GTT - can I refuse? Feel backed into a corner...

[theyoungvisiter]

Does anyone have any advice on the implications of refusing a GTT?

The background is that I'm pg with second baby, first all fine, no history of diabetes, no risk factors, normal weight, young etc.

So far with this pg all my urine and random blood glucose tests have been fine, but at my 20 week scan the baby's abdomen was 2 weeks ahead, which I was told could be a marker for gestational diabetes and I was referred for a GTT, which I passed without problems.

However I have now been told I'm booked in for further GTTs as the pregnancy progresses - next one at 28 weeks. This despite no further problems.

I REALLY don't want to have it - first I feel I'm being made to jump through hoops for absolutely no reason - surely if I don't have gestational diabetes then the baby's abdomen is nothing to do with this and it's just a fat baby - therefore why do I need to be retested? Also I absolutely hated the first test - had a horrible time getting across London feeling faint and sick, and I nearly vomited during the test, and it's a nightmare trying to organise it round my DS who is 2 and impossible to control for 3 boring hours while undergoing the bloods.

Could I refuse to go back unless there are further red flags? I am totally happy to be retested if there are further concerns - but I don't want to go back just for the sake of it. Has anyone refused in similar circumstances? What implications would it have if I did refuse?

[JamInMyWellies]

Sorry young visitor I have no experience of this but I would imagine if you agree to be closely monitored urine samples etc they would allow it.

[CantSleepWontSleep]

NL - of course GTTs improve the outcome for the baby, if they pick up GD that would otherwise go undetected! Obviously not everyone who is sent for a GTT will have a positive result, but far better to test more people in order to pick up those that do have it than to let it go uncontrolled in those that do.

Someone made a comment about a friend living on pasta so a GTT was irrelevant for them. This is rubbish. I have GD, and cannot eat white pasta as it sends blood sugar sky high in most people with any form of diabetes.

Using a glucose drink, whilst not exactly a pleasant test, is the quickest and simplest way to see how the body reacts to a rush of sugar, which it can get from any number of food sources in an average day.

You are not as standard on a 'diabetic pathway' once you've had a GTT. I only just failed mine (at 17 weeks), and had to take my bloods at home for a few days before they would even conclude that I did have GD for sure.

tyv - in this case I can see why you would want to refuse a GTT, and there does seem little reason for it, so I think I would try and discuss it with your consultant, or, as you say, wait and see what the next growth scan shows first.

[BabiesEverywhere]

The fundal measurement thing is a joke, one week I was 7 weeks ahead and a week later spot on for dates

I refused both GTT (no risk factors and no history) and growth scans made me unpopular but sod them. I am now 40 weeks with a measuring on time but solid baby.

But they wanted to induce me OR elective CS at 38 weeks to prevent issues of a big baby and if I had agreed to growth scans etc that was the medical pathway I would of been on...scary.

[CantSleepWontSleep]

Leonie, you obviously had a bad experience which has stayed with you and clouded your views, but your generalisations are, quite frankly, scaremongering bollocks.

[NorthernLurker]

cantsleep won't sleep - my understanding of the research - and this is two years ago that I was looking into it last - was that whilst it is perhaps logical for us to assume that if gestational diabetes is suggested by a GTT the outcome for the baby will be improved, that is not in fact demonstrated by the available research. We specifically asked our consultant that question and he couldn't answer it.
What is absolutely certain, ime and that of others on this board, is that a pregnancy in which gestational diabetes is diagnosed or even suspected is a pregnancy which becames medicalised and more stressful. Any woman has the right to refuse the GTT in the same way that she can refuse to scans and blood tests.
I really don't see why you felt the need to accuse Leonie of 'scaremongery bollocks' either? Leonie has written eloquently about her experience - which exactly echoes my feelings on this subject so you will see that I am bound to consider her opinion far from bollocks. Imo - if anyone is scaremongery it is the medics who are pressuring healthy pregnant women into a test they don't need.

