Talking about this with a friend of mine... Is it wise to refuse the GD test? Is it possible for a Dr to see if you have GD without you having to drink the glucose?
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Talking about this with a friend of mine... Is it wise to refuse the GD test? Is it possible for a Dr to see if you have GD without you having to drink the glucose?
I know it's not the most pleasant test but I'm not really sure why you'd want to refuse it? Random and fasting blood sugar levels can pick up problems but the glucose challenge is more accurate and sensitive.
The glucose drink just tastes like flat lemonade.
I started a thread about this a few months ago :) Basically, ofcorse you can! You aren't required to have any testing you feel uncomfortable with. I refused the GD test based on the fact that I am young, healthy and had a low risk and uncomplicated pregnancy. In the event that I did test positive, in my low-risk situation it would only have been managed with a low GI diet and a bit of watching what I ate, which I was doing anyway. Lots of people are not even offered the GD test if they're young and healthy. For me, being young and healthy, the risk of a false reading wasn't an acceptable risk for me, as I was in a trial homebirth program, and having GD means you can no longer be in it. So I refused, and my midwife was 100% fine with that. In fact, they were fine with me refusing NT testing, GD and GB or whatever it is :) Weigh up the pros and cons, like if you're low risk and eating well etc. You'll be able to go in and tell someone if things start to change and you get GD symptoms, a good care provider will be checking for warning signs anyway. Hope that helps.
Although being healthy, eating healthy and being young is a positive it doesn't guarantee you won't develop GD (or any other disease/illness). You cant predict the development of GD based on these. It is however the individuals choice to be tested and thats that.
Its a relatively simple test and can prove to be life saving (in the event that one has developed GD and doesn't know). Eating healthy and improving lifestyle is one of the recommended treatment for those who develop GD but is not always in isolation so further monitoring is involved so eating healthy isn't a guarantee either.
I personally don't see why someone would refuse this test- why risk it? I do however respect everyones right to choose what they feel is right for them :)
To answer your question tho, lol, I am not sure if you can be tested for GD without drinking the glucose. The purpose of the test is to see how your insulin levels change during the period of testing after you have had the drink. I think that perhaps frequent blood sugar testing may do, but I am not sure. Maybe speak to your midwife/GP about it :)
No, you can definitely not predict if you will have GD or not! But my midwives (and the OB I saw) all confirmed that of I were GD positive, it would be managed with a low GI diet and watching what I do and don't eat. Seeing as I already did that, I didn't feel the need for the test. I also didn't want unnecessary intervention at my birth because I had GD. Like a I said, a good care provider will be able to monitor you accordingly. I'll try to link my thread, it had lots of helpful answers from both sides of the fence.
I refused it for this pg, no issues. I had the test last pg and didn't have GD, so as well as having no risk factors at all, I also knew that.
I also didn't bother having follow up bloods at that stage to test iron levels, etc, I was happy with my earlier test results.
It's totally your choice.
I was pregnant with DS at age 19, weighed 60kg and 171cm tall - and I had GD. I ate well and did everything right but I failed both the GCT and GTT. Although it was only by a small amount, anything over 7.7 after the GTT is considered GD. I managed it with diet obviously and my son was born at 35+5 weighing 2.87kg. Had I have gone to term, I'd say he might have been closer to the 4kg mark - no a giant baby but a healthy sized bub.
In answer to the OP's question though, yes you can refuse the test, but if you plan on birthing in a birthing centre or are considered high risk, I don't think it would be wise. Is there any particular reason you wish to refuse it?
I have had 3 children and not once did I have the GD test. I birthed through a midwife program which was a very women trust your body type program. My midwife and I spoke about it and because I didn't have absolutely any indicating factors to diabetes we decided I wasn't going to take it.
My midwives were perfectly fine with the decision even supported it.
I would love to refuse the test as I just can't handle the glucose. With DS I had a migraine for quite a few days after drinking it and I promised myself never again. But after reading all this: its probably not wise for me to refuse it :-( I just wish there was an easier way to test for it!
I wasn't going to do the test this pregnancy either, after remembering how awful I felt last time. The midwife I saw said I was so low risk that it was fine either way. I decided to do it anyway at the last minute, and yep, I have it. So you just never know.
This time though the drink was much easier, it seemed much less disgusting, so I hope the same goes for you. I think it had something to do with being green this time, made it taste better, ha ha.
