Adventures in Glucose Tolerance Testing

[Disclaimer: This blog entry is not in any way meant to give medical advice or replace the opinion of a doctor. If you are sparked by something I discuss in this blog, please do your own research and then discuss with your OB, midwife, etc. We all have different versions of what is right for us...here I am discussing my experiences and what I found was right for me. My opinions in no way, express what I think anyone else should do.]

It is pretty common knowledge that when a woman enters week 28 of her pregnancy, she has to take the glucose tolerance test. This test is a pre-screening for gestational diabetes. It is important to note that GDM can be very dangerous. It can cause high birth weight, make mom more likely to develop type 2 diabetes later on, still births, and obesity in baby. It is necessary to screen for this. A lot of people don't realize that diabetes is actually a really common thing to develop during pregnancy, because a pregnancy makes our bodies a little sweeter than normal anyway, and then in addition to this, the typical American woman loves to rush to the store claiming their baby is craving sundaes, chocolate cake, etc. While it's totally okay to have cravings, it is important to isolate true pregnancy cravings from just us wanting to eat something. Pregnancies do not make us crave McDonalds. Something is off there... If the baby needs a certain nutrient, we will crave it. For example, I have craved avocado and shrimp...both fats, and both make sense. When I crave something like root beer, it is an easy craving to dismiss because I know it is not something my baby needs. (But I have been craving root beer...and it has been tough! So those of you saying "Hey...I crave chocolate cake!" I get it...)

However, it is entirely possible for a woman with an impeccable diet to develop Gestational Diabetes, hence our need for the screening. In a typical hospital setting, this involves a one-hour tolerance test. A woman has to drink glucola, which I will talk more about later in this blog, and has a 5 minute time limit to consume it. (And yes they watch you...where's the trust??) After this, you must remain sitting in the lab for an hour, and then you will be called back to have your blood drawn. You cannot walk around, drink water, etc. If you throw up, you must come back another day and repeat.

If a woman fails her one-hour test, she will go on to take a three hour test, which is basically doing the one hour test three times, often times with a glucola that contains more sugar than the first. If you fail 2 out of 3 tests you are considered to have gestational diabetes and then go on to modify your diet and monitor yourself.

With my first pregnancy, I had the pleasure (sarcasm) of taking this test twice. I took it a 14 weeks because I was on a drug called metformin, which regulated my sugars and ultimately regulated my hormones so I could get pregnant. Though I wanted to come off of this, I was nervous I would need it, so I got to do a glucose test early. I remember chugging the nasty drink and being told if I threw it up I'd have to come back and do it again. Gross! I fought hard for an hour to not throw up, which was not easy given I had to just sit there in the office, with the food network on, where I was not allowed to drink any water. This test ended up going fine. So I came off the meds.

Then I had to take this test another time during my pregnancy at 28 weeks. This one was a little more tolerable, but still seemed so wrong to me. They ended up telling me because I was so close to the failing mark, to modify my diet anyway. This didn't sit right to me (why have a cutoff if you're going to treat people close to the cutoff like they failed and then not even do further testing?) so I refused...and I ended up having a 6 lb baby, we are both fine and super healthy. It was then that I began to question if the way we were going about testing for diabetes was the right way. I started to research.

Upon my research, I was actually completely shocked to find that this glucola drink contains all sorts of ingredients that are very questionable for me personally. Most ingredients are derived from corn, the most upsetting one being corn syrup. There was also yellow #5/#6, a dye banned in most of Europe, which is linked to hyperactivity, allergies and even cancer. The most frightening one to me however, was BVO, or brominated vegetable oil. This is a chemical you will find on a lot of your wood furniture and on clothing. It's main purpose is a fire retardant, but it is also used in soft drinks to prevent the different fluids from separating. Wait...what is wrong with that sentence I just wrote??

Even in the US, we are striving hard to get BVO out of our soft drinks. It absolutely makes me cringe that it is in something we are giving to pregnant women like it is no big deal! And to think if you fail the 1 hour test, you have to drink three of these, with higher sugar content, therefore higher amounts of these ingredients. These ingredients did not sit well with me, and I swore that the next time I was pregnant I would look more into my options.

