Alright, it would seem that I need to shake off my squeamishness about taking pictures in medical buildings.  When I was reading about these tests, I found a number of bloggers who photographed every stage of their tests.  I’m not that blogger – but I should be.

First of all, this is not as bad as it’s made out to be.  Well, the drink itself isn’t at least.  Depending on how your body processes sugar, the rest is up to the glucose Gods!

The day I hit twenty-six week mark, was also the day I took my ‘Glucose Challenge Test’, again, we’d moved the date to accommodate the transfer to Dubai, but I was happy to get it over and done with nonetheless.  Varying doctors have slightly different procedures, what I write about below, is my doctors procedure, so don’t freak if it’s different to yours!

Drink the 50g of glucose drink within five minutes of starting (which they’d given me to take home at my last appointment), wait an hour, have blood drawn.  The one-hour test has no official dietary guidelines except eating nothing between the glucose drink and your blood draw. Most practices and online pregnancy forums will tell you to watch your sugar and carb intake the day of the test and to stick to a lot of protein.  The results came in a few days later, (though I had to chase a little for them) and my glucose was ‘a little elevated’.

They wanted my glucose level to be below: 135 (130 – 140 for most OB’s offices)

Mine was: 165

I think this was largely to do with the fact I had two sliced of toast with a little peanut butter and two clementine oranges for breakfast, washed down by the glucose drink.  Although they tell you not to fast, be careful not to sugar-overload your breakfast.  Stick with something like eggs and toast.

This means that I had to go back for a three-hour ‘Glucose tolerance test’, a fasting test.  No food from midnight the night before, be at the doctors at 8am (so you can go get lunch as quickly as possible after you’re done!) have fasting blood drawn, drink a drink twice as sweet (100g glucose) in the same five minute window and have blood drawn at one hour, two hours and three hours after drinking the syrupy liquid.

After doing a little reading online, I came across this;

“The truth about this test is that the 1-hour test is pretty easy to “fail” and many people do! They make the threshold low enough so that they catch anyone who could be having an issue, just in case. The levels on the 3-hour test are much more reasonable and easier to meet. Your odds of actually having gestational diabetes is very small, between 2 and 10%, so try to relax and just eat normally for the few days before your test (unless your doctor tells you otherwise) and think positively.”

For some reason, this didn’t settle me, not one little bit and I was pretty worked up.

We (hubby came with me in case of vomiting, fainting and/or being too woozy to drive home) arrived, as instructed, at 8am for my fasting glucose blood draw – the phlebotomist was 25 minutes late so I was peeved (and hungry!)  Blood was taken, drink was consumed (I got offered the choice of orange or fruit punch!) and it was out to the waiting room for my first hour-long wait.

The first time I did a very similar test (diagnosing insulin resistance for PCOS earlier in 2013), it was horrible, I was almost sick (numerous times), I was woozy and faint and spent the long part of two hours, in the disabled bathroom, clutching on to the rails so I didn’t pass out.  It was pretty harrowing!

This time, it wasn’t as bad, I felt woozy, a little queasy, hot, sweaty, told Col that I felt like I was dying at one point and couldn’t concentrate on the book I’d brought with me to read, but after the first 45 minutes and a short walk down the corridor (the waiting room was pretty freakin’ warm) I felt much better and didn’t have a single issue for hours two or three (other than them struggling to find a vein in both arms and then my vein collapsing on the 3rd jab to it and some rude cow rather loudly talking on her phone).

In order to pass the tolerance test, your blood sugar scores must be below set levels at each hour.  Two or more, out of four over these set levels and you are considered to have a diagnosis of Gestational Diabetes.

My phlebotomist told me to give the office a call after 24-hours, (so noon Friday), which I did.  I left a voice-mail for my nurse to call me back, told her what I wanted (results, with numbers, unlike the 1-hour test where she just said it was elevated!!) and waited.

While I was waiting, I discovered that with LabCorp in some states (including Texas) you can register for their online patient results system, they will even email you when your blood has been processed, to let you know the results are available – excellent! Right? Let’s sign right up!

