Why Do I Need to Drink that Sickly Sugar Stuff?

If you’re already taken the Glucose Tolerance Test (GTT), you’ll remember that it wasn’t the most enjoyable pregnancy test you’ve endured (are any of them?) Usually, you’re required to drink a special sugar enhanced drink called Glucola (you’ve got 5 minutes to get it down), after which you wait an hour and then have blood drawn, which is then tested to see how your body processes sugar.

I can tell you, that drink is pretty nasty. It makes some pregnant women feel downright nauseous. Some women add ice or lemon juice, so it’s more of a lemonade-type beverage. I just gulp it down as fast as I can, and try not to think about it!

What is the Test For?

This is a routine test that is done to check for Gestational Diabetes Mellitus (GDM).  This is different than regular diabetes. In GDM, the hormones secreted by the placenta alter how insulin is used in the pregnant body. If untreated, a pregnant woman with GDM may experience problems with ecclampsia, blood pressure, urinary tract infections and an increased risk of Type II Diabetes later in life. The newborn may experience problems of the heart and kidney, and respiratory distress syndrome.

When is the Test Done?

The test is usually offered to most women around 28 weeks gestation. However, if you have a family history of diabetes or had gestational diabetes in a previous pregnancy they may test you earlier.  There are no risks involved, although some women are concerned about the effects that this blast of glucose has on a baby who is not used to receiving it is such quantities.

If you “fail” the one hour test, there’s another 3-hours glucose test. (It is important to note that only about a third of women who test positive on the first test are found to have diabetes upon further diagnosis.) You will be asked to drink or eat something with sugar and will be tested at 30 minutes, one hour, two hours, and three hours. You must pass in three of these tests to “pass” the entire test.

Treating Gestational Diabetes

If you are found to have Gestational Diabetes Mellitus (GDM), you will more than likely be sent to a nutritionist to learn ways that you can control your glucose levels through diet. You will also have a plan for monitoring blood sugar levels to assess your progress. Glucose intolerance during pregnancy affects about 100,000 women every year. The condition usually ends with the pregnancy. However, a small number of women will continue to be diabetic after delivery, so you’ll have to take another glucose test six weeks postpartum.

Do You Need to be Tested for GDM?

A friend of mine was just complaining that her doctor wants her to “redo the whole stinkin’ test.” Somehow they lost her lab results, and she’s tempted to just skip the whole thing, rather than drink the nasty glucose and take another blood test. “Is that crazy??” she wants to know (this is actually her 3rd pregnancy, and she’s never had a glucose problem in the past).

Well, no. It seems she wouldn’t be all that crazy, considering her current situation.

Although GTT  is routine in many places, the American College of Obstetrics and Gynecologists (ACOG) has actually stated that many women are tested unnecessarily. You may not need laboratory testing to screen for GDM if you meet all of the following criteria:

  • Less than 25 years old
  • Not a member of a racial or ethnic group with a high prevalence of diabetes (eg, Hispanic, African, Native American, South or East Asian, or Pacific Islands ancestry)
  • A body mass index (BMI) 25
  • No history of abnormal glucose tolerance
  • No previous history of adverse pregnancy outcomes usually associated with GDM
  • No known diabetes in first-degree relative

Women who are at a higher risk for GDM usually have one of the following risk factors:

  • age
  • ethnicity
  • obesity
  • family history of diabetes
  • past obstetric history

It can’t hurt to take the test, but if you can talk to your doctor about whether or not it is really  necessary for you.

The Jelly Bean Alternative

I thought it was interesting to note that several years ago some studies were done showing that eating 18 Brach’s® jelly beans worked just as well as the glucola. This definitely sounds a lot more pleasant, and supposedly has few stomach side effects than the glucola. Some women are just told to eat certain sugary foods before the test, which also seems to make sense.

feature image from the mommy diary

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