Is glucose tolerance test necessary? — The Bump
November 2012 Moms

Is glucose tolerance test necessary?

If I have no diabetes in my family, no history of any women having gestational diabetes, why should I do it?  I don't really see the purpose of this being standard.

Re: Is glucose tolerance test necessary?

  • KadyraKadyra member
    Because most women with GD have no personal or family history if diabetes. And if you don't have the test and have undetected GD, your baby is at risk for spontaneous fetal demise due to chronic high blood sugar. Or being enormous. And if larger than 8lbs13oz the baby is at risk for neonatal hypoglycemia. It's not worth it to refuse to chug some nasty drink and a blood draw. 
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  • I agree that it's a good idea in most cases. A friend of mine is opting out but only because she's considered high-risk and is being monitored very closely with weekly appointments and NSTs. That said, I've heard that most European countries don't do them and consider it unnecessary. That glucose drink contains chemicals I'd prefer not to consume, so I'll be asking my OB if we can do the "breakfast" test instead:

    http://www.ncbi.nlm.nih.gov/pubmed/12017956?dopt=Abstract

    Apparently some OBs and midwives have the woman eat a certain amount of jellybeans, a couple of bananas or a glass of orange juice instead of the glucola drink. Much more humane options if you ask me.

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  • imageZoeMay06:

    I agree that it's a good idea in most cases. A friend of mine is opting out but only because she's considered high-risk and is being monitored very closely with weekly appointments and NSTs. That said, I've heard that most European countries don't do them and consider it unnecessary. That glucose drink contains chemicals I'd prefer not to consume, so I'll be asking my OB if we can do the "breakfast" test instead:

    http://www.ncbi.nlm.nih.gov/pubmed/12017956?dopt=Abstract

    Apparently some OBs and midwives have the woman eat a certain amount of jellybeans, a couple of bananas or a glass of orange juice instead of the glucola drink. Much more humane options if you ask me.

    This is what I was thinking. 


  • They aren't necessary. This is my 4th pregnancy, and I've never had one. My urine has been monitored with each one, and if I had been found to have sugar in my urine, perhaps some additional testing would have been recommended by my midwives.
  • For me the benefits far out way anything else.  It's really not terrible and I'd rather do it and the peace of mind than not do it and risk having GD go undetected putting both baby and myself a risk.

    Also re: European countries not doing it, they don't have the overwhelming obesity issues ou country has and are not consuming as many processed foods with high levels of high fructose corn syrup which can increase the occurances.  

     If you're  not a fan of the glucola the link to the "breakfast" test is great and worth asking your provider about.

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  • KadyraKadyra member

    imageAHomebirthMama:
    They aren't necessary. This is my 4th pregnancy, and I've never had one. My urine has been monitored with each one, and if I had been found to have sugar in my urine, perhaps some additional testing would have been recommended by my midwives.

    Sorry, but it's actually malpractice in the US not to offer it.

    Many diabetics never spill glucose in their urine and many nondiabetics do do this is a poor test to screen for it. Glad you never had problems, but I think it's irresponsible.  

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  • I agree with the pp it's irresponsible not to do it...it's a simple test, if you prefer to skip the drink, discuss the above mentioned other options with your OB.  It's not about your weight going into pregnancy, it's about your body reacting differently than it should to the pregnancy hormones.  And if people could tell blood sugar by their urine don't you think the millions of diabetics would love to stop pricking their fingers...
  • I'm opting out this time around.  I had it done with both my previous pregnancies and they were both fine.  I get my urine checked for glucose at every appt and as long as that stays in the clear and I don't have a sudden weight gain or anything, I'm going to skip it this time around.
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  • imagelavet22:
    I'm opting out this time around.  I had it done with both my previous pregnancies and they were both fine.  I get my urine checked for glucose at every appt and as long as that stays in the clear and I don't have a sudden weight gain or anything, I'm going to skip it this time around.

    This is not logical. GD doesn't cause a sudden weight change. And it's something caused by the placenta. Just because your last 2 placentas were fine doesn't mean this one is.

     

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  • Sorry, I'm lurking here (bedrest makes you booored!), but my mom lost her first baby at 42 weeks (stillborn) due to undiagnosed GD back in the day when they didn't test routinely  (and then had GD with me but not my sister, so previous pregnancies are not an indicator) so I am always kind of surprised when people want to opt out for whatever reason. 

    No reason is worth potentially (way worst case scenario) losing your baby.  Most of my friends who have had GD have been fit and healthy (my mom included) and my most recent friend to have it is the girl who works out like crazy, is slender but has amazing muscle tone, and has her burgers wrapped in lettuce instead of bread, etc. because she is so health-conscious.  So that's my PSA to those of you who think that you don't need the test because you have a healthy lifestyle, no family history, you're not obese, didn't have it before, whatever.  The potential consequences are soooo not worth it for not wanting to drink a gross drink (or eat jellybeans, or whatever your caregiver recommends).

    Here's to happy and safe pregnancies and babies to us all!


     

  • imageKadyra:
    Because most women with GD have no personal or family history if diabetes. And if you don't have the test and have undetected GD, your baby is at risk for spontaneous fetal demise due to chronic high blood sugar. Or being enormous. And if larger than 8lbs13oz the baby is at risk for neonatal hypoglycemia. It's not worth it to refuse to chug some nasty drink and a blood draw. 

    This!!! My suggestion do the test! 

  • dicer2dicer2 member
    I had GD with my first pregnancy.  No risk factors, no family history, I'm small and only gained 18lbs total.  I borderline passed the 3-hour test but my OB sent me to the diabetes center anyway.  Good thing!  Diet did not work and my GD required insulin shots to control.  I was induced a week early because there is a much higher risk of stillbirth with insulin-controled GD when left to go past the due date.  My baby was born at a healthy weight and did not require any medical intervention and I believe this only happened because I had my GD under control.
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  • mick64mick64 member

    I'm a dietitian and I work with GD patients. While family history and size can play a role, I have had many, many patients with no obvious risk factors for GD.  The urine glucose test is a poor screen for GD as multiple PP's have noted. If you really don't want to do the drink, ask your doctor about the breakfast test that was linked, or other alternatives, such as actual blood glucose monitoring.  Some people who do have GD are very easily controlled with diet, but I've seen several who have required insulin. Blood sugars that high do increase the risk of a large baby, which can complicate delivery, and it can also cause problems for blood glucose regulation in the baby post birth. I'd want to know if that was an issue so that I could make sure baby's blood sugars were monitored appropriately.  Just breastfeeding isn't necessarily enough when the baby's insulin/glucose regulation system has been messed with due to maternal GD..

    FWIW, the drink really isn't that bad.  It's just glucose, which you everyone consumes on a regular basis.  It may be colored so food dye is an issue, but it's not like it's got all these crazy weird chemicals in it.  And the amount consumed is not enough to really be concerned about anyway.  Unless during your pregnancy you have consumed absolutely no processed foods and no sugar, it's really a moot point. 

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