Why you shouldn’t refuse this test during pregnancy

I was 20 weeks pregnant with my son, and feeling fairly happy about pregnancy. I’d had the usual spate of morning sickness between 6-14 weeks but was putting that behind me. My baby boy seemed happy and healthy and was measuring perfectly at my 20 week scan. I was feeling fortunate and amazed at the astonishing job my body was doing. Things were looking good.

Then my midwife mentioned booking me in for my GTT (glucose tolerance test) again. My BMI was 0.2 above the limit that my NHS trust set for testing. I was a bit miffed, to be fair. 0.2 seemed like a tiny amount – and my baby was measuring perfectly.

I felt like I was being tarred with the brush of being ‘unhealthy’ or ‘fat’. I felt like she was saying that I had done something to put my baby in danger and the test seemed like it was a punishment – a shameful display of all the fat women who should have lost weight before they got pregnant. I didn’t feel like I was overweight enough for it to be a necessity and I resented it.

I suppose I was on the defensive. I didn’t like what it might say about me if I did have gestational diabetes. In the end, I think the only reason I agreed to it was to prove everyone wrong.

You should never refuse this test during pregnancy. What is GD or gestational diabetes?


I fasted the night before, endured the blood tests and sugary drink and two-hour wait, supremely confident in the fact that I would not have it. But three hours after getting home from the test, my GP phoned.

I had gestational diabetes. My hospital’s limit for the two-hour after the drink blood test was 7.8 – my result was 7.9. It was a pretty devastating blow. The first thing I felt was anger; it seemed so ridiculous that I had it! 0.1 was a tiny variation and the test was bound to have a margin of error.

The result had upsetting consequences. It meant consultant care – no midwife-led units or birth pools. I would have to severely modify my diet to have no sugar and very few carbohydrates. It meant I might have to inject insulin. It meant I would likely be induced. There was no way to hide that from my friends and family. I’d have to tell. And they would think it was a shame but it was my own fault – I was overweight. For 0.1 off their limit. I cried quite a bit for the first few days. I felt humiliated.

But I needn’t have. Gestational diabetes occurs when pregnancy hormones interfere with the body’s ability to deal with excess blood sugar. Usually, everyone produces enough insulin to keep their blood sugar level relatively constant (except for type 1 diabetics). With GD, a woman still produces insulin, but hormones are thought to interfere with the body’s insulin receptors, resulting in abnormally high blood sugar levels

There are risk factors that increase the likelihood that you will have it: polycystic ovary syndrome; a first degree relative with type 2 diabetes; smoking; having had a baby classed as above the 90th centile in a previous pregnancy – and being overweight or obese.

Many of the women who develop GD have no risk factor at all, and many specialists advocate testing all women because of this.

When I attended clinics for GD, I noted that, to me, the vast majority of women did not look overweight or unhealthy. I spoke to a woman at my first session who was a size 8 and, like me, convinced it must be a mistake. But she did have it – and so did I.

Weight is a factor but is just that – one of many that could influence your body’s ability to manage sugar. I have gradually come to accept that I should not feel shame. Since my first pregnancy, both my father and maternal grandfather have developed type 2 diabetes.

In my second pregnancy I started testing at 11 weeks and my sugar levels were already high. My consultant told me that to have it so early in pregnancy, my weight had very little bearing. Being a stone or two lighter may have delayed it for a few weeks but there was no avoiding it; it was in my genes.

So here I am in my second pregnancy, finger pricking to test blood 5-10 times a day and injecting insulin 3 times daily. My little pink bump is cooking away nicely, measuring well for her dates, while her healthy and exuberant brother is excitedly telling me the colours of the blocks in the towers he is building at my feet. Life isn’t too bad. I can live with GD, even though the chances of avoiding type 2 at some point post-pregnancy are fairly slim. But many women are still going undiagnosed.

There is a great variation in the way the test is done from county to county – some simply drink Lucozade themselves and pop to the GP for a blood test. This method neglects to test fasting sugar which can also be a strong indication of GD. Some have the much more invasive fasting GTT, where you have several blood tests and a long wait without breakfast. Some trusts will test you with any risk factor but in some you are lucky to get it if you are in two or three. Some have one BMI limit for women testing, others a different figure. Some say you have diabetes if your result is over 7.8, others 8 or 9.

I am in favour of making the test more uniform and strict for all – and I believe that testing all women would be a sensible move. Although GD is perfectly manageable if detected, it can cause some dangerous complications if not monitored. As well as difficult births due to larger babies, mothers who go past term with GD are at much higher risk. I am so grateful that that tiny 0.1 over meant I was able to mimimise these risks for both my children.

