must I do the glucose test????

[porcamiseria]

I am being bad I know, but I am only just over the age level (ie did not have it last time). I really dont fancy going without food all morning and its a really inconvenient day. what do people think the risk is, has anyone vetoed it? Thanks

I dont want to piss hospital about, and be ungrateful, just not sure why its necessary

Or look at the evidence at any rate. NICE have the full guidelines, and the research that was available at the time of the guideline being written will be graded. You can then go look at that origional research and make your own informed decision. From memory I'm nearly sure there are papers on age related risk so there may be good info for you on how real this risk is or is not for you. I think...and I mean think... age is a less sensitive screen, but please don't qoute me!

Some of the risks associate with GD that is undiagnosed or unchecked after diagnosis are:

For You:
Risk of developing high blood pressure
Risk of having a very large baby -- requiring a cs delivery

For the baby:
Large size may lead to delivery complications, shoulder dislocation, etc.
Breathing difficulties (which can be very scary in a newborn)
Low blood sugar right after delivery

I'm not going to comment on any individual's situation. I'm not a HCP. I can only speak from my own experiences of 3 pregnancies, in each of which sugar appeared in my urine at around 33w. In each case I researched, discussed with my dr, consultant and mw, and took what I considered to be an informed decision. In each case most of the HCPs involved supported me in these choices.

All my babies were very big, but long and lean. After each birth I asked: does s/he look like a diabetes baby? And the answers were all categorical 'no's.

Of course uncontrolled diabetes in pgcy is dangerous. I don't advocate ignoring it. I would support standard application of the GTT if it did not then have unnecessary effects on the labour and aftercare.

I refused it with dd2 and dd3. Never had any symptoms that suggested it was needed and delivered two healthy babies.

I had no symptoms when I was in the process of developing type1 diabetes in my first pregnancy. A very slight increased thirst and increased urination maybe - a common enough pregnancy symptom. In actual fact I didn't have to actually do the GTT because my initial reading was so off the scale the last thing they were going to do was give me anything with sugar in....instead I got a crash course in administering insulin instead!

Of course type 1 and GD are different beasts, but I relate my experience because it is entirely possible to have no obvious symptoms despite sugar levels high enough to cause serious problems if unchecked. Do not rely on the fact you feel fine.

Due to my diabetes I was induced at 39.5 weeks with my first 2dc, both births were without major problem, no instruments, stitches etc... with dc3 I went into labour naturally and ended up with emergency c-section. There are never any guarantees!

I did it and after all the build up from my mw about how dangerous the situation was the test came back inconclusive. Seemed pointless having starved myself for it but if asked again I would still do it, just to be safe.

Obviously, its up to you whether you have the test or not.

It's a PITA to go without food for a few hours - I'm the most peckish person alive, but even I managed to go without breakfast just the once! It's not the most invasive or dangerous test there is and can highlight extra care you and your baby may need during pregnancy.

I was diagnosed with GD with both of my pregnancies. I was under consultant rather than midwife care, but all that meant in reality was that I was monitored closely during pregnancy. It was also recommended that I didn't have home births. I had active births and breast fed both DC.

Whatever you decide, good luck with you're pregnancy!

I think that it's worth pointing out that even if in PrettyCandles hospital there is some sort of proticol about treating women who have 'passed' the GTT differently, this is by no means universal, or even to my knowledge common. Even with a diagnosis of GD last time, which I managed by diet, I had an active labour with only some monitoring when I first arrived on the labour ward and again during the last part of the second stage. Only those who end up taking insulin during the course of the pregnancy end up on an insulin drip. I can't think what would go in a drip if you weren't on insulin.

I refused the GTT during my first pregnancy as I was convinced that being slim, fit and healthy I couldn't possibly have GD and I didn't want to take the morning off work. Fortunately my GD was then picked up through a urine test and subsequent blood monitoring, and I felt very stupid to have refused the GTT. My GD certainly isn't controlled just by cutting back on sugar, I have also had to drastically cut back my consumption of starchy carbs, avoid all refined sugar and keep fruit to a few things which I can tolerate. Why would anyone do that if they didn't have to just to avoid a GTT?

There will always be stories of people saying I refused it and then it was fine, but this is to be expected, in order to pick up a decent proportion of people with GD you will have to set the risk factors for doing the GTT at a level which will include plenty of people (the majority) who don't have it. No medical test can only be offered to people who will end up testing positive! For every story of someone who refused it and was fine, there will be another story like mine where the decision was a mistake.

I'm thin, active and a healthy eater. I'm also 36. I had never had any diabetes related problems or reason to believe I would. My hospital tests everyone over 35 with a screening test (no fasting) as soon as you get your BFP. I failed the screening test and tried to talk the dr out of the three hour since I had read that 2/3 of the failed scrrenings pass the 3-hour. Dr talked me into doing the test. I failed. Turns out I had pre-diabetes that probably would not have been noticed. I'll be on insulin my entire pregnancy (from 4 weeks to delivery). I was positive that there was no reason for me to take the stupid test- but, will be eternally thankful that I did for many reasons.

If your fear is the possibility of insulin, the vast majority of people who have normal GD don't have to go on insulin, they just watch what they eat. And, cross my heart, the insulin isn't bad. I cried before I did my first one then felt like an idiot when it was done.