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  1. #1
    xjessicax is offline Member
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    Default How does the OGTT work?

    Hi guys, I'm coming to the time in my pregnancy where I've been given the form to go fast for 12 hours, drink a nice amount of glucose, then have my blood taken, I'm just wondering if any of you have thought about declining the test?
    Surely there must be a better way for one to be diagnosed to have or not have gestational diabetes rather than a rather unrealistic test like this?


    I know I certainly don't drink that amount of glucose in the morning nor sit around waiting for my blood pressure to spike, I'm active after eating, and have a balanced diet. Surely there is a more accurate way of testing.
    Can't I be given a false positive if I'm not used to that quantity of sugar being digested?

    Any thoughts are appreciated thanks.
    Monkey is 6
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    Munchkin - May 16 2012

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  2. #2
    Miss_C's Avatar
    Miss_C is offline Member
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    Default

    you can refuse the GTT same as you can refuse a scan or any other type of test, even taking your blood pressure in fact the ONLY thing you have to do is register the birth. So you can eat what you want, do what you want. Your choice.

    Given the fact that diabetes is very serious and is not just about big babies I fail to see why anyone would choose not to be tested. It's not pleasant granted, I had mine today and they ended up taking blood from my wrist and foot cos the arms in my veins are not easy to find at the best of times and normally need to be super hydrated and fed for them to play ball. I think I had a hypo when I got home, blurred vision, shaking and sweating. BUT I did go grocery shopping and should have eaten before I went so I am sure I exacerbated the situation.

    The blood tests measure how your body copes with the glucose with NO additional help. Hence the fasting large quantity and then no exercise. If the body shows it can't cope or struggled then it will be monitored and steps taken to help it cope ie ensuring low gi foods are eaten and exercise is undertaken GD can be diet and exercise controlled in most cases. Monitoring your levels is the next step and keeping a diary and that is very easy to do, the pin pricks don't hurt and it just a matter of writing the levels down 4 times a day.

    You could show up as positive from the test but the above monitoring would then take place if that was the case.
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  3. #3
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    MeNThem is offline Member
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    Its actually one of the most accurate ways to test for it AFAIK.

    The science behind it is all related to your insulin response and how your body manages the high dose of glucose to the blood... so its actually a perfectly "fine" way to test it. It generally won't give false positives, and if it does, the give you a slightly different one which lasts over a longer period and then it will generally clear the false positives from the true positives.

    I don't know which one you have been referred to, but I recall there is a 2 hour and a 3 hour GTT. If you have been given the referral for the 2 hour one, then its the 'easy' first step one. If you have been given the 3 hour one straight off, you could request the 2 hour one first?

    I've had two of these before - ironically not when pregnant... my Obs didn't think I needed it with the twins, so never had it and was fine. The drink is not that bad - like a slightly sweeter lemonade. The worst part was the boredom of sitting there for me.
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  4. #4
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    Do you mean there is a 1hr one and a 2 hr one MeNThem? I've always had to do the GTT ( 2hr one) and thought that was the long one? The short one (1hr) is the GCT I think?

    OP - you can decline the test if you don't want it but it really isn't a big deal. The drink makes me feel abit sick because it's so sweet but you get used to it ( I've been tested 4 times in 3 pregnancies and once not pregnant).

  5. #5
    xjessicax is offline Member
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    I've had the test three times before, my blood pressure generally runs quite low, and lower than normal in this pregnancy so I'm worried about what the glucose may actually do to my body. (re overload/passing out/false positive), so I know the time it takes, what is tastes like, and what is involved.

    What I'm wondering is if there is an alternative test to the long ogtt (yes its the long one, not the screening one). And if so are there any ladies on here that can share their experience.

    I generally don't have a high sugar/carb diet and try to eat mostly low gi foods as a general rule already, and have read some reports of false positives due to the body being shocked with a large amount of glucose it isn't used to taking. Hence the curiosity, is there a different test out there.

