Week 27: The famed glucose test

Update: August 9th, 2018

First of all, thanks to Julia, Leslie, Mrs. Song, my doctor and my sister Joyce who is a studying pediatrician for giving me a ton of really good advice.

My doctor at the woman's clinic just called back and was able to give me my testing numbers over the phone for the 75g test:

  • My first blood draw was 77 mg/dL after fasting
  • Second blood draw was 208 mg/dL (at the one hour mark)
  • Third blood draw was 150 mg/dL (a the two hour mark)

Overall, this is considered a fail but I wanted to go in and understand why.

According to the American Diabetes Association "Standards of Medical Care in Diabetes--2010,"[6, 7] the presence of any one of the following criteria supports the diagnosis of diabetes mellitus:

HbA1C = 6.5%

FPG greater than 126 mg/dL (7.0 mmol/L); fasting is defined as no caloric intake for at least 8 hours

A 2-hour plasma glucose level = 200 mg/dL (11.1 mmol/L) during a 75-g OGTT

The cutoffs for the majority of pregnant population for the 100g test can be found here:

  • Fasting 95 mg/dL (5.3)
  • 1 hour 180 mg/dL (10.0)
  • 2 hours 155 mg/dL (8.6)
  • 3 hours 140 mg/dL (7.8)

Cutoffs suggested to me by my doctor were:

  • Fasting 95 mg/dL
  • 1 hour 200 mg/dL
  • 2 hour 152 mg/dL

According to that article, "Patients with a single abnormal value on a 3-hour OGTT are likely to exhibit some degree of glucose intolerance. Left untreated, these patients are at higher risk for fetal macrosomia and neonatal morbidity. Consequently, patients with a single abnormal value should receive dietary and physical activity counseling. If the abnormal value on the OGTT was obtained before 26 weeks' gestation, a repeat OGTT should be performed approximately 4 weeks later."

So, in my case, the second number was abnormally high if I were to look roughly at the numbers for a 100g test.

It's not clear what the cutoffs for each of those blood draws are supposed to be and I suspect they are different for different races and ethnicities. One of the publicly available documents that I was pointed to is this one. If you skip down to the conclusion, it says that the results of a 75g or 100g test can actually be correlated to whether or not you will be need a Caesarian because the baby is big. Please correct me if I'm interpreting all of this wrong!

Also one of the things that I gathered is that Caucasian women and East-Asians have different tolerances for sugar. This is a known and recorded thing. If I think about 75g of sugar, there is really no scenario under which I think my body can tolerate that. I pretty much know this personally already because I regularly test my sugar levels using two machines and a variety of strips.

Another thing I gathered is that typically the 75g test comes after the 50g test under certain conditions. I had a short period of rapid weight gain and so it was likely protocol that the decision to give me the 75g test was made. This probably makes sense considering I would almost certainly decline to take a 75g test if I had failed the 50g test.

August 7th, 2018

I’m hanging out at LabCorp at the moment getting ready for my blood glucose test. I was supposed to do it the day after our baby shower (which btw was again a great success thanks to Keely et al). We got everything we wanted from our baby registry plus a whole lot more from our extraordinary generous friends and family. Thank you!!

Back to talking about this Glucose Test

The Glucose Test when done at LabCorp, is $17 and will test sugar processing abilities. You can read about it at a high level on Medline. The test takes about three hours. I came in a little after noon to get my blood drawn. I had a light dinner at about 8pm last night before going to bed.

Both of my parents have diabetes and my mother warned me that she had likely developed gestational diabetes. Despite this, I have not been stringent on controlling my sugar intake throughout my life and during this pregnancy. I've been having chocolate as well as ice cream desserts. According to Google, the proper sugar intake is less than 20g for women during pregnancy. I have done something like this while experimenting with the keto-diet (which btw works), but ultimately decided that it is better to be able to tolerate a diverse set of food. Also, I love sugar. I plan to be completely honest with my little one about that so hopefully no resentment!

12:30 first blood drawn done

The way the test works is that first they draw one set of blood. Then, the next thing that you have to do is down a bottle of fruit punch drink:

My first guess of course would be straight up: Sugar

What's in this stuff anyway? I look online and find a link to the EasyDex Glucose Beverage. Essentially, it looks like a highly precise bottle of sugar water.

1:40 second blood drawn done

Glucose Tolerance Beverage. They apparently come in all sorts of different flavors and colors. The one that I got to have was pretty tasty. It had a tangy and very fruity flavor. It'd actually be pretty neat if these bottles were carbonated. I wonder what effect that would have on the test.

Right around 1:40pm, they call you up to do the second blood draw. Here's a pic of me after taking the second blood draw. I'm starting to wonder where they're going to take the third blood draw from. I already got poked yesterday with a vaccine needle too :p

2:15pm I feel a little tired. Hopefully its not because my body is not good at taking sugar. I notice that LabCorp has a For Rent sign in the window (415) 728-7107. Its kind of unfortunate that such a convenience might have to move from the neighborhood:

2:40 third blood drawn done

That one pinched! Or maybe that was just in my head, they took the third set of blood from the same right arm as the first set and changed the color of the bandaid. I suppose that's it for now, will wait for the results from the doctor next. In the mean time, I've read through mayoclinic's Gestational Diabetes info. Waiting to hear results. More to come ...

4:28 August 7th

Not great news, it looks like I’ve failed the glucose test. My doctor says that I’ll have to go in two weeks from now to figure out what to do so I’ll be doing that. In the mean time, I’ll be going on a mini keto diet ie < 20g of sugar. :( Poor junior, hopefully he’ll be alright even though he’s 66% there on his way out of this house.

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