chance I am willing to take. I must stress though, as much as I want this birth, should there be any complications of any sort I would of course be seeking medical help, BUT only when it is needed and not as a matter of course.

Leonie I disagree with some others on here in that your posting style really helped me think about the test, why they said they needed to do it, whether I felt it was needed and how much intervention it could cause... So, thank you, I am a healthy happy pregnant lady with no complications as yet and no worries about my natural ability to birth my baby. Skipping the GTT is what I have chosen and I must stress, that there are still a good few many weeks for any symptoms to become apparent naturally rather than ingesting a huge rush of sugar into myself and the baby. If these symptoms occur I will gladly seek medical support but as it stands the GTT was not for me.

islandbaby - sorry this might be a bit late for you but there aren't any risks associated with the test - apart from having to starve yourself before hand! :)

Just to say, I have NONE of the risk factors for GD. Nevertheless, I have developed GD. I have seen the posts from people about the guy who says it doesn't exist and it is over-medicalising a problem which isn't real. However, there is a relationship between GD and stillbirth etc.

It is very possible that they are exagerating the problem hugely, however the medical profession are not doing this out of malice. I personally do think that the medical profession have a tendency to resort to the medical (drug) model too easily. However, it is only when blood sugars are uncontrollable by diet that they will medicate. It is possible that the cases controlled by diet are perhaps unnecessary. However, the GI diet that you need to eat is exceptionally healthy, both for you and the baby. It is a bit incovenient, I do have to cook more, but actually because what I'm feeding myself is more healthy, it is much better for my baby. So, if it is unnecessary, it is still actually a good thing. And if it isn't unnecessary (in terms of the negative impact of GD in some instances on the babies development/life), then obviously it is vital to do.

In view of this, failing the GTT, and ending up with a diagnosis of GD, whilst perhaps in some cases (possibly even the majority of cases) is unnecessary, it does no harm at all to the baby, or to you (based on the fact that most cases are managed by food and exercise), and potentially it does a life-saving amount of good.

Based on that, why whouldn't you have the test?

Saying that, I am still happy to disagree with the doctors about when they want to induce me etc. But that is because I want that to be based on monitoring not on hospital policy! If it is genuinely based on concerns about the baby then fine, but otherwise I'd rather wait for nature to take it's course.

alison

I don't understand why you wouldn't have the test. What risk in the test is percieved by OP. A measured ammount of lucosade (or what tastes like undiluted kiora here) will send your blood sugar high, but a big bowl of pasta and a slice of cake will do the same if you do have GD and you could be doing that weekly thoughout your pregnancy, or even daily depending on you diet.

In my first pregnancy I was diagnosed with GD following a high blood sugar reading at 28 week midwife appointment, I had none of the risk factors. For the record I managed the diabetes by diet alone, was well monitored but went full term and gave birth naturally without any medical intervention, to a healthy 7lb7ozDD. My consultant was more than happy with this, in fact it was his advice, I didn't have to argue about being induced early.

This time I'm monitoring my bloods at home and so far (23wks) it hasn't returned.

Like Ally, if it does come back I will still hope to go full term waiting for nature to do it's thing, however all a consultant needs to say is, the placenta is starting break down and I'll be requesting the croquet hook myself - times up babe!

Well manage GD for many is a minor inconvenience. Undiagnosed and unmanaged GD can put your baby at real risk.

Can I ask what the 'risks' and signs of GD are? I'm 23+4 at the mo, and am booked in for a GTT test at 28 weeks, but haven't been given any real info on GD.

As far as I am aware there are very few signs that you can pick up with GD as they meld into general pregnancy stuff - maybe thirsty, maybe headache, needing to wee more often - see what I'm getting at.

It's usually picked up with a routine blood test or sugar in your urine at a MW appointment - but this doesn't mean you have GD but it would trigger a GTT.

There are a few threads on GD here and the Diabetes association has info too. Look for info on reliable sites.

As I understand it the main risk, especially with GD in the last Trimester is having a bigger baby and the placenta not coping. You don't want your baby to get too big as that can cause problems at birth. If you do get GD you will be well monitored and supported. People with GD are often induced at 38 weeks to avoid complications if there are concerns about the babys size or the condition of the placenta.

Good luck and try not to worry ( easy said I know)

wish I had the balls to refuse but I generally just do as I am told. Had GD diagnosed with DS1 (was sent for test because of highish BMI). they wrote the result down wrong so it was total gibberish but decided to put me on the GD "programme" anyway - cue much time at the hospital, missing work for pointless app. with the consultant who looked at my diary and said "fine" every two weeks. Was entirely diet controlled and only went over the upper limit when they changed the limit! Submitted to induction on my due date despite Baby not scanning large and had a hellish 5 day saga of failed induction ending in CS. Really do feel that I was overmedicalised and interfered with. DS had very slightly low blood sugar at birth and that ws dealt with within 24 hours. Really wanted to not to go donw this route again but have already been bullied into it by booking in midwife so here we go again...