    I'd rather not take the longer test.
    Monkey is 6
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    Munchkin - May 16 2012

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  6. #6
    Miralen's Avatar
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    I hear you on wanting not to take the longer test, I hate hate hate the carb loading diet that goes with the OGTT. When I failed (impaired tolerance not full on diabetes) my first GTT my FS then ordered another test as I said that I had to eat more in carbs alone than I'd eat food in total for a day and that I know my metabolism is a little slow.

    From memory the test I did was the Hba1c, it is a test that looks at what your levels (insulin I think?) have been doing over the past three months. It was just a go in and have blood drawn type of test. I don't know if it might be a suitable test to do for GD instead of the GTT but it might be worth asking about it.

    Can you/have you done the short test first instead of going straight to the GTT? I was able to do the short one this time around first off, but failed by 0.1 because the clinic closed at 4 and I didn't get my drink until 3:10 so had to then do the GTT which I passed
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  7. #7
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    xjessicax - the OGTT is a test of how your body copes with glucose (the broken down form of any kind of carbohydrate, whether it comes from lollies, potatoes, fruit, bread - whatever). This particular test uses the easiest way of infusing glucose into your system (i.e. orally as opposed to directly into your vein, which is actually a more accurate test). What it does, is measure the increase in blood glucose concentration (peak glucose) caused solely by the drink (this can vary in people who have a very good response by the pancreas to secrete or release insulin (they have a lower peak in glucose) and the rate of fall in blood glucose concentration over time (hence the multiple blood tests required). The faster the rate of fall, the better you 'tolerate' a glucose load (and less likely to have diabetes).

    Essentially what it measures is your insulin sensitivity - this is directly related to diabetes, and is a measure of both your immediate pancreatic response (to secrete insulin which is aimed at lowering blood glucose concentration), and your body's response to the insulin that is then in your system.

    During pregnancy, in a wide number of species, not only humans, insulin responsiveness is decreased, meaning that the tissues that take up glucose in response to insulin (muscle and fat mostly), don't do this well enough.

    This can be a good thing during lactation - as it diverts the glucose in the blood stream away from muscle and fat, to the mammary gland to make the lactose in milk. But during pregnancy, if the pancreas is not responding to the glucose, or the body is unresponsive to the insulin released, it can leave too much glucose available for the growing baby - causing excessive weight gain, or increased growth. Preterm labour is also associated with GD.

    This is why (IMO) its important to check for gestational diabetes during pregnancy, so that it can be monitored or treated with diet and/or insulin injections.

    There are some other ways of trying to diagnose diabetes from a single blood sample - fasting glucose levels, the glucose to insulin ratio - but these are not very reliable, and there is not really a set 'level' yet that these should be at to actually spark concern. The more accurate ways involve 20+ blood samples over a 3 hour window... so not as pleasant.

    *just realised I'm rambling on..* (I did a PhD on glucose tolerance and insulin sensitivity in pregnancy and lactation - can't help it, sorry!)

    so - IMO the OGTT is the best way of testing for and in turn preventing GD in a relatively fast and accurate way. The way our physiology changes during pregnancy is remarkable, and even people who are perfectly healthy and are an ideal weight can get GD, simply because of how our bodies change to accommodate the life growing inside us.

    Edit - Re: overload, passing out, false positives - these are unlikely. You can't 'overdose' on sugar - you can eat way too much and feel sick, but your body will always break it down and either use it for energy or store it for use later. Passing out is unlikely, you may feel sleepy, like you would after a large meal, this is because the insulin peak after the glucose load causes your body to stop releasing fatty acids for energy, so you have less energy and feel like sleeping. Because it is a quantitative test thats done over time that follows the pattern of change in glucose and insulin, the rate of false positives is low. Plus they will almost always try to treat GD with diet before starting on insulin injections.
    Last edited by Castalilli; 11-02-2012 at 01:48 PM. Reason: Wanted to answer OP's other questions
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  8. #8
    xjessicax is offline Member
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    Thank you Casta, I've been finding it difficult to find reliable sources so I thoroughly appreciate the time you have put into responding.
    Monkey is 6
    Monster is 5
    Munchkin - May 16 2012

    Counting my Blessings



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