Should I delay my GTT?

[Cocosilk]

I had gestational diabetes, just scraped in with a fasting of 5.1mmol (in Australia, which is stricter than some other countries I think).
Now I'm 6 weeks postpartum and my blood glucose should supposedly be 'back to normal' but I know from testing at home that it's taken nearly the full 6 weeks to start seeing readings in the 4mmol range so I haven't gone back to eating many carbs. When I did I seemed to be getting the same kind of readings as I was during pregnancy.
Now my dilemma is that I may only be on the cusp of being prediabetic and don't want to drink the glucose drink unless I think I will be diagnosed since only then would I get subsidised test strips. Otherwise I'm loading myself with a sickly drink while breastfeeding and after having eaten low carb for the past few months.
The problem is the cusp for diagnosis apparently can vary from one doctor to another with some diagnosing prediabetes with a fasting of 6.1mmol and others at 5.5 mmol and over.
I doubt I will get a diagnosis if they use 6.1mmol, but my morning fasting has sometimes been 5.6mmol recently so I may with the lower cut off. I have yet to hear which of the two my doctor uses.

Would you bother to do the GTT if your readings looked like mine do today:
7am 4.5mmol after 8h fasting (low carb day yesterday) and 5h sleep.
(Then I went back to sleep, thanks hubby)
10am 5.6 mmol (classic dawn phenomenon?) 11h fasting / 7h sleep
11am 5.0 mmol, 12h fasting and about to eat breakfast. ( EDIT: I also breastfed my baby between 10am and 11am when my fasting levels dropped from 5.6 to 5.0. )

Is it worth drinking that drink or do I just eat low carb from now on and not bother to test once the strips run out?

It seems that breastfeeding will drop your levels too so I wonder how that my affect my GTT results considering I will likely be breastfeeding shortly before having my blood taken for the fasting level. I may even have to breastfeed before the 2 hour blood test happens as I'll have my 6 week old baby with me at the time.

 

[JohnEGreen]

Well personally I would if my medical team thought it advisable but do keep in mind that for the GTT to be valid you have to eat normal amounts of carbs for several days prior to the test.

 

[Cocosilk]

Well personally I would if my medical team thought it advisable but do keep in mind that for the GTT to be valid you have to eat normal amounts of carbs for several days prior to the test.

I know this about eating carbs in the lead up to the GTT, and that's another reason I don't want to do the test if I don't have to.

The two days this week where I ate a few more carbs (homemade pancakes with no added sugar), the two following fasting readings were 5.6 mmol after 8h of fasting.
So if they won't diagnose me at 5.6 mmol, then I'd rather avoid the carbs so I don't have to wean myself off them all over again.

 

[Pasha]

Why not wait for three months to elapse and then do a HbA1c test. ?

 

[DCUKMod]

Personally? I never dodge a test. I've had my Doc just add A1cs to other test papers, "because it's been a little while", and blood is being drawn. I don't resist.

It is what it is. Any blood test is a snapshot of that day. Even an A1c is the snapshot of the longer term. It's all dynamic.

Knowledge is power. If you dodge, you can never go back and get that information. Any information in the future doesn't tel. Quite the same story, because it's missing detail.

Of course, it's your choice, but you asked opinions.

 

[HSSS]

The higher carb days this week won’t be the same as the gtt because you weren’t carbed up for them!

I understand not wanting to wean back off carbs after but I’d want to know where I was at now regardless of that inconvenience.

Potentially missing problems for a few days of higher carbs wouldn’t be worth it to me. Conversely the relief of knowing, for now at least, the problem has passed I wouldn’t want to miss either.

 

[Cocosilk]

Why not wait for three months to elapse and then do a HbA1c test. ?

The woman in pathology I spoke to today mentioned that blood test too. But if I eat low carb, I expect my bs levels to look fairly normal, so that won't tell me how sensitive I have become to carbs. It will help me know though if my current diet is keeping my bs at a good level despite my sometimes slightly elevated fasting level, but since I have been testing at home anyway, I think I know roughly what to expect.
If I was going to go back to what I was eating before diagnosis, then both Hb1ac and GTT would be really useful I think. But since I'll need to test my reaction to carbs to get a proper diagnosis, I'm probably better off to do it intensely and eat some carbs for a few days then just do the GTT rather than eat carbs for a few months before a Hb1ac test. But good to know it's an option!

 

[Daibell]

Hi. I wouldn't bother with GTT if it was me as your current BS levels are fine. You can always ask for an HBa1C or do occasional finger prick tests using strips you bought yourself. As for carbs it always makes sense to keep the carbs down anyway to avoid weight gain but you don't need to keep them very low.

