Do I really need the GTT?

[Ivortheengine8]

OK, So I am supposed to have a test booked on Thursday for the GTT, I presume it is because my BMI is 32 this time around (I didnt have one two years ago with dd) I don't have any other risk factors. My BP has come down and is now under 120/60.

Anyway, I presume I will have to drag dd(21 months) off to the hospital and wait around for it, I don't have anyone to take her and I also have an appointment at the hospital on Friday with the consultant :(

Is it really essentiel and even if it was high wouldn't I just have to watch my diet?

nomore - screening (of any sort) is the first step in a cascade on intervention. As far as I'm aware the GTT is caried out in circumstances which do not represent the 'usual' response of the pregnant body. In none of my pregnancies did I fast then take in a massive dose of sugar and sit still (whilst under stress from being tested in hospital). In the absence of any other indication or risk factor it was not an intervention I wished to subject myself to. Tbh it winds me up to read about so many women on here who are going for the test without an understanding of the issues behind it. A diagnosis of GD will as you say take over a pregnancy. That said clearly sometimes babies and mums need particular management.

:( that sucks Bikerunski.
Northern, that is indeed a good point you make.

Bloody hell ladies, I really just thought GTT was simply a pin prick and that was the end of it. God I feel so naive now :(

My BMI is 36

oops - pressed go too quick!!

I just assumed that it was because I had a high BMI that I had to have it.

When is yours Broody?
Do they leave th needle in ladies throughout the 2 hours?

Broody, you are probably the same as me, just a higher BMI :(

No they don't leave the needle in Ivor. They just need a small sample of blood across the two hours to see how your body handles the sugary drink.

I would go for it, either just to reassure you if it comes back fine, or if you do have it then its best to know. Just because you didnt have test for your dd doesnt necessarily mean its not necessary to test now. I never had the test for my ds1, for ds2 they did test but came back okay, and this one tested and I do have it this time. It's a pain hanging round the hosp for ages esp if you have to bring other children with you, but better safe than sorry, if they offer you to test then you might aswel really.
Should be fine to walk dd around the hospital a bit while your waiting, as long as you come back in time for the blood tests i cant see them minding.

Mine isn't till 2nd September - I'll be bang on 28 weeks.

But Northern how are they supposed to identify those women who do have GD if they can't set parameters for the screening? I'm having the test next week as I had with DS1 as my dad had type 2DM. I've had to change the date as I didn't want my toddler with me but I'll happily take the test. Fingers crossed I'll be fine again, but if I do have it, I'd rather know and be monitored in the appropriate way to ensure the health of my baby.

The risk factors will have been determined through research, not some random decision made by a man in a suit somewhere. As for everything, it's different in different areas, just as in some areas you aren't offered a 12 week scan, and GBS testing isn't uniform. I'd rather be offered everything personally.
I accept that pregnancy is far more medicalised than is ideal, but GD poses a serious risk to mum and baby, and I'd happily go through a more medicalised pregancy knowing that the chance of a successful outcome is higher.

'I'd happily go through a more medicalised pregancy knowing that the chance of a successful outcome is higher' - that's just the question you should ask. When I asked how outcomes were affected by GD management I got a very wooly answer indeed from my highly experienced consultant. It just isn't as simple as GT test - management - induction - healthy mum and baby. There are risks and rewards in all these descisions and I don't think that is made clear to pregnant women. I suspect the GTT is portrayed as a benign test that has only an up side and I don't believe that to be the case. ALL testing poses questions about future management and should be entered in to only with that being understood.
Since I was pregnant last I believe NICE guidelines have been broadened to include BMI as an indication - when I was pregnant last only certain hospitals were using that. I am not convinced by the medical profession's approach to to the pregnant fat women so it goes without saying that I am not convinced by this either.

(Sorry Icoulddo should have said - with a family history of diabetes I would have been more inclined to look at the validity of the test but happily for me that isn't the case. In your shoes I would have been far more likely to have the test)

Really cant understand why anyone would refuse a screening test offered to them to determine if them/their unborn child is at risk from a condition that could have serious implications. Out of interst did you refuse the 12/21 week scans as well or is it just the tests that may inconvenience you for longer than you wish?

Fine Chynah - you can't understand it so you go ahead and accept every test you are offered. Perhaps you could stretch to respecting my autonomy over my own body though?

Ok. So i have type 1 diabetes. I understand very well the risks in pregnancy of diabetes of any type, particularly the un-diagnosed and hence uncontrolled variety. Elevation in blood sugars can cause a whole array of issues ranging from large babies to early placental degradation and hence stillbirth. This is not an issue to be taken lightly. How you choose to manage it, if you have it is your own issue.

