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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!
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.
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:
http://www.3centres.com.au/guideline..._screening.pdf:
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.
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.
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 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.
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.
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
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.
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.
I am overweight and ive never had it with either child...not even close to a high level...:
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.
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.
I recommend you read THIS great article by Henci Goer, who is coming to Australia very soon!
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?
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
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.
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.
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
I was overweight in my first pregnancy and had the 2 hour GTT, came back normal, so weight gain is not and indicator. This time I only had the screening test and came back normal too, its possible for anyone can get GD, however must say it does depend on what you eat during pregnancy a little bit, if you eat sugar all the time the likely hood of getting GD is a bit higher.
I couldnt even compare the GTT test with the Step B, Step B is very dangerous and if you end up having it and give birth vaginally it is a worse danger to the newborn than not taking the ABs.
ETA my glucose level came back as 4 very low and im oveweight.
*Belle* i think people are comparing the 2 tests because like GD, a +ve result doesn't mean much. One study read found that about 80% of women who had StrepB at 34 weeks no longer had it at term and 30% who didn't have it at 34 weeks DID have it at term. It's not that strep B isn't harmful, or that GD isn't, it's that the TEST is unreliable even as a diagnostic tool.
Bx
:
Yes, that's my reasons for not taking the Strep B test. Besides, I have complete faith in the care I receive at the Birth Centre; I trust their decades of experience as well as their ability to help me make an informed decision about any test or disease which could affect me or my baby.
My advice would be for the sake of a couple of hours of your time and a little discompfort to you, it's not worth taking the risk by skipping the test. Better to be safe than sorry.
My SIL had GD and she was otherise healthy and certainly NOT overweight (a size 6-8)
I, on the other hand ,am overweight and didn't have gestational diabetes at all.
I am small built, not overweight and have failed the GD test with all of my pregnancies so far - I am still waiting on the results of this one. But I also have a history of polyhydramnios and large babies, which wouldn't have been discovered the first time if I hadn't have failed the glucose test. Because of being very borderline with the test, I was sent for more ultrasounds to try to determine the cause. Although not officially diagnosed with GD, I am considered borderline and somewhat at risk.
Also, because of a history of thrombocytopenia, I have to have regular full blood counts anyway, so the glucose test was no biggie ....
But like everyone else has said, it is ultimately your choice (like I choose not to have the down syndrome testing done at 12 weeks)
If you feel it is totally unnecessary, then talk it over with your docs and midwives.
I was a bit overweight when I got pregnant but only put on 6kg during pregnancy, so weight gain is kind of neither here nor there. But my age also put me at risk.
I can't comment on how reliable the actual test was but my results were borderline.
Down the track, knowing this actually helped a bit because DD was a biggish baby (8lb 10oz) but is now an average-sized baby. I've been told her big size at birth was probably down to the fact that I was borderline GD so that eased my mind a little when she was not gaining as much as might have been expected when she was a newborn.
Can you have a smallish baby (ie. 6 1/2 pounds or less at full term) and still have GD or does a diagnosis of GD always result in a bigger baby?
Gee I wish I had read this thread before my GD test! I really did not want to have it, but just did because it seemed the done thing.
If you do decide to have it, is not pleasant, but its not the worse thing ever. It was funny though, I was on like this sugar rush high in the path waiting room after the drink. I could hardly sit still!!
BTW, my results were fine,.
Jac yes you could have a small baby and still have GD...the two dont necessarily go together. ANd Belle I have to say that what you say about what you eat causing GD is just so wrong it is not funny. Eating too much sugar does not cause diabetes of any kind full stop! It is far more complex than that.
Yes the test can give false positives, yes you can have GD and or elevated bloos sugar levels and not have sugar spill over into the urine as that is dependent on how well your kidneys are flushing the excess sugar out and also how well your body is at converting the extra suagr to glycogen stores.
I say it is better to be safe than sorry with this particular test. Even if you were to get a false positive the worst case scenario for first stage of treatment is that your diet would be modified and you would be asked to do some finger ***** blood tests a few times a day. If it was a false positive test your finger ***** tests over the course of a week or two will show this as if it is not truw GD they will fall within a normal range and the docs will quickly be able to see that things are okay.
The danger in ignoring gestational Diabetes has not a lot to do with the baby actually - it has everything to do with permanent damage to the islet cells of the pancreas - your pancreas. If they are overly stressed and it is left untreated permanent damage can occur. Statistically speaking 50% of people who have Gestational Diabetes and Do Not treat it will develop Type II Diabetes within 2 years. For those that do treat their GD and lessen the stress on the pancreas the outcomes are much better with less the 20% going on to develop Type II over the long term.