A test for all pregnant women would mean that the many cases of GD that go undetected would be picked up and those mothers and babies would receive the care and monitoring they need and deserve; it would also mean the inaccurate stigma of having a GTT or GD would gradually fade, meaning women like me would not have to face such a painful and humiliating journey in order to come to terms with having a condition that is, in all likelihood, out of their control.

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33 thoughts on “Why you shouldn’t refuse this test during pregnancy

  1. In my hospital (private / Spanish) everyone is given this test. Fasted and bloods before and after.
    I didn’t realise and am shocked this isn’t the case in the UK.

    1. Private:- So each client would be charged a fee for the test. Business would benefit financially.

  2. Excellent blog! I also had gestational diabetes. My OB used to just look at me and say two words: shoulder dystocia (baby gets stuck because he or she is too big). Kept me right on that diet! Thanks for spreading good info.

    1. Good to share facts, reality :- As that can provide up to date accurate information. We need accurate information to guide us. Historically things can change, but we can aim to understand, and support each other when we have had similar experiences.

  3. Great blog post. I also got tested, I didn’t have it but it honestly had never occurred to me that anyone refuses the test. In fact my doctor told me to get it done and it didn’t really seem like an optional thing to do, perhaps because of the way he approached it. What you say is so true, it’s not about you having done anything wrong, it’s about the pregnancy hormones that sometimes just do things to our bodies that we cannot control. I do hope more women take this test, and more importantly, recognize that if they do have GD it’s not their fault.

  4. Thank you for writing about gestational diabetes. I was diagnosed early in my pregnancy and very thankful that I was advised to take the test earlier than usual. I often read about people refusing to take the test out of fear, thinking the condition doesn’t exist or simply not liking the idea of taking the glucose drink.

    I managed to change my diet and keep my blood sugars in a reasonable level. I take insulin in the evenings to help with my fasting level, but so far I’ve not had to have my dose increased. The changes have benefited me so much. I have a high BMI and have been losing weight rather than gaining it, which is good. Baby is growing at a regular rate, too.

    I was terrified at first and bitter about being diagnosed, but now I’m used to it and all the monitoring is a part of daily life.

    1. It’s really tough to adjust to the news and easy to feel bitter. There’s a real sense of self-loathing that comes with it in this country which I think could be eliminated with a uniform test and clearer information. Glad you’re managing well now – it’s not so bad when you’re in the routine! Thanks for commenting.

  5. What a great post. I was tested for GD with my second pregnancy but the results were negative. I’ve always wondered about what the risks are if you are diagnosed with it.
    Reading this, I agree with you that it should be a standard test for all pregnant women.

    Laura xx

    1. If all pregnant women were tested :- What about the financial costs? Would it be cost effective? There is a limit on finances / resources. Cost : Benefit Analysis?

  6. I agree it’s a good idea to test every pregnant mum-to-be! I was tested in my first pregnancy because my mum had GD in her pregnancies – it was negative thankfully (although I ended up being induced early for pre eclampsia anyway!). It’s only a small inconvenience for one day and could end up preventing a lot of problems! Great post #KCACOLS

  7. I was tested for GD due to being overweight and thankfully came back negative. My due date is tomorrow but no sign of baby girl showing yet!. Throughout my pregnancy I have had growth scans to make sure she is growing correctly, I was told this due to my BMI but everytime i got to my scan they just looked at me and asked about my GD. I said I don’t have it! I have the test but it came back negative. They were surprised as my baby is a very good weight and slightly on the large size. I just wish they wouldn’t assume I had GD. although I m overweight, I am very active and eat very healthily. My husband is 6ft 5 and I am not short either so I was expecting to have a large baby from the start! xx


  8. A really well written post. I didn’t have GD with my pregnancies, but have friends who have. I can completely understand your frustration and worry at the time. Am pleased to read both mum and babies are OK following the births!! ❤️ #KCACOLS
    Kathy xxx

  9. I didn’t have GD, but I remember being told that if you got it, it was just one of those things, nothing to do with your lifestyle and it goes away afterwards. Glad your GP spotted it and you got treated and your pregnancy is going well.

