GTT - Normal glucose levels after 2 hours?

[USAUK202]

I recently had my GTT at 28 weeks. My fasting glucose level was well within normal, however my levels after 2 hours was 7.7 so just .1 below the limit for concern.

The midwife didn't seem too concerned, but said it was "borderline" and that I'd just squeezed by. I know that GD tends to get worse as pregnancy progresses and I feel like I'm only at 28 weeks so I don't have room for it to get any worse! I realise there has to be a cutoff, but I'm uncomfortable knowing that if my level had been just .1 higher I'd have immediately been referred to the antenatal diabetes team and asked to monitor blood sugars daily, change my diet, etc. Because I was .1 below I've not been given any way to monitor further or know if it's gotten any worse!

What are levels typically after the two hour mark? Has anyone with levels so close to the cutoff eventually ended up with GD? Is there any way to monitor this at home?8

Sorry you are feeling worried about this. I was also concerned about GD but didn't meet criteria to get a blood glucose monitor so I brought myself one online and have been using that since about 14 weeks.

I haven't been diagnosed with GD but think I may be borderline. I would speak to your midwife about your concerns and see if they can provide you with a monitor though.

It has helped me understand what foods I can tolerate well and what foods I need to avoid. As well as this I had a good read of the Gestational Diabetes UK website about what meals to have, food pairing, exercise after food etc.

Levels in the UK at set at to be below 5.3mmol/litre fasting (so pre breakfast), below 7.8mmol/litre 1 hour after a meal, and below 6.4 mmol/litre 2 hours after a meal.

With my son my level was 9.0 after 2 hours so obviously diagnosed straight away (28 weeks)

This time, I have not had GTT due to COVID, just HBA1C which is blood test general overview of the last 12 weeks which have all come back 'normal' but I just didn't trust it. I got myself a monitoring kit (from Amazon but pharmacies etc do them too), and was getting high numbers so mentioned to midwife who passed on to diabetes team, have since been diagnosed off home testing

Have a look at the GDUK website and FB Group - there's lots of people who are/were 'borderline' that can probably give you some guidance and information.

www.gestationaldiabetes.co.uk/

It may be that you don't have it and won't get it which is great, but I felt the same as you and I needed to be sure x

Sympathies OP - it's awkward being in a sort of halfway house. I can't help with your specific question, but wondered if you'd consider proactively eating a gd diet? It's not unhealthy to do so even if you don't have it, and hopefully would prevent your levels getting worse? Seems like the obvious solution to me. Appreciate you also want more info and answers though! Xx

Yes I was “diagnosed” based on being 0.1 above the cutoff and sent down the GD pathway. Tbh it caused a lot of extra stress and it transpired that I never had GD but impaired glucose tolerance which was there before and and after pregnancy. It took two more glucose tests and a lot of consultations to clear things up. I’m definitely glad that it was picked up and have adjusted my diet since then and feel much better. However I feel they are very black or white during pregnancy in telling women they have GD (which can vary hugely in severity) or not.

All the doctors I saw were very reassuring of borderline results. I was referred to two nutritional courses to understand how to maintain a healthy diet. I think it’s an issue of common sense. The doctors have no way of knowing whether a borderline patient will continue stuffing themselves with cakes and carbs if they manage to scrape through without diagnosis. Similarly another borderline patient might be quite healthy and just have reactive glucose but are treated like they have full blown diabetes. GD is so closely tied with lifestyle that it’s very difficult to find the correct pathway for each patient.

You can buy a blood glucose monitor from any pharmacy and monitor your sugars 2hrs after eating, plus fasting sugars first thing in the morning. If things start looking abnormal or you notice symptoms of diabetes then you can always get in touch with the midwife again. I basically kept things under control with a very low carb diet (there are good GD recipe threads on MN). As mentioned it’s more a common sense thing. Borderline sugars after eating are not an immediate danger to the baby since the sugar level is lower the rest of the time. But it’s tempting to make unhealthier diet choices in the absence of an official GD diagnosis which could lead to worse outcomes.

Thanks, it's helpful to hear about everyone else's experience. I have adjusted my diet so it's low carb/sugar although without the monitor it's hard to really know what's going on so, I think I'll order one so I can monitor at home as suggested. If I'm honest I've been really stressed with work throughout this pregnancy and have been eating pretty poorly so I feel awful about that now!

@CoffeeDay

Did you find that your blood sugars ever went really high or did they just stay borderline?