Recently, I had a checkup that included the dreaded glucose tolerance test (GTT). I didn't really know what to expect--it didn't seem like anyone could give me a good synopsis--and I was kind of worked up about this one. I've had some wacky blood sugar episodes in the past, so I was unsure how my body would react. I wanted to provide this roadmap to you (if and when it's relevant to your experience). I know it helps me to know
in detail what to expect beforehand. Shut up.
The Background: Why and When?
The purpose of jumping through this hoop is to screen pregnant ladies for gestational diabetes. While there are risk factors, anyone can develop gestational diabetes, and it occurs in about 2%-10% of pregnancies. Surprising precisely no one, it is on the rise right along with regular diabetes (the sugar diabeetus) at the moment. It's not a terrible thing to have, and if you do, it can be managed pretty easily. However, there are several reasons they want to screen for it in order to identify those who do have it:
- a diagnosis of gestational diabetes increases your risk of developing diabetes in the next 10-20 years
- when untreated, it can be associated with some poorer outcomes for the baby (related to blood sugar, but some can be serious)
- THE BIG ONE (literally)...gestational diabetes is associated with very large babies. Like 10+ pounds. The objection here is obvious (ow ow my body), but there are also associated risks, such as all the things that can go less-than-awesomely when you/your team are trying to deliver a very large baby: use of forceps, emergency c-section, and so on.
That sounds scary. But that's generally when the diabetes is untreated. If you can treat it, it's very manageable. And if you can catch it, you can treat it. That is why all pregnant ladies are screened for gestational diabetes (can I call you gestdi? GD? I'm tired of typing all that). For the purposes of precision: a screen is a test that the entire population takes--in this case, ladies who are with child--and you either "pass" (no further examination needed) or "fail" (follow-up testing required, but you may or may not actually have GD). So it basically tells the doctor whether or not more info is needed.
This screen is generally performed between 24 and 28 weeks of pregnancy, because that's about when the GD tends to show up. My screen was done a little early (23 weeks) because they don't math very well over there, but the doctor didn't seem to think it was a problem. Basically they'll do it at whatever point in that time frame you already have an appointment. At that point in pregnancy, you are going for checkups every 4 weeks at a minimum.
The What and the How Gross Is It?
Like I said, I was worked up about this one. You hear lots of bad stuff, ranging from how barf-inducing the drink is to how people pass out afterwards. I was so nervous about drinking the sugar drank that my blood pressure was normal (as opposed to very high, which it usually is because I'm so nervous about having my blood pressure taken). So it totally distracted me from the usual BP freakout. All that is to say that I would like to assure you up front that it is not that bad. At all. I wish someone had told me that. I am working on a theory that a lot of pregnant ladies are just drama queens.
Here's the rundown...
Before the test: You can eat and drink normally prior to the test. I think there's a lot of confusion about this. There is such a thing as a fasting glucose test, but that's not what this is. So cross that worry off right away! Now, my doctor did suggest against rolling in with a "bear claw and a Big Gulp in hand"--I'm sure that much sugar is not a good idea right beforehand. I told her that if I came in with a bear claw and a Big Gulp, I've been kidnapped and I'm trying to signal you.
I had a bowl of cereal and some OJ. I flirted with the idea of a mega breakfast but just decided to keep it normal so my baseline would be pretty accurate. Normal breakfast, just like going to a normal appointment. Sans coffee, because...see above with the blood pressure.
Some offices will give you the sugar drank prior to your appointment, and you drink it before you come in. This is not how my office did it, but just know it can go either way.
At the appointment: The first source of much drama is that you have to drink a sugar drank. The brand name is Glucola, and it won't be hitting your neighborhood grocery any time soon. The premise is that the sugar drank has a known quantity of sugar in it (50g of glucose). So if they know your initial intake, and they know how much time has passed since you drank it, they know what your blood sugar SHOULD be at the measurement point.
Gluuuuuuuuucolaaaaaa
In case you can't tell, it's about the size of one of those small glass soda bottles you might get on an airplane or at a cheap friend's soda party or something. Not bad at all, quantity wise.
Ok, but how does it taste? Everyone is like "ew gross I gagged and then died and then I gagged some more." Cool it, Anthony Bourdain. We're not at a wine tasting here. Let's use a little context. It does not taste bad. I wouldn't order it at a restaurant, but it does not taste bad. It just is sweet. I would liken it to flat soda or concentrated Gatorade. You will be fine. Phew--that scary is out of the way too.
As an aside, my doctor gave me this tip: choose the orange flavor, and drink it really cold. Well, that was a nice joke, because I didn't get a choice. I ended up with the red drank (fruit punch?) and it was also fine. I have heard the "lemon-lime" is not a good choice (then again, these peeps love the dramz), so I would say opt for the orange or red if it's up to you. They keep it in the fridge, so it's cold.
the red drank tasted like this, which is to say childhood.
Don't act like you're all too sophisticated now.
So you drank the drank and did not die or gag. Nice work. Here's where it gets technical. At the moment you finish, they note the time [I guess if they give it to you in advance, you note the time when you finish and then head in to the doctor's office]. You don't have to re-awaken your college chugging skills, but a brisk drinking experience is best for measurement purposes. So, for me, the nurse wrote down 10:09am and sent me back out to the waiting room.
PreCISEly one hour after you finish the drank, they will draw your blood. I moseyed up to the lab, checked in for that appointment, and waited for my timed blood draw.
The Wait (How did it feel?): So you can do whatever you want for that hour, except eat or drink (water is allowed). I will say that I got a brief sugar rush--probably on the order of a few Pixy Stix, a la Toddlers & Tiaras--and a little while after that, the baby had his own little go-go juice party. So mostly we wandered around (my mom was there with me as fainter-catcher...thanks Jules!) and sat and watched the baby kickbox my guts. None of the following happened: shaking, vomiting, fainting, feeling woozy, yucky tummy, dying*. Of course, I can't promise that YOU will feel like a million bucks, but I think I would be more likely than the average bear to have had a blood sugar roller coaster, and I was fine. If you eat a normal breakfast and don't try to run 10 miles in your hour-long wait, you should be able to process the sugar drank (provided, I guess, that you don't have the GD).
*My point here is not to imply that these things can't happen to you (except perhaps for the dying) or that something is wrong with you if they do. I just think that if your main source of information on these procedures is your email newsletters, with their comment sections and message boards, you get a bit of a response bias. People only weigh in if they had an unusual experience, so you get a skewed picture of how it goes. I would merely like to assure people that it's most likely to be just fine. There are enough things to be anxious about as is; this shouldn't be one of them.
Then they drew my blood, which is fine. At this point in pregnancy, you have already given them about a gallon of your blood, so this one is no big. One vial. If you have issues with blood draws, you'll have to deal with that in your own way, but this one is small in the universe of pregnancy blood draws.
Later that day, I got a notification that my results were normal, so no follow-up needed. Thus, I can't speak to what happens if you need the follow-up test, but I think it's more of the same (you might have to fast, it's a bigger drank, and a longer series of timed blood draws). I can find out if you need to know.
I also had a very large lunch, which I highly recommend. Get things back to normal and go on your merry way.
Cheers!
