How necessary is the gestational diabetes test?

[sasha]

Really, if you're not at risk at all? I mean, I am assuming that being at risk would include weight gain or other symptoms, am I right?

It's just... it's really yuck. And I'll have to find care for S when I go, and it's a long way to drive, and I don't think I need it. But I want to be really informed so that I can say "no" and have them respect my well-informed decision LOL!

[Antheia]

Personally i wouldn't risk skipping the test. GD can be dangerous if not treated. Yes many things can increase your risk but i don't think anyone has zero risk. I think there is always still a chance of getting it. But it is up to you, so if you don't want to get it done then that's fine. I would just research a lot about the symptoms so you can keep a look out if anything becomes suspicous.

[Schmickers]

Not necessarily very necessary at all. Many hospitals have stopped offering it routinely, unless there are other risk factors. The information available varies, and so there is no clear guideline as to whether testing is beneficial or not. From an Australian research project that aims to rationalise investigations during pregnancy:

In the absence of high level evidence to either support or abandon the
practice of screening for gestational diabetes mellitus (GDM), midwives
and doctors may reasonably a) not offer screening b) selectively offer
screening to all women with risk factors or c) offer screening to all
pregnant women.

http://www.3centres.com.au/guideline..._screening.pdf

It should be noted that in the full booklet the 3 Centres Collaboration produces, they suggest having the test, but essentially this is only because it is what has always been done - as they themselves point out, there is not enough evidence for them to recommend it or rule it out.

[~Raven~]

I don't think being overweight is always a factor in GD. One lady from my anti natal classes had it and she wasn't.

[Chocaholic]

I have been asked by my Ob and GP to do the full test (which is two hours) rather than the screening test (which is one hour). I did not have GD with my first child but because he was a reasonably big baby (4.3 kg), they both believe there is a higher chance that I will get GD. Oh, I am overweight and my grandfather had diabetes so they are other risk factors apparently.

I know the test is gross but I would prefer to rule out GD rather than having to continually watch for symptoms. After all, if it can help safeguard my baby against complications during the pregnancy then I want it.

It is your choice and regardless of what your choice is, if you are comfortable with it then go for it.

[Cricket]

What are the other risk factors for GD? When they check your urine for glucose spilling - would that be an early warning sign, or would you be in fairly rough shape by then? It seems to me that if everything is progressing normally, with clear urine tests every time, and a "normal" growth rate for mother and baby, that you would be OK to pass on the test. But I suppose it's always better to be safe than sorry.

[paradise lost]

In the UK they NEVER do the test unless you have + glucose in your urine on 2 seperate occasions or ++ or +++ once. I was never tested for it, i never even had a trace. There is not a higher number of untreated GD women here at all. If you don't have glucose in your wee and you feel fine you'll be ok to skip it i'd reckon.

Bx

[kyliealysha]

I don't think the risk factors apply, as GD is primarily due to hormonal reasons. My team leader is stick thin and she got it during her pregnancy. I wouldn't be risking it, but it's your choice.

[sasha]

Thanks for your thoughts. I did a little internet research and the sites (as usual when you're looking for some health related information!) range from "scarey-do-not-ever-skip-this- test-or-you-and-your-baby-will-die-horribly" [please note hyperbole here!!] to "you'll be fine, don't worry too much about it". I didn't do the Group B Strep test with S because I didn't want to be fed antibiotics when he was born, and the info about Group B is equally as disturbing, so I refuse to be too terrified!

From the articles I've read, including a recent study in the MJA, nobody really knows what causes it, and the risks are very low. I'm going to chat to the midwives who are generally very keen to talk over these things.

[visitor1]

I don't think being overweight is always a factor in GD. One lady from my anti natal classes had it and she wasn't.

I am overweight and ive never had it with either child...not even close to a high level...

[[M]umma[M]ia]

yes u need to go have the test! that is why its there....one day of drinkin that sweet stuff aint gonna kill you. u dont have to be overweight or anything to have it and if u do and dont know u cud be putting ur baby at risk.

[Beatrix]

I have just had my third baby and i havent had the test once!

I talked it over with my midwife in my first pregnancy and she said honestly she didnt think i was high risk so i never bothered. I had the same midwife for the next two pgs and we didnt do it then either.

[BellyBelly]

I recommend you read THIS great article by Henci Goer, who is coming to Australia very soon!

[Jac]

So what if mother is normal/underweight and baby is small size for gestational age? Is there any reason you would need to take the test in this instance?

[paradise lost]

Jac honestly, unless you have glucose in your urine (which is tested at every appointment in the UK, and might also be in Aus?) you don't need the test. Read the article Kelly has linked in, and you'll see how useless it really is as a diagnostic tool.

Bx

[Jac]

You know what's funny, I have to provide a urine sample for each visit to the OB and I admit that I'm not exactly sure what they're testing for! I thought it had someting to do with blood pressure/ketones in urine but now I will have to ask and see. I'm sure someone else will know though.

[Stars69]

Um I do the urine tests as well and never had glucose show, yet I have GD. I eat well, have not put much weight on etc.

The diabetes educator advised that sometimes there are NO external symptoms that you may notice. There are risk factors, being over 30, being overweight, genetic history etc that come into play but if you don't have the test and you do have GD, there is a liklihood that the baby will need to go into the special care nursery after birth to help it cope with all the extra work it has had to do producing insulin with the mothere's higher sugar level.

Your choice of course, but I would rather be uncomfortable for a little while than to run the risk of anything happening down the track.

[paradise lost]

That's interesting Stars, do you have anything in your urine that shouldn't (sounds a bit dodgy! LOL)? My middies definitely told me they only do the test if you have glucose because if you don't have glucose there you don't require treatment (i think they said sub or pre diabetic, can't remember). Like people can come up positive for the test when it's very temporary (because you SHOULD have more sugar in your blood while PG, to feed the baby, or something, and you can have more some times than others). But if there's no glucose that indicates it's within normal-for-you levels.

The testing here goes: glucose in urine? If yes then blood test. Glucose in blood high? If yes then glucose tolerance test. Glucose tolerance low? If yes then diagnose GD and treat. This is standard practice in the UK, so it's interesting to me. Hope you don't mind talking about it!

Bx