Refusing GD test?

[~ Mylitta ~]

Like many of the others have already said, you can certainly refuse to take the test, but I'm another who would always have it just in case. It's not the most pleasant, but I'm sure having undiagnosed GD would be much worse.

I've done it 3 times now and the easiest time was when the drink was refrigerated. It was so much easier to drink when it was cold. Perhaps before you decide where to have the test done you can ring a few of the closest collection centres and ask them if they keep their drinks refrigerated. If you rang in advance and asked one to pop a drink in the fridge for you I'm sure they'd be happy to do it. They have so many things for tests that go in fridges I'm sure they would have ample fridge space for one drink.

[PumpkinZulu]

I just want to say, although completely possible (and I'm sure someone on here may have even experienced it) GD that goes completely unnoticed to the point that it becomes dangerous is very unlikely. As I've already said, a good healthcare provider will pick up on the other markers for GD. You will most likely display other signs before anything 'bad' happens. And as em said, there are a lot of false positives.

[e_p]

I'm a nurse don't need to explain the test to me but there are a lot of false positives.

I declined having the test. The blood sugar levels that determine whether or not you have GD varies between care providers, not to mention that there are a lot of false positives. I was low risk and eating a balanced diet, low in processed foods and high in protein, fresh fruit & veg and wholegrains. When a positive result can mean pressure to have interventions that may or may not be evidence based (insulin, induction, caesarean), I think it's important to be informed with the benefits AND the the risks of testing. All tests and procedures require your consent (actually, informed consent...but my experience is that consent in maternity care is often not especially informed) and you have a right to refuse or decline anything you don't want.

[kelsbels]

My ob asked if I wanted the test (as she has with all tests) but did suggest it was wise to have for peace of mind. I have terrible reactions to the glucose drink (vomitting, fainting etc) but chose to have it this time anyway as last time I had quite bad polyhydramnios which is sometimes due to GD (after having the GTT test it came back negative anyway). I'm still waiting for the results due tomorrow.

[AndiE]

I'm all into knowing what's going on with your pregnancy so you can be fully informed at every stage. Just my opinion, but that's whey I do the GD test, and the other tests. I'd just prefer to know what's happening with my body and potentially my baby.

I had GD with DS1 (diet controlled) and didn't get it with DS2. All going well with this bubba and I'll take another test when the time comes.

My only argument against taking the test is that when I tested positive it immediately started the Ob talking about possibility of inducing early because of the "chance" bub could be a big baby (I didn't want intervention of any kind and was quite vocal about that!). For the record, DS1 was 2.9kg when he was born (after spontaneous birth) at 39w5d.

ETA: I see a bit of talk about the test not being accurate. After my diagnosis, I had to test my levels four times a day (from memory) and that definitely showed I had GD. So in terms of accuracy, it's not really just one test that determines whether you have GD. It's ongoing. Well ... in my books, anyway.

[onthefly]

I had it only because of specific risk factors in my case and wanted this piece of information also - it's not guaranteed accurate though, so whether you do it or not, I think you need to be aware of symptoms and ways to reduce the likelihood (ie, good eating, exercise etc).

Ultimately it's your decision to make, as with everything else pertaining to your body.

[Cassius2]

you can refuse the GD test. I was having a homebirth and knew that i would be receiving a high level of one on one care that would mean that my care providers would be able to help us manage the condition either through the pregnancy or post-birth. so with that in mind I chose not to take the test.

we discussed it with our care providers and away we went

[Traveller]

I had it with my first two children because I wasn't educated enough to make a decision other than to say yes. I didn't have it with the twins because they only do it for high risk people or those who are showing symptoms from other tests. In fact my midwife over there was appauled that they would make women go through such an unpleasant test when there is a quick and easy screening available to decide who needs the test. Just my 2c, I would probably still take the test but I wouldn't make a big deal of someone who refused it if they were educated as to why and were eating a healthy diet that would control most GD symptoms anyway.

[HotI]

I was concerned about what effect all that glucose in one go would have on the baby. I chose not to have the GD test this pregnancy.

My midwife said that the threshold for diagnosis has recently been lowered, so more women will be diagnosed and potentially face extra intervention.

[Bella29]

I like this article by Michel Odent about GD..... He calls it a diagnosis looking for a disease.

