Refusing a GTT?

[DamnitCharlie]

I'm really thinking of refusing to have a GTT for diabetes. I only have one risk factor - type 1 diabetic mother. Healthy in every other way. At risk of a small baby rather than a big one.
Last time I felt sick and thought I would pass out doing it and was sent home for the 2 hours. This time I am still suffering from morning sickness so will vomit if I fast in the morning and I have toddler to look after during it.

Anyone else refused it or been offered an alternative? Surely they can do a blood test to get a rough idea of my blood sugar levels without fasting?

No, They'll need to see baseline bloods (your fasting ones) and then to have something the compare your other bloods to, else theres really no point.

It's up to you, personally I wouldn't be (and aren't) refusing. I've suffered with sickness so I know its going to be tough going when I go, but I feel needs must. Im going because of my weight, so obviously a more self inflicted reason than yours but I just feel that its a test I need to put up with to make sure I can provide a hospitable environment for baby bean. Anything that's more of a benefit for baby is just something I will go with.

However, just have a read up on what you can do. They could just monitor you for symptoms and then test you when you showing signs and symptoms? I think they can do it up to 36 weeks?

I wasn't keen on having a GTT but thought it was best for me and my baby to find out. I only had one risk factor too (my father has type 2 diabetes). It really is the best test to have to diagnose GD. Is there anyone who could look after toddler for you?

I’m in Australia so not sure if things are different over here. I was told my only other option if I refused the GTT was to do 2 weeks of blood sugar monitoring at home where I had to check blood sugars 4 times daily for the whole 2 weeks. I also had purchase the monitoring device myself. I opted to do the GTT as is seemed the lesser of two evils for me. Of course you have the right to refuse any form of medical testing. But then you are running the risk of undiagnosed gestational diabetes.

We monitor diabetes risk here for a reason op. We don't do everything right by any stretch but take the test. My df had diabetes in later life. That was my only risk factor but actually whilst in the delivery suite chatting to the senior midwife it sounds likely my dm had it when she had ds in the 70's but nobody realised. I didn't btw but better to know & be prepared & address it whilst pregnant if it's an issue

I’m glad this has come up - I was thinking of refusing mine too. It will mean a whole day off work (not really an issue but just feels like a p* take) and I just don’t believe I’m really at risk. My Father has ‘borderline’ Type 2 but this is mainly due to his lifestyle - he’s very sedentary, eats badly etc. I can’t see that I’m really at risk.

My test isn’t booked until October so I’m going to discuss it with my Midwife at the next appointment.

Would be interested to hear what you decide!

Just a word of warning. I've just been diagnosed today at 30 weeks after having none of the risk factors. No family history, excellent bmi, nothing indicated in my urine etc. The only reason I was even tested was because after measuring small at my 28 week check I was sent for a growth scan which indicated the baby was actually very large so gtt was ordered. Its really better to know early if you will be affected so you can have all the extra monitoring and get it under control if needed - why risk your babies safety?

I refused my last one but my only risk factor was an aunt with type 1. The midwife had booked me in but I spoke with my consultant and he said it would be fine to miss it. I was having very regular scans though so any issues with baby being too big would have been picked up.

No, you need to do this - having a parent with diabetes is statistically more likely to result in a positive. My Dad is type 2 and I have GD.

Undiagnosed GD can cause huge harm to your baby - I am 34+5 and was diagnosed at 28 weeks.

My baby is tracking on average growth but that doesn't mean that things are ok, big babies are not the only issue with GD. I have been warned my baby may need special care if her blood sugars are unstable after birth.

You need to suck it up and get on with it for the baby's sake I'm afraid!

If there is diabetes of either kind you are higher risk for gestational diabetes. This leads to an increased risk of still birth, shoulder dystocia, neonatal death, neonatal hypoglycemia (and subsequent brain injury) diabetes and obesity in your child. It's important OP.

If you have any risk factors it is worth taking the test. It's far better to go through some discomfort than to have an undiagnosed GD pregnancy.
There are many instances where women without risk factors, including those who are slim and fit and are diagnosed with the condition.

@chelseacat you don't need to take a whole day off work, a morning probably but you'll be done for 11am.

I really don't understand the mindset of refusing tests and interventions. Id be more understanding if it was just you at stake, but all of these are to protect your child. The NHS is pretty strapped as it is so they wouldn't be ordering these for you willy nilly.

