Carb loading and 3 hour GTT

[MaterPrimaePuellae]

I failed the 1 hour GTT with a pretty high #-- 169. The rest of the pregnancy has been perfect-- 13 lb weight gain at 30 weeks, blood pressure consistently under 112/60, no protein in urine, etc. I started the pregnancy at 5'7", 150 lbs. I avoided carbs for 18 hours before the test, and now I'm wondering if that was exactly the wrong course to take.

The nurse who scheduled the three hour test gave me zero instructions for what to do before the test (she didn't even tell me whether to fast or not, though I'm sure I'm supposed to). Online, I'm reading a lot about carb-loading and how important it is to ensure test accuracy. The MW, however, told me to cut down on carbs before the three hour test, and from all I can read, that seems to encourage false positives and be against standard practice. (?) (I'm thinking specifically of this helpful site:
http://www.plus-sizepregnancy.org/gd/gd_testing.htm

I would really appreciate any info/advice!!

[umsami]

Honestly, your 1 hour isn't that high. It's quite possible that you'll pass the 3 hour just fine.

I don't believe in carb-loading or carb-avoiding before the test. Why? Because I think you want to get an accurate picture of how your body really does handle carbs. The goal is not to "fool" the test--but to truly see if you have gestational diabetes... and if you do, see if it can be managed with diet or do you need meds or insulin so that you have a healthy baby. Another option would be to borrow a blood glucose montior and actually see how your body is handling the actual food you're eating. Your fasting a.m. blood glucose should be below 95. One hour after finishing eating, you want your blood glucose levels to be below 140. Two hours after, 120.

The only advice I've read consistently is to eat a high protein, high fat (no carb) breakfast before your test. I'd also drink some water so you don't feel dehydrated.

Your 13 pound weight gain seems a little low for somebody of your height/weight at 30 weeks. (Normal weight/BMI). But all of your other

Good luck

[MaterPrimaePuellae]

Thank you! I realized in reading your response that my post was a little confusing-- I'll edit that.

In hindsight, as I think you're saying, I think I should have eaten a regular diet w/ a protein breakfast before the 1 hour test.

Now, however, I have to take the three hour test, and I am trying to determine what I need to do before the three hour test. I've found some lab and hospital based forms online that stress the importance of consuming <150 g of carbs the three days before the test, but the nurse at the MW's office did not even mention that. If that's the assumed behavior in setting the test criteria, then I definitely want to follow that protocol....

Anyway, thanks for your response! I'm planning to call my favorite midwife next week and ask her directly. I'm a little frustrated that their instuctions were so vague.

ETA: I agree, the 13 lb weight gain is not "perfect," it's statistically a bit low-- but in my previous pregnancy, I gained less in the beginning and more in the end, so I think *for me* it's probably healthy. In any case, I only meant to stress that it's not like I've gained 50 lbs.

[lillysweets]

The odds are in your favor lady. Only 15% of women with an abnormal Glucose Tolerance Test (GTT) will have an abnormal 3 hour GTT. There is some controversy with the accuracy of the GTT so some doctors are switching to eating a big meal for the test instead of drinking that sugar liquid that you had to drink. So I would have to agree with the other poster, a consistent habit of lower carbs and higher protein/fat meals are ideal throughout the pregnancy. ALSO, pregnancy exercises! Develop a daily routine in which you are doing some gentle exercises in the morn and walking for 20 minutes or more in the evening. This will help stabilize your blood sugar by using up that excess glucose. Take a 20 minute walk before your 3 hour GTT, that should make a difference.

[BeeBliss]

I failed the 1 hour with a score close to yours.

A dietitian told me the 1-hour and 3-hour tests are outdated and don't accurately measure glucose tolerance for some types of eaters. I am naturally a low simple carb eater which is what the glucose tolerance is. We don't eat a lot of processed grains and simple sugars, but instead whole grains and sugars like fructose from fruit. My body produces a certain amount of insulin for my eating habits and the 1-hour glucose test overwhelmed it.

Carb loading is supposed to build up your insulin output because this is what your body thinks you're going to need in the future based on what you are eating now. If you are a low simple carb eater like myself, then you do this carb loading to "test" that your body can produce the insulin you needed if you ate like a normal American (high simple carb diet). Some people, even with carb loading, still can't pass the 3-hour GT test and these are the true GD people.

If I were you, I'd carb load. I did and I passed. And then I went right back to my healthier diet when the test was over.

[BeeBliss]

PS.
After you drink that 3-hour goo, if the lab will allow it, walk around periodically and so what you normally do after a meal.

[MaterPrimaePuellae]

Originally Posted by BeeBliss

I failed the 1 hour with a score close to yours.

A dietitian told me the 1-hour and 3-hour tests are outdated and don't accurately measure glucose tolerance for some types of eaters. I am naturally a low simple carb eater which is what the glucose tolerance is. We don't eat a lot of processed grains and simple sugars, but instead whole grains and sugars like fructose from fruit. My body produces a certain amount of insulin for my eating habits and the 1-hour glucose test overwhelmed it.
...
If I were you, I'd carb load. I did and I passed. And then I went right back to my healthier diet when the test was over.

I think this is exactly what happened to me. I do eat pasta a few time a week, but otherwise, I eat only whole wheat breads, plenty of protein, absolutely no soda, if I drink juice at all, it's diluted... etc.
Anyway, after posting, I went out and bought a meter, and my BG levels have been perfectly fine at fasting and 1 hr post meal levels for days and days-- like, never over 125, and frequently around 90. Also, I realized today (after getting by far the lowest post-meal reading yet) that stress seems to impact my BG level a lot... and I was VERY stressed on the day of the test. So. Not. too. accurate, IMHO.

So... I'm refusing the 3 hr test, and I'm never taking the 1 hr test again. If I had to take the 3 hr test for some bizarre reason, I would definitely carb load.

Thanks for all the advice!