For me, opting out of this test completely was just not an option. I am aware I have sugar issues given that I have PCOS, so I want to make sure my baby and I are safe and do not have gestational diabetes. But to drink something that contains ingredients that I do not consume in my regular diet, and then have to sit for an hour like a couch potato with no water or anything...just didn't make sense to me! I don't have a perfect diet and I definitely indulge in the occasional sundae, but after doing so, I always want to get up and walk! It's natural instinct. Why on earth would you ask me to do something completely against my lifestyle just to see if I have something that is further harmed by all the ingredients you are giving me?

I then decided to talk to my midwife, to see what she advised, as I finally have someone assisting me who I trust completely. She told me that she could do the glucose tolerance test on me in the comfort of my own home with a finger prick. She also informed me that she did NOT use glucola, and basically reiterated everything I already posted in this blog. She gave me three options: Odwalla juice, Naked juice, 28 jelly beans, or I had the option of eating a pancake breakfast with lots of syrup. All of these contained the same 50g of sugar that the glucola contains. I thought about my options...I really hate odwalla, and I actually don't regularly consume pancakes with syrup normally. (nor have I had jelly beans in like 10 years) So I figured my best option would be naked juice. Now, I don't usually drink naked juice either, and I know they have run into some controversy over their "natural flavors" ingredient. But let's all be real here...we all get some "natural flavors" here and there, and I knew it was the lesser of the evils.

So off to the store I went, where I bought my Red Machine, which was the brand of naked juice I was told has the same 50g of sugar as the glucola. I drank it down in just one minute, and it was delicious! My son kept asking me for some, so I actually had to finish chugging in the other room. Sorry, buddy!

An hour later, my midwives showed up to draw my blood. I laid down while my assistant midwife calmed me and apologized for the little prick I was about to feel. (Seriously, you don't get this kind of care just anywhere!) The prick was quick, and once enough blood was on the slide, they popped it in their little machine and out popped the number 134. My husband jumped out of his chair..."What does that mean?" My midwife said "It's normal." The cut-off is 145. She said nothing to me about modifying diet or anything and assured me this meant I was doing a great job. Yay!

I told my midwife how grateful I was that I didn't have to drink glucola, and she told me that even the naked juice I just drank is not something people should be consuming on a daily basis, but again is a much lesser evil to the glucola drink. Really juice is not a great thing to have in our regular diets as it contains a lot of sugar. I, of course knew this, but it is always great to have these things reiterated. We talked about how unnatural it is to just sit there after consuming so much sugar, and my assistant midwife talked about how she tells people often to pretend they left something in their car so they can walk around a little and get the chance to have some water. She expressed how when we don't normally consume these crazy ingredients, we are really just asking to have a reaction. So many women fail this one hour test and then three nasty glucola drinks later, are told that they are totally fine and all the additional testing was unnecessary. There just has to be a better way, and I think my midwives are spot on!

So for those who are reading this and thinking "A-ha!" I urge you, please have a conversation with your doctors or midwives. Do what is right for you, and come to a decision TOGETHER. I would never encourage anyone to fight their doctors or opt out completely...you just never know who is going to pop up positive. But perhaps ask about other options, and tell them of what you have read and your discomfort if that is how you feel. There are other options and other tests that can be done, but you need to figure out what is right together. And if you don't feel uncomfortable, then go for it and take the glucose test the way it is...I will not judge. We all have to do what is right for us. After the reaction I had to the glucola, I knew it wasn't right for me...but perhaps others react just fine and don't have any issues. I know a lot of these glucola ingredients are found in the regular American diet and many people are not alarmed by them. If you know you can tolerate them, then I say that's more knowledge and power for you. This blog is not meant to spark a mommy war, just passing along some information. Happy Glucose Tolerance Testing to all my fellow mamas out there, no matter which way you choose...and may the odds be ever in your favor!