Don't understand why I need a GTT

[pinkjumper1]

I have a relative with type 1 diabetes and I've been told I will need a glucose tolerance test. As far as I know type 1 diabetes is caused by an autoimmune disorder. Gestational diabetes is caused by insulin resistance like type 2 diabetes so I understand there is a link between these conditions but I don't understand why family history of type 1 diabetes would increase my risk of GD. I've had a look at the NICE guidelines and the RCOG website but I can't find anything. I'll happily have the test if I really need it but I'm low risk otherwise and don't want unnecessary investigations.

Doesn't everyone have a blood glucose test? I thought it was standard.

It's standard in some areas - it is in mine

I think it's standard now, nothing to do with your relative's diabetes. Anyone can get it.

In my area if you're over 35 OR if you have a BMI over 30 OR if you have a family history of diabetes you're tested during pregnancy,

I imagine it's due to your relative with type 1 diabetes, maybe they don't trust a person's testimony as to which type of diabetes their relative has/had, so test everyone who has a relative with any type of diabetes.

I can't comment on whether the person you spoke with has the facts correct re type 1 and GD, but I live abroad and its a standard test in all pregnancies here. Good thing too as I had it with my second baby (but not with my first). I didn't have any obvious risk factors.

And in terms of unnecessary investigations, you know you just drink a bottle of Lucozade and then they test your wee a couple of hours later right? It's not remotely invasive or going to put you/your baby at risk

Jiggly mine was a fasting blood test, then a bottle of Lucozade, and then another blood test two hours later. So slightly invasive.

In my area it's standard to get tested if a family member has diabetes because you are at higher risk of developing GD. They were right in my case and I am glad they did the test. Had to do a fasting blood test and wee sample, drink a glucose drink (not Lucozade actually) and after 2 hours I had to have another blood sample taken.

I had to have one too because my dad has type 1. I was given the impression there is a statistical link between those with diabetic relatives and GD in pregnancy.
The test is dull but very straight forward. Fasting blood test, overly sweet drink in 5 mins, wait 2 hours with little activity and follow up bloods.
Given they test your urine for sugars (as well as proteins) at every appointment, and you'll be sent if any show up, I think it's just one thing they are very careful about.

Oops obviously forgot about the blood test! I give blood so I'm used to it I guess! Sorry OP

Op I have just done the test. I have never had any sugar in my urine or GD in my previous pregnancies. This one came back as positive!. Would you not be rather safe than sorry? Its not invasive and the problems caused by GD can be huge!

There is statistical evidence that having a first degree relative with diabetes does make you higher risk for having GDM. Some trusts offer everyone the GTT wheras some trusts just offer women with GDM risk factors.

Ive been advised (by a medic) that if you have a close relative with type 1 you are predisposed to it or other autoimmune disorders. My dad, uncle and sister are all type 1.

I wouldn't really call a simple blood test an 'unnecessary investigation'. It's a couple of hours out of your day and is in the best interest of you and your baby. No need to get worked up about it.

I had the test with my first but not with this one, was surprised as I thought it was something everyone had - nothing with myself has changed other than age

I refused the test recently - I was offered it because I'm measuring a month ahead. However my partner is 6'5" (I'm 5'2") and I have no risk factors.

I was lucky to be able to test my own blood sugars regularly over a couple of days at work, as I'm a health care professional, which gave me confidence in not having the GTT. But I don't regret refusing it. I think the 'nocebo' effect is real, and understand where your reluctance is coming from. I posted here at the time and all responses were along the lines of 'it's only a couple of hours, why wouldn't you just do it??'. But interventions aren't neutral, how you feel matters and it's ok to think on it. Discuss it more with your midwife if you feel you need to x

Thanks for the replies. As I say I will have the test if I really need it - I just don't understand the logic but I wouldn't want to put the baby at risk obviously. I've had GTTs before so I know what's involved - just hoping to avoid it this time as I can't bear anything sweet. I don't eat any sugar or white carbs and felt really sick when I had to have some birthday cake so I don't think the Lucozade would stay down!

The glucose content you 'need' to consume can also be substituted by something else like pasta or rice or something (fast sugars). Try and get them to consider that.
Enough advice online (for diabetics for obvious reasons), but MPs love to work with straightforward things, even if it inconveniences their patients.