 

[Bluetit1802]

What I can't get my head round is that different doctors use different criteria for a diagnosis. Surely there must be some specific guidelines they are all supposed to follow so everyone is singing from the same hymn sheet?
These are the UK guidelines, and as far as I know, all doctors follow them. It is a bit more stringent for gestational diabetes, and I don't know the figures, but surely your forthcoming OGTT is for pre-diabetes or diabetes, not gestational?

What should the OGTT results be?
People without diabetes

• Fasting value (before test): under 6 mmol/L
• At 2 hours: under 7.8 mmol/L

People with impaired glucose tolerance (IGT)

• Fasting value (before test): 6.0 to 7.0 mmol/L
• At 2 hours: 7.9 to 11.0 mmol/L

Diabetic levels

• Fasting value (before test): over 7.0 mmol/L
• At 2 hours: over 11.0 mmol/L

 

[Cocosilk]

Hi. I wouldn't bother with GTT if it was me as your current BS levels are fine. You can always ask for an HBa1C or do occasional finger prick tests using strips you bought yourself. As for carbs it always makes sense to keep the carbs down anyway to avoid weight gain but you don't need to keep them very low.

I feel a bit like that except I'd rather pay $15 for 100 strips than $70 for the same if it's not subsidised.
I only wonder too if bs levels can change much over just a few months when my fasting was 5.1 at 28 weeks pregnant on a GTT, and now at 6 weeks postpartum I've had a couple of nice readings at home (4.5, 4.6) and then a few borderline again (5.6 has been the highest) and I've been mostly low carbing but dealing with sleep deprivation and regulating pregnancy hormones, and breastfeeding a newborn, which may also be playing a part still. I may need another month or two for the hormones to settle down.

 

[Cocosilk]

What I can't get my head round is that different doctors use different criteria for a diagnosis. Surely there must be some specific guidelines they are all supposed to follow so everyone is singing from the same hymn sheet?
These are the UK guidelines, and as far as I know, all doctors follow them. It is a bit more stringent for gestational diabetes, and I don't know the figures, but surely your forthcoming OGTT is for pre-diabetes or diabetes, not gestational?

What should the OGTT results be?
People without diabetes

• Fasting value (before test): under 6 mmol/L
• At 2 hours: under 7.8 mmol/L

People with impaired glucose tolerance (IGT)

• Fasting value (before test): 6.0 to 7.0 mmol/L
• At 2 hours: 7.9 to 11.0 mmol/L

Diabetic levels

• Fasting value (before test): over 7.0 mmol/L
• At 2 hours: over 11.0 mmol/L

There's those figures you quoted but I see these too
https://www.diabetes.co.uk/pre-diabetes.html

https://www.diabetes.co.uk/diabetes_care/fasting-blood-sugar-levels.html

http://ayucar.com/cHJlLWRpYWJldGVzLW51bWJlcnMtY2hhcnQ/

 

[Cocosilk]

There is also this phenomenon that could be playing a part with my fasting levels https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher

Although for me, I'd say breastfeeding might be affecting my levels more. I can't remember anymore now but I may have breastfed just before my 4.5 fasting reading. I didn't before the 5.6, which I got a few hours later after some more sleep, but I'm pretty sure I did breastfeed after that 5.6 reading and before the 5.0 reading one hour later.

EDIT: to further my records of how breastfeeding might be affecting my fasting levels.
Meals yesterday included:
3 eggs, cheese, butter, avocado, 1/2 cup melted (frozen) raspberries, sourdough rye, coffee, cream.
Lovely readings post breakfast: 1h 6.2; 2h 5.1
3pm lamb leg steak
7pm liver, raw garlic, yoghurt, cucumber, cream, olive oil, apple cider vinegar.
Slept from 8pm - 11pm (catch up after all-nighter with baby)
Midnight (12:30am) I ate olives, walnuts, cheese, raw cauliflower and miso soup with seaweed.
2:40am 5.6 mmol (2 h after above snack)
Slept 4am - 8am
Breastfed 8am - 9am
Slept 9am - 11am
11:07am BS: 3.9 mmol, Ketones: 0.5 - 1.0 mmol after 10h fasting and before breastfeeding.
Breastfed bubs but I didn't eat so 11h fasting
12:08am 4.4 Dawn phenomenon while breastfeeding.

 

[1spuds]

Cocosilk,those are excellent links! Im really enjoying Low Carb Rn,that lady nails it!!
Thank you!