Any other way to be tested for gestational diabetes?

[Ro84]

Hi,
I was given an appointment to have the glucose tolerance test done last month and since then i have just been having anxiety, crying and feeling guilty because i cannot physically have blood taken out of me 3 times in the same day.
I never liked needles and fainted before when someone takes my blood but since i am pregnant this is out of control. My normal blood pressure is 90/60 at its best, so i suppose that the decrease in blood volume it doesn't help this either. Phlebotomists/nurses and even ED doctors struggle to find my veins, sometimes the blood stops flowing after a few drops which makes the doctors to poke around and then i faint. I fainted in my 12 week appointment (my reasoning, it was too much blood at once for my 4'11" and 40 kg). A few days later i had the trisomies blood test. My right arm (which is my good-vein arm) was bruised so no blood came out of it, so the tried the left arm. All was fine but i could feel the blood flowing out of my and it felt like a really long time. Despite my being lying lying down and with the senior phlebotomist talking to me i fainted. I came back after a few seconds and my husband was called to the room then after 1-2 minutes of feeling clammy and not well i fainted again, this time my husband said it felt like minutes and i was convulsing. I came around, and i delayed the whole clinic, they kept me there 0ver 2 hours because i was still pale and not feeling well despite the tea and biscuits. The rest of the day i felt sick and the next day i had to leave work early as i was feeling weak and light headed. Last week i ended up i ED and the doctor put a line, oh my god, i went all white and couldn't get up from the couch as if i did i would have fainted. im proud i didn't fainted but i felt again clammy, sweaty and sick. So i delayed the whole ED by lying in that bed for 20 mins.
I have spoken with my midwife and with the people who perform the test in the hospital (by phone and then personally). They cannot take blood only 2 times, it has to be 3. They cannot put a line (why, wouldn't it be easier???). They just say they strongly recommend me to have it but i can refuse. i told them that i want to know if i am diabetic (family history), can i have another test or i can check my blood sugars for a week with a monitor, just like diabetics do? "no, we don't do that". it's like talking to different walls. They must think i am exaggerating. It might be a psychological problem, but the fainting, veins closing and feeling sick for the next 2 days is real. Even if overcome all my fears and low BP, the best phlebotomist wont be able to find 3 flowing veins in my body on the same day.
I don't know what to do, i don't want to go undiagnosed but i cannot continue having this anxiety, lack of sleep and guilt about having/not having this test. I feel that all this fainting and anxiety is worse for the baby than any diabetes. Is there other possible way to know if someone is diabetic?

Goodness that sounds dreadful, I’m sorry I can’t offer advice but what did your midwife say when you told her you didn’t feel capable of doing the GTT?

Your situation sounds very stressful for you, not just for the gestational diabetes diagnosis but for all your interactions with health care.

The glucose tolerance test is the best way to find out what is happening, but as you have been told you can refuse it.

May I strongly suggest you ask your GP for a referral to mental health services for CBT - that's cognitive behavioural therapy. Explain that your phobia is preventing you from taken advantage of test to support your pregnancy.

My DD has a needle phobia, and she had about 6 sessions which really helped her. She still becomes anxious but can 'control' her reactions enough that she can have injections and have bloods taken.

Make that appointment as soon as you can so you can get into the system

I attempted the gtt testing and they only got blood once, and failed the next time! However if your results come back from gtt as potentially having it they provide a diabetes testing kit to test at home for the next 2-3 days. It does involve a finger prick before and after eating 3 times a day but no actual blood draw! For my second pregnancy I opted for this method only and declined the actual gtt testing and that was absolutely fine with the midwives. It's worth proposing that if you're happy to test that way. It's a clearer picture too!

I'm diabetic, and suggest trying to get hold of some strips to test your urine for sugar.

If you test your blood sugar, test it in the morning to get a fasting reading. Also test it before meals and then 2 hours later to see how your sugar levels are going up and down, if they don't come down 2 hours after a meal it could be a problem. A chart with normal blood sugar levels is available on the diabetes uk website.

@gingerkittycat Gestionational diabetess isn’t the same, you don’t always get sugar in the urine and the ‘normal’ pre and post blood sugar ranges are different.

There is no other test that can diagnose gestational diabetes accurately, it’s about how your body responds to a pre-measured amount of glucose that gives them the result. Sorry

@CatchingBabies sorry, I wasn't aware of the differences.

Sure the GTT is the best way but they should have alternatives for people who are not medically able to get it done. You couldn’t stick a needle 3 times in a day in a person with haemophilia! Cbt would be great but I live in Northern Ireland. It would take 2 weeks to get an appointment with my GP, and then I don’t know how many months of waiting list (people here commit suicide while on waiting lists so I don’t think I’ll get treated before giving birth).
I just think you should be giving alternatives when you are not able to do a test a particular way, they always do that with other conditions. I can’t believe i am the only person in this world who cannot get their bloods taking more than once in a day, is everyone else circulation and blood pressure perfect??

