Anyone decided NOT to do the glucose test?

[Jill72]

Has anyone made the decision not to take the glucose tolerance test?

No, I have turned down a few others but this one is important. Gestational Diabetes can have serious effects on the mother and unborn baby so if I had it I wanted to know so we could do the best we could to prevent it progressing.

What are your reasons for not wanting it?

I refused the gtt with my second pregnancy. My only connection was that my brother had type I diabetes, and my gtt had ben fine with my first pregnancy. I knew what the symptoms were, and I said I would let them know if I had any.

I don't understand why you would refuse it? What are your reasons?

Is that the one with a really high rate of false positives? If so, I had it, it came back that my sugar levels were too high and I had to go for further testing (four blood tests in a day, fasting and an hour after each meal) and they came back fine. I'd still have the test again though, just in case.

Have you tried doing a gtt in a small hospital room with an 18 month old?

That was reason enough for me :)

I want to know more about it as I don't feel I fully understand - my BMI is only just over the acceptable mark but already they are starting to say I can't do this or that and I feel that the birth I wanted is quickly being whittled away and don't want this to be another stick they beat me with. I am open to listen to the great common sense advice from mums on MN to get a more rounded understanding.

In that case isn't it better to know that you DON'T have it so it removes a stick to beat you with?

I have to have it next week at 35 weeks but that is because baby was measuring very large and I had sugar in my wee. But as it can have serious complications for both mother and baby if you do have it then isn't it better to know so you know how to manage it?

I had it at 16 weeks as every urine test up to 15 weeks had come back positive for glucose. It came back normal so they've dropped it now, my midwife even said she'd put me in for it so early so that if it came up later on we'd already ruled it out. As LadyGoneGaga said, if you do had GD then this way you're better prepared, and if you don't then it's one less stick for them to beat you with. I know quite a few people who've had to have it and in only one case was it due to her weight, they pull it up for all sorts of people for all sorts of reasons.

I've had similar issues with my BMI being (one point!) higher than the accepted limit. However I have also had the plasure of watching the looks of disbelief when my BP has been low and I didn't gain any weight til 18 weeks.

I know I am going to be pushed to do it again as my BMI is high. I had to eat a shed load of things and then later that morning go and have blood drawn. I didn't have it though if you have a bad bmi then thats another thing they want to worry about. Has any one else had the death and disaster talk as I was told I could get pre eclampsia to which I have never had in 4 pregnancy's. I only get high blood pressure when I see those pesky doctors. I don't do well on those electronic bp machines either. Doctors want to do these test I feel to insulate them from malpractice suits. If they have made you have all the tests then if something goes wrong they can't get sued.

The only indicator I have is a slightly high BMI - no glucose in samples, baby measures average, normal blood pressure. I agree that doing the test will then inform me and I will probably do the test but I wanted to see what other peoples experiences were and what the general feeling is about it. I have been told that I cannot have a water birth due to BMI,(dress size 16 / 18), I could have blindly accepted this but when I asked what the MEDICAL reason is for not being able to it turns out it is health and safety - in case they can't get you out of the tub!!! With no disrespect to anyone I am no HUGE unmanageable gal!! It annoyed me that they made this decision based only on a numerical figure rather than using common sense and making an individual risk assessment on the person they see in front of them - It is making me question the agenda / reason behind other things I am being told. I would in no way endanger my baby but I want to be clear about the reasons behind the things I am being told or asked to do.

jill72 you sound in a very similar position to me - my BMI was 34, so not ridiculously huge, and I was thinking it was a waste of time doing the GTT too.

However, my GTT was above the limits, so have been blood testing 4 times a day for the last 5 weeks or so, and my levels are extremely difficult to keep under the required limits, even with medication.

So I would say definately have it done. I also was reluctant to go, with 3 other kids to sort out it is very difficult to fit in appointments, but even if you go and it is negative, then at least you know you are ok. I'm now having lots of extra monitoring, and hopefully everything will be fine, but better to be safe than sorry I guess.

I had BMI of 31 and a previous baby of over 4.5KG (DS2) as risk factors, although I was tested in DS2's pregnancy and didn't have GD then. This is my 5th pregnancy to go past 20 weeks and I haven't had GD in any of the others. I didn't have any symptoms or glucose in my urine etc but had the GTT anyway as having previously lost twins after they were born extremely prematurely at 24 weeks, only last year, I didn't want to take any risks.

Needless to say, I do have GD and although I was only just over the levels when diagnosed at 24 weeks, I am not on pretty large amounts of insulin 4 times a day. There was never any question of me having a home birth due to a blood disorder I have and being on heparin, but the GD and insulin meant the Home from home unit was also out of the question, as I will need to be on insulin and glucose drips during labour. Other than that though, the hospital have been willing to see how things went and I am partly being induced because I wanted to be. Had I wanted to try for a spontaneous labour I strongly got the impression they would support that and monitor me accordingly.

GD can have extremely serious implications for baby and Mother. I appreciate it's hard not to get the sort of birth you want, but it would be much harder not to even get to take home the baby you are carrying and all because of avoiding a test that could have helped avoid problems.