Personally, I have decided, that with excellent, 'non-diabetic' glycaemic control from conception and throughout the 34 weeks of pregnancy to date that I am going to go to term with regular monitoring and scans and should anything change we will have to make a decision then. i feel very strongly about having un-necessary interventions (hence i am choosing to go against the advice of a 39 week induction and to go to term), but if my glycaemic control wasnt excellent, I would not take on this risk, no way. and I hear you thinking 'but you have type 1 thats much more serious you need insulin anyway'. not so, its not what type of diabetes you have, its whether its under control that determines how serious it is/the impact it has on your pregnancy outcome.

whatever one's personal feelings about over-medicalisation of pregnancy (which due to the NHS's blanket risk assessment of people with diabetes which does tend to happen regardless of personal level of glycaemic control etc, and if you end up in this position you will have to push back to make sure you get the pregnancy/labour/birth you want), un-diagnosed GD is a massive risk for many many complications of pregnancy and plenty of people who are not obese get it. i would say the same to anyone: get the test, see what the result is, and argue later about the kind of monitoring, labour and delivery you want.

Thanks ladies, It wasn't supposed to be an argument, I was simply asking a question because I don't know much about it.
If it changes anything, I am being consultant led anyway because of previous DVT after my last pregnancy so I don't have total freedom in my choices anyway for the birth/delivery. I have a consultant appointment again on Friday and for what it's worth it really doesn't seem much different to a midlife led care.
Chynah, its not about 'inconvenience' I was asking if I really need the test or not, its not that easy to make a 21 month old tantruming toddler sit for two hours as you probably know, If I were by myself I wouldn't even think about it.
I agree that it is up to each individual if they chose to do it or not and it's not really a place to judge from.

Take the test, OP - it could save your life a couple of decades down the road, and don't forget you have a child to think of - you also don't want to suffer kidney failure, strokes and heart attacks while she is still at school. If the test is positive you may require treatment - which could save you from being disabled in 10 years' time. Type 2 Diabetes can be a silent killer and wreck families. Your doctor is right to be vigilant.
The childcare problem for mums with hospital or doctor appointments is always tricky, I sympathise. Perhaps you can ring up in advance and ask if there is an area for kids (lots of waiting areas near clinics or radiology departments) that you could sit out your test in. As long as you're not exercising. Or just somewhere with chairs and you can bring some toys or books to read to her. One thing I have always found useful for long waits (like plane journeys or airports) is to buy a couple of new kiddie magazines with stickers and freebie toys in it to entertain my child when we had a long wait. Two magazines should cover the duration of the test and any waiting time - they're generally no more than £2.50 each.

Sorry, I've just seen you're on the pregnancy thread - congratulations, didn't realise you were pregnant. No, the GTT in pregnancy if advised is very important - if your blood sugars escalate while pregnant you have no way of knowing, and it could be too late, with serious damage to the baby. Do go for the test, and best of luck with the pregnancy. Maybe get 3 magazines!!

Thanks Kipper, Thats a nice reply :)
........................................................OK I will go, I think you have all persauded me and it will put my mind at rest. I will take some toys or something for DD and she will just have to behave!
Northern, I do appreciate you imput and I do see your POV though. :)

In Australia they offer the screen to everyone irrespective of risk factors - I tested positive despite being barely thirty, no history of diabetes in the family and BMI of 22.

I do absolutely understand what NorthernLurker is saying, and that diagnosis meant that I then had to fight tooth and nail for my low intervention birth, it made it about a million times more complicated and took a huge amount of emotional energy. It annoys me that women are just told to do x, y and z without real informed consent being present. And it's well documented that fat women are discriminated against in health provision generally, so it doesn't surprise me that this is another example.

BUT I understand that recent research (I've just received a second positive diagnosis, so am reading up again) indicates that the risk is more than just having a big baby and subsuquently complicated birth, there's also research showing that GD babies, where the GD was poorly controlled, have a higher risk of complications that mimic those present in premature babies, even if the GD baby is fullterm. I haven't yet got hold of the right studies to show me how great that risk is, but it's certainly there.

If you want, OP, since I'm researching this at the moment anyway, I can share some links as I dig them up?

Thanks toirtoise, Yes, dig em up and I'll have a look.
I think one of the main problems here is that things just are not explained properly so half the time we are doing something we have no idea about. Thank God for google!