Glucose Tolerance Test at 6 weeks?

[MacKinnon]

I refused a one hour GTT today. I'm 6w4d. I have two, supposed, risk factors. 1) a higher BMI (I'm a 14-16, so bigger, but not obese)
2) bigger babies (they were 8lb15oz and 8lb10oz) she said that's "close enough" to 9lbs to count.

I made the nurse mad, but I have had no history of gestational diabetes, no family history, no problems with the 1 hour in my other pregnancies. I wasn't doing it! Sorry! So what's the story with this, anyone know?? Is this really routine now, like she tried to tell me?

[umsami]

My guess is she suspects that you're actually an undiagnosed type 2. If they bug you, ask for a Hemoglobin A1C test (bloodwork). It shows your average blood sugars over the past 3 months or so... and they can easily tell from that if you're "normal' or not.

[etsdtm99]

i recently had a friend who had to do the test at 8 weeks because she was bigger but not obese and had trouble getting pregnant (long cycles..) SO maybe it is routine now? but those are not big babies!! i would have refused too

[MacKinnon]

She said it's routine to be done with the first appointment labs (bloodwork, urine test, etc.) for anyone with multiple risk factors- babies over 9lbs, high BMI, history of gestational diabetes, family history of diabetes, etc. I was just surprised, more than anything, and I didn't have time to do the test right then, as I wasn't told in advance. I was not prepared, and I don't like being taken unaware, and wanted to know more about why this would be done routinely now. She was also shocked that I was allowed to go 11 days over due and then birth a 8lb 15oz baby with no drugs or interventions. I'm temporarily in care of this OB practice due to multiple early losses, I'm transferring care back to a midwifery practice as soon as I'm out of the first trimester. Thankfully!

[SeattleRain]

It sounds like you just have a bad OB practice! I see an OB and I'm overweight and I didn't have to do the GTT on the first appointment. In fact, I'm almost 19 weeks and she hasn't said anything about it yet. I have a feeling its standard in YOUR practice, not in every practice.

If it does turn out that you have undiagnosed GD, and have to switch to an OB practice for delivery, I'd definitely seek out a different practice.

[broodymama]

I'm a bigger mama (was obese, now borderline overweight/normal pre-pregnancy) and my last two babes were 10 lb and 9 lb 9 oz. I had a couple appointments at the local military hospital and they pushed every other test at me (they consider me advanced maternal age) but didn't push for a GTT.

[khaoskat]

Originally Posted by ilovemyavery

She said it's routine to be done with the first appointment labs (bloodwork, urine test, etc.) for anyone with multiple risk factors- babies over 9lbs, high BMI, history of gestational diabetes, family history of diabetes, etc. I was just surprised, more than anything, and I didn't have time to do the test right then, as I wasn't told in advance. I was not prepared, and I don't like being taken unaware, and wanted to know more about why this would be done routinely now. She was also shocked that I was allowed to go 11 days over due and then birth a 8lb 15oz baby with no drugs or interventions. I'm temporarily in care of this OB practice due to multiple early losses, I'm transferring care back to a midwifery practice as soon as I'm out of the first trimester. Thankfully!

Not a single one of my three living children were under 9 lbs 2 ozs at birth. I have never taken the GTT test prior to the normal 26-28 week time frame. I am actually refusing it this next time

[klocke]

Unfortunately this is becoming a standard test for most OB practices. I just recently switched from a midwife to an OB and before I choose one I saw several for consultations. At least 3 mentioned that I should have had a glucose done during the first trimester. Apparently this is becoming routine. I have no risk factors and have never had GD in any of my pregnancies. My babies have been between 7lbs 2oz and 8lbs 10oz so not huge and I'm a size 8 so maybe not model thin, LOL, but proportioned. I refused as well since I am already 23 weeks and will be having the test done in a few weeks anyway around 26 weeks. The nurse made a fuss with me too but then again I refused the pap too because I had one done 11 months ago and they were upset about that too.

[Chryseis]

It's not always routine, but I think some doctors have different "risk factor" thresholds. Sometimes this varies from practice to practice and sometimes from OB to OB. I am obese, had an 11 pound baby, and never had to take the 1 hour test until 28 weeks during my second pregnancy. I was actually diagnosed my second pregnancy, so I did have an earlier test this time (at about 13 weeks), but my doctor left it up to me.

However, one of my closest friends went to another doctor in the same practice. She was on her first pregnancy, no family risk factors, however she was obese. The doctor didn't even bother to test her, she sent her directly to the Diabetes Education class and had her start monitoring her blood sugar. She never had GD. I found it crazy offensive and absolutely refused to ever see that doctor because of it. I actually told my doctor that I would deliver at a different hospital if I went into labor and she was on call.