So I did.  Or at least I tried to.  Until the form asked me for the last four-digits of my social security number – which, I don’t have.  I tried 8888, didn’t work, I tried leaving it blank, didn’t work, I tried the last four digits of Col’s SSN, didn’t work, I tried the last four digits of my tax identification number, didn’t work.  I tried submitting an IT help-desk ticket, tried calling the local branch of LabCorp – got a wholly unpleasant cow on the other end, who gave me a different number to call, knowing full-well that it’d be closed and I wouldn’t get anywhere.  Didn’t work.  And I was pissed.

By this time, it was 4.15pm, so I decide to call my OB’s office back and see if I can catch my nurse (website said it’s open til 5pm), only to discover the office had closed at 4pm and my nurse didn’t have the courtesy to call me back – whether she had results or not.

Also, I discovered that my friend had blood taken earlier in the day and her results took less than an hour.  So my blood was boiling (my first instance of irrational pregnancy-rage).  I cried.  And spent the next few hours panicking about my test results.  I also filled in an online survey about the Southwest OBGYN clinic, stating that I wasn’t happy that the nurse didn’t return my call that day and had left me to worry all weekend.  An hour later, my phone rang, it was the clinical manager of SWOBGYN, Andrea, calling to put my mind at ease for the weekend, that my test results were ‘normal’ and I wasn’t in the bracket for ‘Gestational Diabetes’.  She didn’t give me any figures, but said enough to save me from climbing the walls all weekend.

Some OB’s test as you go and give you results throughout the test.  I wish my OB’s office did that, a little education of the masses doesn’t cost all that much, especially when you’re doing the test anyways, right?

Blood values for a 3-hour 100-gram oral glucose tolerance test (in MY OBGYN’s office) are:

• Fasting: must be less than 95 (Mine was 93)
• 1 hour: less than 195 (Mine was 165)
• 2 hour: less than 165 (Mine was 95)
• 3 hour: less than 155 (Mine was 93)

OBGYN said that they’re going to keep testing my urine (which is normal), and that if any glucose starts appearing in my urine, she’s going to make me repeat my 3-hour glucose test (yuck!)  She said that around 28 weeks gestation, your placenta does something (there’s a medical term, beginning with ‘H’ that I can’t for the life of me remember) that increases your glucose levels and for someone with existing glucose resistance (I.E PCOS), it’s important to keep an eye on it.  She also wants me to go back on the Metformin that my fertility specialist prescribed for me – though at 1000mg, not the 1500mg that I was on before I got pregnant.

I’m also keeping a closer eye on my diet going forward, planning out core exercises for postpartum, and also was attempting to regulate my CHO/Carb levels, instead of the peaking and valleying that I know is going on in my body. Also, having chatted to my very own BFF dietician, she said that your body shouldn’t take 3-hours to get back to your fasting sugar.  Ideally that should be done within an hour.  My body is taking three-times as long, not cool – and something for me to work on, going forward!

Some tips for the 3-hour fasting glucose tolerance test

– Firstly, DO NOT Google how to pass this test.  DO NOT try and fake or influence the results.  Do not artificially amend your diet for the days/weeks leading up to your test.  Eat normally – like *really* normally, not how you think you should be eating.  If you DO have Gestational Diabetes, it’s best for both you AND your baby that you find out ASAP and get the treatment you both need.  Why would you mess with that?

You may think that this is a crazy thing to advise, but, seriously, have a poke around the internet, you will find TONNES of women who are asking for tips to pass the test.  It’s more common than it should be, in spite of being ridiculously stupid!

– If you fail the one-hour test by only a point or two, some people request to re-do the 1-hour blood draw.  Advocate for yourself – you may be able to have a do-over, for me, I didn’t know my exact figures when she booked my 3-hour test, but based on my weight issue alone, I’d have not been granted a do-over.

– Shake the bottle.  You don’t want super-sweet sediment lying at the bottom of the bottle, you want equal pain the whole way through! haha! 😉  Also, if you aren’t given the bottle to take home (I was at the 1-hour, not the 3-hour), request that it’s chilled, it’s MUCH easier to go down if it’s cold!

– Pack a snack.  You will need it.  You will be starving – especially if your OB requests you fast from 8.30pm the night before.  I packed two clementine oranges and a small snack bar from Target, I ate one of the oranges in the elevator on my way down to the car and went straight to lunch.