Thanks for your comments midori - you are right that bringing a healthy baby home is all that matters in the end and it seems that people are saying that this test is important. I just want to be sure that I have all the info I need to make right decisions - this is why I love this site as you get to hear so many different perspectives or discover things you have missed!! :)

I don't think you really need to worry about a 'false positive' as if you are diagnosed then you will be asked to test each day (between 4 and 7 times) first of all eating your normal diet, then making dietry adjustments if needed to keep your levels under control.

AFAIK, if you are diet controlled, even a home birth wouldn't be out of the question.

I had this even though I thought I was very unlikely to have GD, as it would be helpful to know if I did. I refused consent for booking bloods though- HIV, syphilis, rubella antibodies, blood group and rhesus factor etc.

I've refused it twice. Like the op my only 'risk' factor was BMI. I felt the evidence base at that time for having the test was weak (though I think there hav been more studies done since). I also had a very practical objection in that the whole thing was not going to work anyway. I was sick throughout all my pregnancies. If I had fasted (not a problem) and then drunk the sugary stuff you need to, without question I would have thrown up. I also felt that the increase in interventions proposed - starting with the GTT and ending with possible induction, drips in labour etc was not in my best interests to contemplate without other compelling evidence. There was none. All of my children were born at healthy weights through vaginal deliveries.
It really worries me that women with high BMIs are made to feel that they are endangering their babies and therefore MUST accept intervention. I think the GTT should be very carefully considered because on that one reading a lot of decisions may rest. Even if you 'fail' the GTT but then control your blood sugar well you will still be labelled as diabetic by many medical professionals and that is not always a good thing. That was my gut feeling when I refused the test with dd3 and my midwife then confirmed that opinion when I talked to her about it afterwards.

I passed my GTT at 26 weeks but they wouldn't let it drop (high bmi) and they eventually 'diagnosed' me with GD at 38 weeks and I was induced, dd was pretty much force fed formula etc etc. It was all horrible.

Had my booking in for this pg today, told the mw the story and she was horrified at how I'd been treated and admitted that it looked like they saw my bmi, decided I must have GD and that was that.

That's awful Gwendoline - and exactly the mindset I was worried about.

my consultant wants me to have one and |I am not keen. my only risk factor is that I have pCOS, although I was slim when I conceived (60kg). It is bloody annoying tbh as I know I will have issues keeping the liquid down and I will be embarrassed. \Might have to do it though just in case as I know gestational diabetes can be nasty and better safe than sorry.

"my BMI was 34, so not ridiculously huge"

Sorry, but a BMI of 34 classes you as obese, unless you are very muscular. An ideal BMI is considred to be between 18 and 25.

"I refused consent for booking bloods though- HIV, syphilis, rubella antibodies, blood group and rhesus factor etc."

Why? These aren't diagnostic tests like the triple test is. If you are rhesus negative and it is your first pregnancy you will be fine, but if you are rhesus negative and your partner and unborn baby are positive it could have serious implications. This explains it better than I can.

I have none of the risk factors for GD, except that they picked up high blood sugar at my 28 week bloods. Got sent for the GTT and it came back positive, so now I'm under the care of the diabetes team. It's a bit more effort going to the hopsital more often, but actually the diabetes people are much nicer than my community midwife!

If you can be bothered to read, I think that the NICE guidelines (chapter 4) have some good information about risk factors, diagnosis and treatment:

www.nice.org.uk/CG063fullguideline

I, too, felt a bit like the birth I'd imagined was being slowly taken away after the diagnosis. But now I've had some time to think about it, I am calmer and don't mind so much. In fact, I think I'd been quite blase earlier, and being forced to think about induction and interventions has given me time to actually consider all the options instead of just thinking 'oh it won't happen to me'.

As for the waterbirth, I am surprised that BMI is given as a reason for not allowing it - might be worth pursuing with another midwife?

gwendoline that's an awful story, I'd hoped that sort of attitude didn't exist :(

I declined the GTT in my last pregnancy (baby now 5 weeks old). Part of it was not wanting to fast, drink something revolting and endure 4 hours at the hospital with my challenging first born. But primarily it was because I felt it wasn't needed. My only risk factor was my bmi (39 at booking). I'd had no problems with my first pregnancy, no history of diabetes in my family, and I knew I wasn't diabetic/pre-diabetic already as I'd been tested a few months before I got pregnant and had no issues with glucose in my urine, baby was an average size and I had no any other symptoms indicating it was a problem.

northernlurker - you have pretty much echoed my suspicions and fears. I am feeling more and more like a product on a factory conveyer belt - I just want to feel as if the professionals are taking notice of ME and my circumstances rather than reeling off by rote guidelines and not stopping to take into account me as an individual.

Yes that is exactly how routine GTT testing makes you feel. You don't have to have it. You may need to re-evaluate that decision at some point but like every test and intervention it is optional. Good luck with your pregnancy

There do seem to be some rather tenuous reasons for giving the test. I have to have one at 28 weeks, I got the appointment letter through at about 15 weeks and I don't have risk factors, my BMI is 17.3 so not overweight. The only reason I can think of was DS weighed over 10lb, although this is very likely to be genetic as I was 9lb10oz.

I won't be refusing it though.