  10. I had gestational diabetes with all 3 of my pregnancies. I was a size 5, 5 ft 10in, and in the best shape I had ever been in my life when I got pregnant with my son and didn’t buy a single piece of bigger clothing until I was 34 weeks pregnant….but I was diagnosed long before that. With my second ….same thing and by the third I told my doctor I wasn’t even going to do the glucose test cause I had already been checking my sugars and they were high. I had to have all 3 via C-section and they were all close to 10 pound babies. And you know what….I don’t feel ashamed at all. Never did. I get angry at people who somehow think it’s a woman’s fault that things happen during pregnancy and we have C sections instead of natural births. I don’t love my kids any less than if I would have not had GD and pushed them out my who-ha. Type 1 diabetes runs in my maternal family therefore I am now high risk for developing it which is why I have vowed to get healthy this year as my last blood results showed me as being borderline. Don’t ever feel ashamed. You are a mother. The proudest thing to be. Thank you for linking up with #momsterslink 💌Trista

    1. Wow. 3 pregnancies must have been tough! I thought 6 months on injections and a low carb diet with my daughter was tough. I am already prediabetic – lots of history in my family too. I really need to get motivated like you!

    2. Seems like you have a good attitude to life, health, etc. People vary, circumstances vary :- Some may stress / worry. Some things we might have control over, some we don’t. I suppose we need to take / make time to find out how we can learn to accept life, health as it is. Maybe living in the Present e.g. Mindfulness can help. ( Past is History :- Facts, Future yet to happen :- information, support, etc may assist. But future not known for certain (uncertain) ).

  11. Such an educational post. I am pregnant with my second baby and was lucky enough not to have GD with my first. I expected to be given the glucose test again by my midwife like I was during my first pregnancy so was surprised when a couple of weeks ago at my 17 week appointment I was told that I wouldnt need it because all my bloods, samples, results etc looked good and because I didnt have it first time round. I walked away from my appointment wondering whether their approach is sensible or not and reading your post has made me wonder again whether this is something I should look into more! Emily #KCACOLS

  12. I was luckily enough not to have GD however I wasn’t tested for it. Great post as people need to know more about this #KCACOLS

  13. A really great informative post. I wasn’t tested for it, but know several friends who have been and a couple who had it. It’s best really to have all the precautions and tests you can in pregnancy, just to get the care you and baby might need #kcacols

  14. I didn’t have GD with any of my pregnancies. I was lucky as I thought I might have it as my father, my mother and my grandparents are diabetic. So I wanted to do this test anyway. It is really important to do it and you should not feel any less if you have it. This must have been very hard for your as I know for my father how tough it is to have to inject insuline all the time. He has to check very often if his levels of sugar are high or not and pretty much live on a diet. It is not an easy life. Thanks so much for sharing this informative post at #KCACOLS. I would love to see you again on Sunday! 🙂 x

  15. This was a great post to read after having recently been diagnosed in early pregnancy. I cried for days after, still tear up to think about. Yep, there’s the waterworks. Thank you hormones! :p
    I haven’t had an appointment with the dietitian yet to develop a strategy for keeping everything in check so I’m in that scary stage of knowing something is wrong but not knowing how to fix it.
    But you’re right, the humiliation attached to it is SO hard. *It’s because I’m too heavy or too old, if I had been fitter or younger…. I mean, if I could have changed it, it must mean I caused it right?* All the irrational feelings and thoughts that I had when I failed my fasting level by one point and my 1 hour by 2.
    Bottom line is that the more I know about how to grow a healthy baby, the better. Yes, it does stress me out, but knowing that this isn’t doom and gloom and that being ‘too thorough’ will yield better results for me and my baby, makes it a little easier to swallow. A little bit.
    Thank you for sharing your experiences openly and candidly. The more people of all shapes, sizes, and ages, who talk about their experience with GDM, the easier it will be to relinquish self blame.

    1. My pleasure. If it helps even a few people to realise thst it is not theur fault and that they are doing their best for their baby then I am very happy. Thanks for commenting 🙂

  16. Thanks for sharing. I had the GTT with all my children (I’m overweight) and it was negative each time. I didn’t think anything of it at the time. Just a test to make sure baby and me were OK.

  17. I’m also really shocked that the test isn’t just standard practice in the UK. I’m British living in Kenya, and had been reluctant to be tested for GD, but my doctor was really really insistent about it. In hindsight, and after reading your post, I should have been more receptive to the testing and it should be something that is checked in every pregnant woman .

  18. Hello
    Most women refuse the test in pregnancy. Gestational diabetes occurs when pregnancy hormones interfere with the body’s ability to deal with excess blood sugar. I have a pregnancy and want to take rest but health is not to support me and I feel sick. Be careful about health in pregnancy.

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