[BabiesEverywhere]

I agree with NorthernLurker and so does the Cochrane Reports

"The best way of identifying and treating women with abnormal blood glucose tests in pregnancy is not known
Glucose in urine is abnormal outside pregnancy but is common in pregnancy. Blood glucose levels are needed to check glucose control in pregnancy. Elevations in pregnancy may return to normal afterwards. This is known as gestational diabetes or impaired glucose tolerance depending on the degree of abnormality. Diabetes has higher levels than impaired glucose tolerance. These abnormalities may be associated with bigger babies and more difficult birth. There are no good tests to identify these babies. The review has not found enough evidence on how to treat these women and their babies, even if identified correctly. More research is needed."

i.e. We can't find all cases of GD and there is no clear evidence on how to treat women who do have it.

[slinkiemalinki]

I didn't have it. My consultant doesn't believe in it - although he tested my blood sugar on a random blood test - doesn't think a big shot of sugar is good for the baby anyway.

[CantSleepWontSleep]

Ah yes, some interesting points on your Cochrane link BE

'No trials reporting treatments for gestational diabetes met the criteria.' - ie they didn't even look at it.

'There are insufficient data for any reliable conclusions about the effects of treatments for impaired glucose tolerance on perinatal outcome.'

Think that supports my case somewhat better than your own really.

Leonie - try actually reading what I've put instead of being a stroppy cow based on how you want to contort it. I at no point said that your experience was bollocks. I actually sympathised with you for your poor experience. It was your generalisations that I said were bollocks. eg 'If you let them take a random glucose / GTT, then like they said, you're on the 'diabetic pathway' and its like a cattle chute, leading from one intervention to the next'. I stand by the fact that this is utter bollocks. I had a GTT in my last pregnancy. It was negative, and no-one ever mentioned it again, despite dd being 9lbs at birth.

If my GD had not been picked up this time, I would have continued eating as I was, and would undoubtedly have had a 'fat' baby. Because I accepted that a GTT was in my best interest, my GD was picked up very early, I was able to change my diet accordingly, and so far my growth scans have shown a perfectly average baby.

Whilst I have been aiming to avoid induction (standard procedure in most hospitals at 38 weeks if insulin is required), I understand that in the 5 years this has been happening in my area, the stillbirth rate has dropped significantly in women with GD. Now by all means tell people your experience to show that it's not all positive, but don't try and play God by telling them to ignore a test that could actually save their baby's life.

I expect I'm banging my head against a brick wall here, but I couldn't let your posts go unchallenged.

[ceebee74]

Am so glad someone started this thread as this is exactly where I am at the moment.

Am 24 weeks pg and have a GTT booked for 29 weeks which I really really really do not want to do - the reason for sending me is because my mum is Type 2 diabetes. However, I had no issues during my first pg and so far, all urine tests have been clear during this one.

My reasons for not wanting to go is that I know that I will not be able to function if I have to starve myself for a morning - I do suffer from faintenss, shaking, sweating etc if I don't eat reguarly (but have been tested for diabetes previously and always negative) and have no intention of deliberately putting myself (and my baby) in that position.

Having read this thread, I feel much more confident to be able to tell my MW that I will not be going for the GTT.

[CantSleepWontSleep]

If the name fits.....

[Qally]

can'tsleepwon'tsleep, I agree with you. It's just a glass of disgusting pop, not crack cocaine - and a low GC diet isn't exactly a nightmare either; if that's what is currently best knowledge on what is best for the baby, then I'll do it after my bloods next week.

Leonie, avoiding chocolate and cheesecake and pasta won't starve your baby. I promise. I'm scoffing plenty of all three, because they're yummy, but I'm under no illusion it's for the bean's sake. It's because I'm a greedy moo, which is probably why I've gone from 9 stone to 12 in 6 months of pregnancy.

[theyoungvisiter]

crikey didn't realise this would be so controversial when I started it!

Thanks for all the input. I'm going to wait and see for the next growth scan and make a decision based on that.

If there's a potential problem I do of course want it picked up - but my hospital are very gung-ho about testing and monitoring at every available opportunity as I know from friends and a previous pg, so I don't want to get too swept along by their protocols if it's not absolutely necessary.