late POGTT
Up to Late pregnancy GTT - Elizabeth Phillips
we continue to do POGTT's until 'delivery' and have had several late diagnosis, which although there really isn't time to initiate any medication, we have identified a woman at greater risk of getting T2 in later life (so can give advice re healthy lifestyle), a baby who is at risk of neonatal hypoglycaemia, so we can monitor/feed and in the next pregnancy, screen much earlier. There is also the problem of late stillbirth from undiagnosed GDM???
We do too for the same reasons. We have a number of women who test negative at 28 weeks and have a significant problem by 34/ 36 weeks even though we recommend that they watch their diet.
we do GTT's up to 34 weeks then after that if diabetes is suspected we offer a 1 hour post prandial glucose. the GTT values are designed to be interpreted around 28 weeks, we have no idea of the diagnostic values beyond that.
We do GTT's up to 36 weeks. For women who present with glycosuria, LFD fetus or polyhydramnios, they may have previously had a negative GTT, we offer HBGM for 5 days to identify those women at greater risk of developing type 2 diabetes in later life and to identify those babies who are risk of neonatal hypoglycaemia.
We have been doing OGTTs up to 38 weeks (not usually at my request!) but on the Warwick Diabetes in Pregnancy course last week we were advised not to do them beyond 32 weeks, but to get the women to do home monitoring.
We also do GTT up to 36/40 then as suggested by Sara we would offer HBGM for 5-7days for the same reasons.
Jenni Peters - Heart of England. We at HEFT now do OGTT's at any gestation. If we have a raised random blood glucose and it is not possible to perform an OGTT then we will ask the ladies to start HBGM and have telephone follow up and also request a HbA1C. On occasions I have also requested that the lady is seen by her Obstetric consultant for a plan for delivery.
We do not do GTT after 36 weeks but would offer Fructosamine or HBA1C blood test and HBGM if there is any concern
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We do GTT up to delivery and do have some late diagnosis for the same reason as Sue said.
We do GTT up to delivery also despite knowing that interpretation of the result is questionable later on in pregnancy. For the same reasons as everyone else it is for future risk of developing diabetes along with being aware of potential delivery issues and neonatal hypoglycaemia
Can I ask those that don't do OGTT after 36/40 is this decision evidenced based?