[MacKinnon]

I guess what bugged me the most was the "rounding up" of my risk factors- ie my BMI was "close enough" to being obese and my babies were "close enough" to being over 9lbs and her tone. She didn't even ask me if I had GD in my other pregnancies. Just said, this is something you have to do! She didn't bother even telling me why until I asked, and then was super irritated that I refused. Of course, she also took the time to explain to me that fast food does not fit into any food group but the "fat" group and I should be more careful in pregnancy not to eat alot of fast food, I can however, have it occasionally. Because, you know, I am overweight because I eat a lot of fast food... By that point, was just done and just smiled and nodded. The OB is really pretty laid back, I seem to find the nurses being the issue. She actually told me they were "a very hands off" practice, and she "didn't understand what my concern was." Yeah lady, routine glucose screening at 6 weeks for "close enough" is definitely hands off....

Ohh--- but being send directly to diabetes ed for being obese is so offensive!! I would be livid and have refused to deliver with that OB too! How ridiculous!!

[newmommy7-08]

OP are you sure this wasn't a practice in PA? Your nurse sounds like the OB's nurse I began my first pregnancy with. Complete with lecture about fast food. This was after 'I had lost 11 # in 2 months. I looked her straight in the eye told her if the only thing i could keep down for now was mcdonalds cheeseburgers then darnit i'm going to eat them! (Any other time I can't stand mcdonalds, but when i was pg w/ DS it was literally the ONLY thing i could eat!)

[CorasMama]

that is absolutely ridiculous. I'm overweight (I was a 16-18 prepregnancy, weighed 197 at 5'8"), and I have never been treated like that. I've also got bigger fish to fry with this pregnancy, but at 17 weeks, the perinatologist hasn't even mentioned a GTT.

Newmommy: when I was still being seen by the midwives, I had a midwife tell me to eat McD's filet o fish, because it was literally the only thing I could choke down, and I'd lost 13# by 8 weeks!

[ColwynsMommy]

The CNM in my OB's office tried to get me to do the GTT at 8 weeks, too. I was livid. I was on Metformin, not because my glucose levels were off (they were perfect) but on the off chance it would help me lose weight prior to getting pregnant. I told her repeatedly that all my glucose levels, in prior pregnancies and right before getting pregnant this time had all been normal. I'm obese, but my babies have all been under 8 lbs.

She never even told me that she was ordering the GTT. She said she'd have them check my glucose when they did my regular prenatal labs, and I didn't notice until I was in the lab! Like I said.. I was livid. I declined (told the lab tech I didn't have time to do it and would come back later.. I had all three kids with me). When I saw my OB at 12 weeks, I complained and she said it was fine that I didn't do it.

I skip the GTT regardless.. I had it done with the boys, but not with Fiona and won't this time, either.

[SeattleRain]

Originally Posted by klocke

Unfortunately this is becoming a standard test for most OB practices. I just recently switched from a midwife to an OB and before I choose one I saw several for consultations. At least 3 mentioned that I should have had a glucose done during the first trimester. Apparently this is becoming routine. I have no risk factors and have never had GD in any of my pregnancies. My babies have been between 7lbs 2oz and 8lbs 10oz so not huge and I'm a size 8 so maybe not model thin, LOL, but proportioned. I refused as well since I am already 23 weeks and will be having the test done in a few weeks anyway around 26 weeks. The nurse made a fuss with me too but then again I refused the pap too because I had one done 11 months ago and they were upset about that too.

Do you have any evidence of this beyond your own experience with a handful of doctors?

[MyZymurgy]

It might be routine for their office - i suspect that is what the nurse meant.

It is not the practice at my OB. I'm larger than you AND my first baby was 9 lbs 15 oz. But a glucose test wasn't even mentioned to me until I neared 26 weeks. (Which I passed easily.)

I wonder why they are doing them so early in some offices. It seems like, at 6 weeks, it would hardly be a test for GD... more a test for D. It seems really crazy to me that they would assume just because a woman is a size 14 and had an almost-9 lb baby that she must be diabetic. I mean, assuming you were getting regular healthcare prior to pregnancy, wouldn't it be fair to assume that type II diabetes would have been caught? If you assume that (which I think is a fair assumption) why not wait until after 20 weeks to check for gestational diabetes?

So, anyway, I think it must routine in your doctor's office. I don't think a power-tripping anti-fat nurse would have the authority to administer a test like that without doctor's approval. But, ask your doctor next time to find out the real scoop.

I'm just surprised that insurance companies are willing to pay for this type of testing...