Question about initial glucose test for gestational DM?

[Burnt Out, ASN, RN]

I was wondering if any of you have had patients do the 1 hour GTT earlier than 24 weeks?

I'm 22w1d in my pregnancy and I have been so thirsty lately and also urinating alot as well, but I do not have much of an appetitie. But I also have PCOS with insulin resistance, so I have an increased risk of having diabetes later on. But so far, I am not spilling sugar into my urine either.

I've talked with my ob/gyn and he told me it was ok to go ahead and do the GTT earlier, but wanted some nursing opinions on it. :)

Thanks in advance

Ginger

[RNLaborNurse4U]

For my last pregnancy, I opted to have an early 1 hr GTT at 16 weeks (once my morning sickness subsided). My risk factors for GD include obesity, strong family history of diabetes, and I have problems with reactive hypoglycemia (when I eat sweet foods, my body produces too much insulin and my blood sugar crashes). I have also done random fasting and 2 hr post prandial blood sugars, and have some be elevated (not during pregnancy).

My early 1 hr GTT was normal (mid 90's), and then I did another 1 hr GTT at 28 weeks, which was borderline at 137. I had decided with my midwife to just go ahead and follow an ADA diet, and was never really considered GD.

I wanted the extra early screening due to my risk factors, and knowing that the sooner I would get GD diagnosed and treated, the healthier my baby and I would be.

I gave birth to a very healthy term 6# 9oz baby girl in August 2003.

[purplemania, BSN, RN]

I think if you are symptomatic and at risk you should do the test. Why wait and worry? Also, glucose in the urine is a LATE sign. It means your blood glucose is high most of the time so is "spilling over" into the urine. I am in favor of knowing now. Good luck with your pregnancy. I hope it is uneventful.

[okie2]

When I starting having symptoms with my second baby @ 20 weeks- I had to fight to get in and even see the Dr. The phone nurse kept insisting I wait until the "normal" time to test. I told her I recognized high BS! Finally I called the NP of the office- she had me come in immediately and my FSBS was over 300 & it had been hours since a small sandwich!!! Needless to say- they didn't even do a GTT- I went straight to an endocrinologist. I had 4 shots of insulin /day- felt great with it too! I didn't require it with my first though.

You know your body!! insist on the test if you feel funny- If I had waited, just think of the complications, and increased risks!

Good Luck! I hope it's just fine.