I get it's an inconvenience, I don't really want to sit in the doctor's on a Thursday morning for 2 hours but thems the breaks.

Gestational diabetes doesn’t always result in a large baby - that only tends to happen when your placenta works properly. It very often results in small babies - and considering you are already at risk here anything that could result in your baby being born even smaller needs to be checked out.

I refused mine, and also growth scans. I didn't think the risk factors particularly applied. I also felt the stress of organising child care, doing the test, waiting for results etc, would be more stressful. I considered my own circumstances and made that choice. There seems to be have been a big push between my first and second child to do far more GTTs and treat people for GD. No one I know who was diagnosed had a big/small baby, they were inducing friends early and all sorts. (I was booked for ELCS anyway)

@JuniLoolaPalooza - you are lucky you didn’t have GD. Plenty of other women who also decline GTT then have a stillbirth associated with the condition. Luck of the draw doesn’t mean you should be encouraging someone not to go through necessary tests.

I'm not encouraging anyone. I just shared my experience. At no point have I said "don't bother OP". Please provide evidence for your assertion about "plenty" of other women declining then suffering stillbirth.

I'd rather think OP's care providers would have given her that information and she is still in two minds thus asking for others' experience.

As it happens, I declined and my midwife and consultant had no problem with it and did not attempt to convince me at all.

But this is OPs choice to make in light of her own personal circumstances with the considered input of her care providers and her baby's other parent.

I look forward to your next post containing the stats you have described.

@Teddybear45 see my post above.

As @TwoShades1 said, you could get your own monitoring device and monitor yourself at home, OP? It sound like it would be much more convenient for you, re the fasting and the toddler etc.

I had some odd blood results after major surgery and now monitor myself for blood sugars and blood pressure, just to ensure everything is returning to normal. You can buy the devices at pharmacies or online.

My mum had undiagnosed GD. I never got to meet that brother as he was stillborn at 39 weeks. She was a good weight, active, ate properly, took the vitamins. Absolutely no risk factors and they tested less often if you had no risk factors as this was a fair few years ago. Minimal monitoring as wasn’t a first baby.

Please take the test. You don’t have to be overweight or have a family history of diabetes to get GD. Yes the risk of GD is low ... but it’s still a risk that can have pretty devastating consequences if it’s not picked up.

My GP was happy for me to monitor bloods at home for baby number 1. We did several readings a day for a few days as DH is T1 so had what we needed. Baby 2 I didn’t feel as sick for so had the GTT.

@JuniLoolaPalooza - give me proof you had a baby first and I’ll give you proof of the women I know who had GTT as a result of declining GTT testing. Everyone can shower anecdotal evidence when it comes to giving dodgy advice to people they don’t care about.

Here is the latest article. OP does have a risk factor - a parent with type 1 diabetes. She should be tested. Advising her that she shouldn’t is irresponsible.

www.google.com/amp/s/www.bbc.co.uk/news/amp/uk-england-47625488

*GTT related stillbirths.

Just to satmy I dont think you will be able to look after your toddler during the test so you need a family member / friend / paid childcare. We are not allowed to leave the waiting room as you are meant to rest / no physical exertion or it can distort the results. Even if you are allowed home I am sure the advice will be the same not to chase a toddler around.

@JuniLoolaPalooza Can I just ask what your rationale behind refusing the growth scans are? Surely they're just a nice added extra...

I potentially can understand postponing things like induction for a few days to see if things happen naturally, but I just feel there's becoming a dangerous trend like in the states to refuse medical care. I really hope we dont go majorly down the free birthing route, it terrifies me. These tests and interventions aren't for the HCP's benefit...

You're more than welcome to advance search me.
I'm uncomfortable discussing this further when ultimately when things go wrong the impact is devastating. OP asked for experiences, that's what I've given. At no point have I advised or encouraged her on any course of action.

I think it's a huge leap to go from declining tests to suggesting freebirthing is becoming the norm. I had two highly medicalised births and would never advocate for a total disengagement from medical care. I have never said anything like that. Merely sharing my personal experience of deciding to decline two tests which I felt would lead to more stress and difficulty than I wanted.

I very much doubt the OP is going to make her decision based on the experience of a stranger on the internet where there are doubts I've even had a baby!