I think you need to seek help on your phobia first and foremost. I was consultancy led because of gestational diabetes and as a result in labour I had to have two canula in.

As far as I know there isn't any alternative for gestational diabeties.
Obviously you can choose to decline the treatment but if I were you, the reasons I would strongly suggest that you try and overcome this are due to it being a test they do for a reason.

I work in a gp surgery and a fellow nurse who wasn't tested for gtt and seemed perfectly healthy, 4 years ago died of ketoacidosis shortly after giving birth as she had had undetected gestational diabeties. It could have been prevented so simply.

Is there any way you can take somebody along for support, your partner maybe? You can buy Emla cream over the counter now, that might help. And at risk of being captain obvious, when you actually get further along the pregnancy and into labour, you may need bloods doing multiple times then and it may be less distressing in time.

Coming from somebody who has had some very traumatic times being put to sleep & having blood taken in the past as they can't ever find a vein, it's not a big thing for me now. It might be that in the grand scheme of having a baby this might become less traumatic for you.

Please don't take medical advice from mumsnet. As demonstrated above, posters may well give you unintentionally wrong information.
FWIW...
It's worth booking a GP appt for CBT referral even if there is a long wait and you end up having it after pregnancy as chances are you'll need bloods for various things later in life.
Even as a slim person the amount of blood taken compared to your overall blood volume is negligible.
You can only take blood from a normal line when you first site it, results from anything taken after that are not valid unfortunately. There are special lines some people have, for example, people with cancers who have damaged veins but need regular bloods. These types of lines are inserted more centrally and are high risk so wouldn't be suitable for this.
The trouble with using a blood glucose monitors is they aren't especially accurate and also testing in this way hasn't been validated for making a diagnosis, they're for monitoring only.
If you really can't face having the test though and you're high risk it but not getting anywhere with the midwife it might be worth asking if you can be seen in the antenatal clinic with the obstetrician who usually manages diabetes, to discuss it further.

I'm afraid i have no useful advice on what you must be going through as somebody who has no problem with needles, people think its helpful to say just get on with it but obviously for somebody who finds it as traumatising as you do its not as simple as that. Just wanted to say i had mine done 2 weeks ago and only had to take blood twice, before and after the sugary drink, i dont know why it needs to be done 3 times?

I had a GTT done and they only took blood twice. Why are they insisting it’s 3 times?

Hi OP,

I’m in NI, I currently have gestational diabetes and I also had a severe blood taking phobia. I say ‘had’ because I had a course of intensive hypnotherapy and now I can tolerate it. I’m ok with injections and always have been, it’s just the blood taking and canulas that I had an issue with. It was so severe that I avoided having blood taken for over 25 years even when it was medically advised.

What got me to have the hypnotherapy was the desire to have a baby. I knew I wouldn’t get through the process without giving blood especially as we thought at one point we would need IVF.

Since having the hypnotherapy I’ve managed to have two procedures under general anaesthetic with cannulas, one pregnancy with GD ending in a c section with spinal and now on pregnancy with 2nd baby and I have GD again so had a GTT and now have blood taken every 4 weeks at the diabetes clinic.

Sorry for the long post but basically saying that I’d massively recommend the hypnotherapy. I’m the most cynical disbelieving person ever but it honestly worked and I thought I was too far gone into the phobia to be helped. Send me a PM if you want any more info

For the posters above, it depends on which hospital the OP is at but in the NI hospital I attend it’s 3. One initial fasting bloods and then one hour and two hours after the glucose drink.

Three tests is the best version - fasting, one hour and two hours. Some people spike badly after an hour but are back to normal after two so would be missed.

I second the suggestion of asking to speak to the diabetes specialist as well as lining yourself up for CBT. FWIW my trust also has long waiting lists but prioritises pregnant women so I got seen very quickly when I was referred. The specialist can talk you through any risk factors you have and discuss the test with you.

I declined the GTT when pg with dd. I had awful nausea issues making me housebound for months. I had to constantly snack or I’d feel like death. I couldn’t cope with having to fast and then have the sugary syrup. One nurse was quite rude to me about declining it, gleefully telling me everything that could go wrong. I told them I’d rather they treated me as if I had gd than to take the gtt. This meant I had to see a diabetic nurse and have a blood monitor. I had to take a tiny drop of blood and test it for boood sugar every morning when I work up and about an hour after breakfast. I think I had to do the same with dnnner too. I had to log all my scores and email them to the nurse every week. Every result was normal bar one and I made no dietary chances so I’m pretty certain I didn’t have gd, but I’d rather treated as if I did than do the gtt.

FWIW there were further complications with this, for example the hospital said because of gd they wouldn’t let me get overdue so I had to be induced on my due date and I get a letter from my gp every year asking me to do a non fasting boood test to check my boood sugar to make sure I’m not now diabetic. I admit sometimes I go get the blood test sometimes I don’t bother. I believe they’ll be asking me to do this annually every single year for the rest of my life.