Good luck, I hope it's easier for you this time
Yep you can refuse it I did. It's not really an accurate test anyway. I mean for starters consuming that much sugar at once is not really normal.
You can ask them to do random blood glucose levels if you want.
As someone who had GD recently, i would urge everyone to take the GTT as unpleasant as it is. I wanted to refuse it but my OB made me, thank goodness she did, i had GD and ended up on insulin. There is no way of telling if you have GD just by simple urine tests etc. Glucose MAY show up in your urine but thats a very big MAYBE. I only had it show up once my entire pregnancy, so its not something you can rely on. Untreated GD can cause big issues for baby as it causes the placenta to deteriorate at a faster rate, as well as it can make baby bigger or smaller depending.
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Coca cola contains more sugar in it :)
In terms of accuracy-it is accurate. Its a measurement of glucose in your blood per mmol/L of blood.- its not an estimation tool like an ultrasound for example where the babies size is estimated IYGWIM
I'm a nurse don't need to explain the test to me but there are a lot of false positives.
:hide:
Sorry, when you said they are inaccurate I thought you were referring to the actual blood sugar level :)
All good I wasn't angry at you :)
I refused it with DD3. I have no family history of GDD and I had never had it with any of my other pregnancies, so I figured there was a bigger chance of me not having it than having it.
I never wanted to have it with DS2 & DD2 but felt rather forced into having it. I get headaches and feel very nauseated after the drink too. I was happy to have not had it done and there was never an issue with me not having it.
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.
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.
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.:
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.
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.
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.
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 :)
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.
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.
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....
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.
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.
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.
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...:
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?
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.
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 ( :rolleyes:) 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.
I am also young, fit and healthy. And I had GD. There's no stereotypical category for people who get GD, unfortunately. It doesn't discriminate. Some people just get it, unfortunately. My first clue was the extreme thirst I developed. 3 or more litres a day, and I was still thirsty. Anyway, mine was only diet controlled, so it wasn't a big deal at all. I was pretty much borderline, so they slapped the GD label on me 'just in case'.
I endured a lot of intervention during my birth. I was scheduled for an IOL before I'd even come to my due date, based on nothing other than the fact I had GD (this was done by a very uninformed MW who didn't know me or my history).
You can absolutely refuse any tests you aren't comfortable with though. It wouldn't be the end of the world. If you do refuse it, keep an eye on your symptoms....... possibly ask if you can have a finger ***** machine to keep an eye on your glucose levels JIC. Not sure if they'd do that, but just an idea.
Yep - I refused it in this pregnancy. Again, like others have said, weighing up the pros and cons, and the fact that I am an extremely health consious person.
I don't normally consume sugary foods when pregnant - and after drinking this fluid in a prior pregnancy, bubs just kicked and punched me so violently for a prolonged period which was very uncomfortable and rather distressing. I suppose if you consume sugary foods on a regular basis it wouldn't be such a shock, but for me it just didn't make sense to expose bub to a high concentration of sugar in order to see if I was likely to develop a condition that I was actively trying to prevent - iykwim? But - each to their own!
X
Yes, I also was 'threatened' with induction and or c/s as soon as I got a positive result for GD. I was about 25 weeks pg. I was pretty horrified they would even mention it at that early stage, without any other complications presenting. At my 39 week checkup at the hospital, the MW booked me in for an IOL just 3 days past my due date. I just nodded and went with it, feeling like I should be saying something. :shakehead:
Of course, when I arrived at 40+3 to be induced, the MW on duty checked me and said I was high, closed, and completely unfavourable. I was thrilled to go home and wait it out.
What you choose to do with the knowledge is up to you. Don't allow anyone to dictate what you will or will not be doing without due medical cause. :hug: It's not a nice feeling to have IOL or C/S thrown in your face as a just in case measure.
Thanks for this thread girls. I am thinking of ditching this test this pregnancy too. I don't eat sugar at all, along with many other things, other than the odd piece of fruit every few days. I do not want to undo all the work I have put in to heal my gut and my sons gut (i'm breastfeeding him still) for one test...and i wasn't sure where i could stand on having this test.
I have a couple questions though....What are some of the warning signs of GD that you can pick up on without a test? Many of you have said your midwife is pretty clued in to what to look for?
Also for those that did have it, you said it was diet controlled....so what does that mean you had to cut out or eat specifically? I already don't eat a huge amount of things, as already said - including sugar, so I am just wondering how different the diet would be and if i'm already kinda on it.
Thanks in Advance!