Does anyone think gestational diabetes is over diagnosed?

[CathyandHeathcliff]

Simply that.
It seems I know a lot of people who have had the test and been told they have it, despite being borderline and have to diet control, not take meds.

I had GD in both pregnancies.
When I heard first, with my first, the community midwife's opening words when I had barely sat down in her visitor's chair were "You're diabetic, young lady". She was quite a sensible and very kind woman generally and once at home, I looked through my purple notes to find that I was actually on the borderline at the time.
But, although I ate scrupulously carefully and exercised in both pregnancies, I ended up on metformin in my both as well as insulin in my second. So I'm interested to see the sweep of responses to your post OP.

no

its a medical condition

it can kill

it is screened for to give people the opportunity to monitor and control it

you are speaking as if it is a subjective opinion, not a scientific fact.

I was literally slap bang on the line when I was tested, and I was very careful with my diet after that - I even measured and loggged everything I ate!

Despite that, I ended up on metformin and a couple of weeks later I had to have my dose doubled.

GD naturally gets more severe as pregnancy goes on, and in a lot of cases you can try all you like but no amount of diet will control it. At least if your borderline and get monitored you can be more sure what’s going on and take action if needed - and if by some miracle it doesn’t get worse at least you know!!

Absolutely not. It's a specific test with specific results, you either have it or you don't, and that includes borderline (many people who are borderline continue on to develop GD as it often worsens throughout pregnancy). The fact that some people have to use diet control as opposed to medication means nothing in regards to diagnosis. Are you saying that if someone has borderline diabetes they shouldn't be diagnosed as such as they can control it with their diet? This makes no sense.

I did until I got diagnosed. I’m only two weeks in and I’m levels aren’t great. I would t have known if I didn’t have the ability to check. Because of the diagnosis my diet has improved and I’m trying to get my excerise in track.

I’m nervous as I’m only 13 weeks and I’m not sure how I’ll go over the 30 weeks

@ICJump best of luck. If you don't mind me asking, what lead to you being diagnosed so early? I'm at risk because of my Caribbean roots, however my test isn't until after the 27 week mark.

Many people who have type 2 diabetes don’t take medication, they control it through diet so I’m unsure what your overall point is. You either have it or you don’t and it’s diagnosed through a test so it’s not as if doctors are quickly diagnosing it for no real reason.

They have changed the parameters recently and now more people are being diagnosed who previously would have been told they’re fine. But I think the argument is that in the past too many people were getting missed. The parameters are based on scientific research. Hopefully this improvement on diagnosis will help to lower the stillbirth rate.

I’m not trying to upset anyone or start an argument, I just find it interesting. I wonder how many people had it before the test was introduced as standard.

I’ve heard the GTT test has a high false positive rate apparently. Not sure how true that is.

I refused the test, I’ve seen nothing to suggest an increase of blood glucose in pregnancy is anything but normal for the vast majority of women

No. I think it's very common as many people have bad diets nowadays.

@CantankerousCamel a friend of mine had terrible results from her GTT. She didn't control it properly and ended up with polyhydramnios, pre-eclampsia and a very premature baby. She has now since developed type two diabetes. There's a huge amount of research in to it. Absolutely your choice not to have the test but gestational diabetes can be really very dangerous if not monitored and there is a huge amount of evidence in support of this.

No. I think it's very common as many people have bad diets nowadays.

I think it is more common but not very common due to bad diet.

All the people I know in rl in recent years who have risk factors for it have tested negative mainly because they know they have risk factors for type 2. This means they have taken more care over their diet and exercise before pregnancy due to this.

My bmi was 30 with my first pregnancy over 10 years ago and tested positive for GD at around 28 weeks, I managed it with a very strict diet and I basically was living on a lower carb diet without consciously doing so.

I lost a good amount of weight and a year after I was down to a healthy bmi and weight and I still am.

I didn't have GD with DC2 but was still tested.

8 years after having a positive GD test I was diagnosed as Type2 at the first blood test during my third pregnancy after losing a nearly 2 stone in as many months.
My presentation was so severe they initially believed I had adult onset type 1 as I am not over weight and I ticked more boxes for that type.

I was treated very well during my pregnancy but my A1c was 106! Which is extremely high, very damaging to myself and the baby I was growing.
I managed to get my A1c down to 40 within the next test but the damage was already done and after being hospitalised with consistent hypos I had a section at 36 weeks to avoid still birth.

I was very upset and angry to discover that under NICE guidelines I was supposed to be offered a yearly diabetes test from my gp after the initial diagnosis of GD with my first.

This was never offered to me and despite losing weight maintaining a healthy bmi and exercising regularly I still developed type2 diabetes.
My case was taken on my the same consultant that looked after Sir Steven Redgrave and was told by him that in the last decade or so a lot more cases of people developing type 2 are presenting without the typical lifestyle presentation of obesity and I was offered and accepted a genetic test to look for information into why I have developed this.
He and his peers believe there are many sub types of diabetes and are still investigating and doing research into this, so no I don't think GD is over diagnosed, I think the perimeters have changed so they can help stop or reverse the effects of a potential type2 diagnosis in the future.

I would implore any mother ttc to first have a HbA1c to make sure her Blood sugars were at a healthy level because there is a 3X fold risk of your baby developing congenital diseases if it's high, it's a very real risk and needs to be taken seriously.

No. And even if it is, there’s absolutely no harm in people trying to control/prevent it worsening through diet.
Far better than being under diagnosed and babies dying from it.
A diagnosis isn’t made on opinion, it’s made on the basis of a medical test. Even if it’s ‘borderline’, it’s still far better to be monitored than not knowing about it at all.

Actually I don’t understand how it could be ‘over diagnosed’? Far better for a borderline result to be identified and managed by diet than for it to go under the radar and meds being needed further down the line, surely?

It’s not more common than before. The reason rates go up is because there is more awareness of symptoms and science/technology has vastly improved. More people are tested now and the tests are accurate therefore there will be more diagnosed which is excellent.

It seems I know a lot of people who have had the test and been told they have it, despite being borderline and have to diet control, not take meds.

How does that equate to it being over diagnosed?

I’ve heard the GTT test has a high false positive rate apparently. Not sure how true that is.

Where did you hear it?

OP, do you think being diet controlled means that they don't really have GD? Because I can't think of any reason why you would suggest it's over diagnoses based on not being given meds?

A friend’s DD (they were TTC for 4 years prior to the pregnancy) died in utero at 28 weeks from undiagnosed gestational diabetes.

@SoyDora That’s horribly sad and I’m sure also very unusual. But doesn’t make it any less devastating of course.

I don’t think people shouldn’t be treated for it even if they’re borderline, I just find it interesting that it seems much more prevelant today, maybe down to technological advances, but also maybe down to more awareness.
I just find it quite an interesting subject and was just an observation. I hope I haven’t upset anybody.

@daffodildelight is caused by pregnancy hormones - not diet.

@CathyandHeathcliff according to the diabetic nurse I see at antenatal, it's not increased in prevalence, they're just testing a wider group of women as standard.

I think there is a lot of confirmation bias. They test a particular group of people (BMI over 30) and discover it in more people with high BMI, well obviously!
I had gestational diabetes (despite BMI being 20 and no other "risk factors" -I had a GTT to try and work out what was causing my abnormal Doppler results), I found it awful as I was written off as a fatty who had brought it on herself, needlessly putting her baby in danger. I had an appointment with a dietitian who suggested: "only have 2 or 3 with your cup of tea rather than the whole packet"