There ia a lot of controversy as to whether treating GD affects birthing outcomes for the baby (i.e. baby size, induction etc...) and I do not want to enter that debate
What I want to emphasise is that really the issue is so much bigger than just the pregnancy.....you need to think of it is a warning sign about the potential of long term damage to your own body not just how it affects the baby you are growing.
i know this is off topic, but im sorry but no birth centre or hospital can guarantee any affects on your baby whether or not you take the test, the healthiness of the baby is up to you and your body and the baby, I understand not taking the test at 34 weeks and hope for the best (maybe they should do the test later, my OB does them at 36-37 weeks) totally your decision. Foe me I thought the test was easier than the pap smear and better to be safe and know as the antibiotics will be less harmful than if the baby actually got Step B while giving birth.:
What about the risks of infections like golden staph etc that you are exposed to in hospitals? No-one seems to be worried about that ;) Those that stay at home are at less risk because there are no sick people in the family home.
Hi Bec,
With my second I wasn't even offered, our Dr only did the GD on 2nd timers if they showed symptoms woohoo
OMG Kelly im so glad you mentioned that about Golden Staph that is a real huge risk, it happened to a friend of mine when she gave birth. I am at total risk of that as I get excema all the time. Also when I gave birth to Julia myself, my husband and my mum all got a cold from the hospital.:
I'm not demanding any guarantee from the carers in a birth centre or hospital - if that were my concern surely I would be taking every test under the sun and demanding a reason for not receiving the outcome I expected... what I said was, I trust their decades of experience to help me decide what is best for my baby and for me.:
I think whatever you decide in pregnancy - and in life in general! - it should be an informed decision, taking on board the information you can find yourself as well as the advice of people you respect and who have your (and your baby's) best interests at heart, rather than simply because it's always been done that way, kwim?
LOL, sasha your last post reminded me of when i was PG with DD. I was craving sushi and eating it more or less daily. I was sensible about what i ate (avoided too much tuna and swordfish and only bought it from very reputable places) and was really enjoying it. People CONSTANTLY said to me "umm..should you be eating raw fish? What about the baby?" and i used to want to lose it and yell (because i had done the research) "WHAT DO YOU THINK PREGGIE WOMEN EAT IN JAPAN!?" LOL. It sounds so obvious when one thinks about it but so many of these "facts" and "recommendations" are really cultural habits, myths and legends.
Bx
PS - i grew one SMART little girl on my fishy fishy fish fish diet....
That's so funny, because fish is honestly the LAST thing I feel like eating right now! :lol:
Pregnancy seems to bring out the fruit monster in me ... I eat several pieces a day - yum! Excuse me, I'm off to find an apple ;)
Sasha...please please have the strep test honey!!!
I was told that i didnt have to have it due to having a c/s..but as it pans out I had strepb, and my little man ended up having mengi****iles and a staf infection...due to them he has (still) many blood cots and dead brain cells and now has cerabal palsy.
please its just a little test that can save a life time of frustions, what ifs and emotional pain.
Bel was saying those things becasue she knows the heart ache I have been through.
Please consider EVERY avenue babe...I wouldnt want ANYONE going through what I am!
Ultimately the decision to have the test is only one that you can make, it doesn't really matter what other people think you should do as long as you are confident in your decision.
However, I had GD that required 4 shots of insulin and careful diet monitoring and I would not have been considered high risk for developing it. The common risk factors are:
*Obesity (BMI over 30)
*Of asian, african, pacific island, indigenous australian, hispanic ancestry
*Over 25
*Previous baby over 4kg
*Close family members with Type 2 diabetes
I was 25, a bit overweight but not obese, european decent , no previous babies. The only risk factor I had was being related to a bunch of Type 2 diabetics. The doctor commented that I had drawn the short straw in the genetic lottery and she even thought that I would remain a Type 2 after the birth because of the lack of risk factors and the severity of the insulin resistance that I had.
I am very glad that I had the test, I shudder to think of the consequences if I had spent 3 months walking around with sky high bsl (to the baby and myself).
BTW, that is interesting about the strep, it was never mentioned and I was never tested for it.
I had my 1 hour GTT last week and got a 8.2 (anything over 7.8 you go for the 2hour test). Went for 2 hour test and got 9.2. I have GD.
I've always been slim, never overweight, no history of diabetes in my family, I am Australian so do not fall into a risk ethnic group and I'm under 30. I've been given an eating plan and the foods on it i ALREADY eat which is strange, but it can also come down to serving size and ultimately it is to do with insulin production. Some people's body apparently just can't keep up no matter your shape, size, history etc.
Just goes to show you that even healthy eating (I do not eat sweets or junk food and didn't before or during PG), you are still at risk of GD.
My very slim, very healthy vegetarian friend had GD with her first pregnancy, she was able to manage it with diet but had to be very very careful. She had no other indicators. (luckily she didn't have it with her second pregnancy).
Another friend, who's also slim and healthy, had it with her last pregnancy, she had to have insulin. She was over 40 though.
I would have the test. I know that it seems sometimes they are "over testing", but so many of them have saved lives that it is worth having.