Wednesday, September 15, 2010

Glucose tolerance test shaky

Every pregnant woman has gone through this: you go to the lab, they pipe you full of this sickly sweet solution, you spend an hour feeling nauseated in the waiting room and they draw blood to see if your body was successfully able to cope with the sugar attack.

I've been hesitant to do this test with my current, third pregnancy. First, I've had very healthy pregnancies. How likely is it, really, that this time around, with a much healthier lifestyle and feeling orders of magnitude better, I am going to suddenly develop gestational diabetes? But that's not the big problem: I guess I can put up with the waiting room. I hate having to the substance I am trying to avoid like the plague to have a healthy lifestyle generally and a healthy pregnancy, specifically, being injected into my body in near-dangerous amounts?

Now I have a whole new reason to mistrust and fear this procedure. Rob Wolff (the well-known paleo fitness advocate) has just published an article on gestational diabetes and glucose tolerance test. The article is rather long, but here is the gist. People like me, have invested a lot into transitioning our bodies from a sugar-burning to a fat-burning system. My body does not encounter sugar very frequently and when it does, it does not count on it as the main source of energy, deprioritizing its metabolism. I do not become sugar-starved or hypoglycemic if I skip meals because my system has a healthy amount of slow-burning high-octane fuel that it takes multiple days to deplete.

Bottom line, if I take the glucose test, I may not do as well as a woman eating twinkies for breakfast, lunch and dinner - training her body to process glucose as fast as humanly possible.  I will grant that eventually, this woman will develop insulin resistance which will turn up in the glucose test and correctly diagnosed as gestational diabetes.

Should I be undergoing the extremely annoying, unhealthy, not to mention long-and-boring procedure just so I can risk being misdiagnosed with the very disease that I avoid when I give up the twinkies?

In my case, the decision is actually easier: I have a wonderful OBGYN who will figure out the right answer if the test comes back positive - I have that much faith in him. However,  I don't even want to imagine the conversation I would be having with a regular doctor:

"You have gestational diabetes!"
"Why do you say so?"
"Your body was not able to process the deathly amount of glucose in the hour provided by the laboratory schedule"
"Oh, that's because it's not used to receiving the deathly amount. Trust me - it won't happen again."
"No, no, this is just a test.  However, you have to eat every 2-3 hours or you may become hypoglycemic and lose consciousness or even die."
"I do not get hypoglycemic. This is because I eat a high-protein high-fat diet that avoids major shifts in blood sugar leading to hypoglycemia."
"Fat is bad for you!  GROWL!"
"I used to think so too. Now I think, large amounts of glucose in a bottle are bad for me as your blood test just showed!"

OK, this dialogue is going to be an endless source of creative amusement for me. Hell, I'll probably do the test. But I am going to talk to my doctor at length about this idea before I sign off my soul there!

3 comments:

  1. Please check www.bloodsugar101.com for the proper way for any low carber to prep for an OGTT. I believe it is 150g CHO for 3 days before the test or modify the results by apporxinately 10 points.

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  2. Hi Kate,

    I know you from the OGrownUps list. I was searching around for info on the gestational diabetes test because I'm scheduled to get mine done this week (week 28) and I found your post in my google reader. Like you, I think giving the test to healthy women not in the risk category is rather silly. I'm thinking of telling my mid-wife I would like to decline the test, but I'm not if it will cause too much drama! I was curious if you had talked to your OB yet about declining the test and if so, what his reaction was?

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