Stand and Deliver: Michel Odent on GD

I didn't test this pregnancy. Partly because I had tested negative in my first pregnancy, partly because my hb Mw is from the UK and they don't test women over there unless they have a risk factor for it. I didn't have risk factors, so didn't test. I did end up having glucose in my urine at one point, so I did some post meals testing with a normal BSL monitor and fasting testing to reassure myself and had very normal BSL readings. So I didn't stress about it.

You certianly don't have to have it. And as Michel points out in his article that treatment does nothing except lower BSL readings... it doesn't improve outcomes for babies. It does often cause separation of mothers from babies, when they need their mums and their mums milk the most....

[k4t]

I completely agree that it is entirely your choice whether to have testing for GD and what type of test. Your doctor or midwife should be able to provide you with all the info you need to make that decision and while they'll have their own opinions you shouldn't feel pressured either way.

After doing a bit more reading I've realized that this is a much more controversial topic than I first thought and there's not a lot of conclusive evidence.

I thought I'd post a link to the three centers guidelines which are used by a lot of Victorian doctors: http://3centres.com.au/library/publi..._screening.pdf

Keep in mind that the glucose challenge test is a "screening" test not a "diagnostic" test so there will always be false positive results. The thresholds of these sort of tests are artificially statistically adjusted to provide a set level of false negatives and false positives for the population but this calculation must vary from lab to lab so your doctor should be able to tell you what the false positive rate is for the test they're referring you for (although they might have to do some research themselves.)

Personally, I think I'll just be asking for an OGTT because I really want to know for sure and am happy to put up with the discomfort, but thats just me and I'm not without risk factors.

[Maruschke]

I'm the kind who would take the test, knowledge is power. You can refuse intervention even if you take the test, so I'd rather take it. Kudos to those who don't want to take it though.

[surprised]

I refused with current pregnancy. I had awful morning sickness for a few months both times and frankly after how I felt in pregnancy 1 with GTT I wasn't up for more nausea!

My GP did a fasting blood sugar level test and as that was normal, both she and the midwives were happy to leave it at that.

[HotI]

I'm the kind who would take the test, knowledge is power. You can refuse intervention even if you take the test, so I'd rather take it. Kudos to those who don't want to take it though.

The test is intervention though. By loading mum and bub's system with glucose, you are changing the fetal environment, even if it is only temporary.

[Maruschke]

The test is intervention though. By loading mum and bub's system with glucose, you are changing the fetal environment, even if it is only temporary.

I guess it is, just on a much smaller level than say induction or cs...

[Ca Plane Pour Moi]

I had it - my grandfather has type II diabetes and, unknown to me at the time, one of his sons has it too. When it starts in your uncle's 30s, then it's a bit more of a risk for me developing GD. It is upsetting to me to think that I'm not going to be having the test with Stormy. I know I could, and I know I could have just one test and that be it... but it wouldn't be just one test, would it? I have to refuse everything and put my baby at risk just to not be abused and bullied. (That's me, not other people and not people reading this, unless I read it again, in which case it is pertinant.) Being honest - this test is the ONE single thing that would make me tell a medical person about a pregnancy.

If you're allowed to take it, take it. Honestly. It is worth it, even if you have a false positive (rare from my experience). And if you do have GD, that puts you at a substantially higher risk of developing type II diabetes in the next 10 years - something you will need to keep on keeping an eye on. And yes, the test is a bit abnormal - but a working body will change it back to "normal" very quickly and honestly, our children are never, ever going to have a sugar rush in the next few years?

[LuluHB]

I'm on my third "long term" pregnancy now and my OB has never suggested I have the test. Not entirely sure why because I would have thought being overweight would be a risk factor, as well as being an older mum. Anyway, it was never suggested for me but if my Ob did suggest it this time I would take it. I go to him because I trust his professional judgment and given past experience with him, if he suggested it now it would be for a good reason.

A friend was over today who is 38 weeks. She was diagnosed with GD and has had to really carefully watch what she eats and is giving herself daily (or more?) tests at home. Her blood sugar level has been great for ages, but then her FIL, MIL, BIL and his fiance stay with them from the UK for the last two weeks. Nothing in her diet changed, but her blood sugar level was through the roof. Her midwife told her that stress can be a major factor affecting your levels.

[RainbowBrite]

I had it for it for the first two but was told it was unnecessary for the next three because I had no history, underweight ( ) and no family history. I had to have it for number 6 because I was on bed rest in hospital and they insisted (i gave birth that afternoon) my last bub I didn't make it that far.