– The night before your test, get up around 11.20-11.30pm and have a protein-filled snack.  Milk and/or cheese was what was recommended to me, I had milk (with a little sugar free chocolate Nesquick powder to make it go down easier) and a few crackers and cheese.  This is to help with the ‘OMG I’M STARVING’ feeling you’ll undoubtedly feel after having fasted for the night/morning.  For me, I’ve been waking up lately ready to eat an entire cow.  Whole.  So I was quite afraid that I’d be nibbling on the plants in the waiting room while I was there.  Thankfully, however, thanks to my protein snack advice, I woke up feeling fine and wasn’t hit by hunger until hour three of the test!!

– From reading the interwebz, some OBGYN’s offices take a simple pin-prick blood draw, mine, however, wanted quite a hefty sample in a vial.  My left arm is problematic to my phlebotomist (thankfully another gal was available to do one-draw in that arm, so I didn’t have to do all four in one spot!) and after having stuck my right arm twice already, on the final draw, my vein collapsed and wouldn’t play nice.

The day before your test, drink excessive amounts of water, hydrate your veins so they are plump and easy to find – for yourself, moreso than the phlebotomist.  I admit, while she was fishing around in my arm with a needle, that I considered offering her my boob to draw from – as they are pretty vein-y since I got pregnant, so she couldn’t have missed! LOL!

– Hope for the best, expect the worst.  Especially if you have PCOS, hypothyroidism, or some other condition related to insulin resistance.  Try not to stress-out.  This was a big one for me cause I was freakin’ the hell out.  Once they said I’d ‘slightly elevated glucose levels’ from my 1-hour test, that was me off the stress-cliff.  Try and stay calm, rumour has it that stress can affect your blood sugar.  Realistically, around about 15% of women fail the 1-hr. Your chances of failing both are really rather low (I should have read all this stuff BEFORE the event, eh?)

– Ask if you can drink water and move around.  Typically, you don’t tend to consume food/sugar and sit still for three hours afterwards.  It was OK for me to use the restroom, walk around a little (I did a couple laps of the corridor outside the waiting room), but they won’t want you going outside, or straying too far in case you pass out, but if you’re with hubby/partner, you should be OK.  I was not allowed to drink water, I guess they wanted a pure reading of how my body deals with the sugar, not how quickly I could flush it out of my system with gallons of water 😉

– Go to the office for your test as early as you can! My OB’s opened at 8am, I was told to be there at 8am (and the staff was late).  Sooner you get the test over and done with, the sooner you can eat again! LOL!

– Take a buddy, just in case you react poorly, or faint etc.  It’s nice to have someone with you, even a friend – this also helps with the three hours of boredom you’re going to endure and in case you become too weak to drive yourself home.

– Schedule a nap for when you’re done with the test and lunch.  You may feel groggy and sleepy.  I felt emotionally drained too, as I had worked myself up all over New Years for the 3-hour test.  I went to bed at 2.15pm, didn’t get my brain to shut up til 3pm and slept for an hour.  It helped.  So did the copious amounts of tea my lovely hubby made me all afternoon!

Next time if/when I get pregnant and am in the US (at home this glucose test isn’t mandatory!!) I’ll request to skip the 1-hour test and go right to the 3-hour test.  Why? Because they don’t take a base-level glucose read before the 1 hour test, so they have nothing to compare it to, which bothers me.  Also, since it was non-fasting, it meant that I ate my breakfast and pretty much washed it down with the glucose drink – I’m not unconvinced that that didn’t affect the blood glucose levels either.

A big issue for me is that mom can be pushed into induction and interventions that could lead to a C-section that simply are not necessary due to slightly elevated blood sugar levels, especially since every woman is different and many women have slightly elevated blood sugars during pregnancy anyway.

This is an important test, it’s horrible and people complain and moan about it whenever the topic is mentioned, but it’s one of those tests that are generally done for a reason.  In my home country, it’s not a ‘standard’ test, meaning that not everyone gets, even the one hour test.  Don’t try and influence it, don’t fake it and just try and suck it up as best you can, because ultimately, it really could be THE test during your pregnancy that helps you and your little one.  Be sensible!