What Is An OGTT or a 3 Hour Glucose Tolerance Test?

What Is An OGTT or a 3 Hour Glucose Tolerance Test?

English: Photograph of abdomen of a pregnant woman

English: Photograph of abdomen of a pregnant woman (Photo credit: Wikipedia)

3 Hour Glucose Tolerance Test Is the Gold Standard

OGTT is an oral glucose tolerance test.  For most women, around week 24-28, they do a 1 hour glucose test in the doctor’s office.  Now, if you had gestational diabetes with an earlier pregnancy or your risk factors are high, you might get tested earlier in your pregnancy, and your doctor might go straight to the 3 hour glucose tolerance test.

The doctor is doing a quick check to see if you need to take the 3 hour glucose tolerance test.  So, if you fail the 1 hour test, they send you for an OGTT.  OGTT is the standard to measure and diagnose you with gestational diabetes.  This test also tells your doctor how “bad” your gestational diabetes is.  So, he/she will know if you are going way high or just a little over.  That information may or may not affect their decision about medication and diet.

So, you arrive at the lab for your 3 hour glucose tolerance test.  You will sit in the lab waiting area for a little over 3 hours so bring something to read or write to keep you busy.  It’s a lonely place and the only thing on the TV’s is the news or Jerry Springer.  Not much fun.  Trust me, you will need something in addition to the 3 year old magazines they have in the lobby.

You come in fasting, not having eaten anything after midnight the night before.  You may or may not be able to drink water.  If you can, drink water so that your blood is easier to draw.  The last thing you want is to be dehydrated and not be able to get blood or take forever.  They take your blood sugar level first as a fasting level for the baseline of the 3 hour glucose tolerance test, then you drink a “glucola” which is a concentrated sugary drink.  (I would say it tastes like coke, but it doesn’t.) It’s pretty sugary, and there may or may not be flavor options.  Then in 1 hour increments they take a sample of your blood to measure.  Otherwise, you sit in the waiting area between blood draws for the 3 hour glucose tolerance test.

Then What Happens?

Once it’s over, you leave and your doctor gets the results fairly quickly.  Then you find out if your body has done a good job of removing the sugar from your blood stream or not.  Some women view it initially as a judgement and feel that they have done something wrong.  You should know that it’s just the hormones and your body is not handling the amount of hormones well, but that does not make you a good or a bad person.

Either way, you will be fine and so will your baby.  Gestational diabetes is very treatable with diet, exercise and sometimes medication.  Read about gestational diabetes meal planning in my recently published book on amazon, and find out how to plan your day to make your pregnancy healthier and happier.

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I Have Gestational Diabetes, When Will The Doctor Put Me On Insulin?

You May Be Wondering If You Will Need Insulin

One question that routinely pops up if an expectant mother has gestational diabetes, is at which stage of the pregnancy should insulin become a part of the medication prescribed. Most doctors prefer to treat patients the ‘natural’ way that is by altering the patient’s diet and encouraging a stricter exercise regime which could be beneficial in keeping excess weight off in addition to stabilizing sugar levels in the blood. If you face a similar problem of high blood sugar levels, it is quite possible that your doctor will conduct routine blood tests every few weeks or so, to test the effectiveness of the diet and exercise combination. In most cases, sugar levels can be brought under control and extra insulin shots are not necessary, but if your doctor advises it, just remember that it is these shots which can help to prevent further pregnancy complications.  This usually happens after 1-2 months of trying diet and exercise, but it depends on your doctor’s practice.

What Is Insulin Used For In Gestational Diabetes?

Insulin is an important hormone that is secreted by the pancreas and which enables the conversion of glucose absorbed from food into energy. Sometimes, a pregnant mother may not even be aware that she has untreated gestational diabetes and in such cases, the pancreas works even harder to meet the body’s insulin requirement. However in such circumstances, there is also a chance that existing glucose levels in the mother’s blood can reach the baby through the placenta, which in turn forces the baby’s pancreas to product extra insulin for faster energy conversion. Extra glucose is then stored as fat and in many cases, such babies are later born with health problems including trouble in breathing properly.

What are insulin shots for gestational diabetes?

After conducting a thorough analysis of your blood test and sugar levels, your doctor will suggest the right type of insulin and the dosage to take. Insulin shots can either be rapid acting insulin or long acting insulin and usually U-100 is prescribed unless a patient requires a higher concentrated dose. You’ll find that insulin is packed in small glass bottles sealed with a rubber lid or in pen like cartridges which are stored in pharmacies at cooler temperatures. Insulin can be administered as an injection in the arm or thigh, given through a pump or by a jet indicator which sprays the insulin directly on the skin. Oral insulin medication is usually not advised for pregnant women.

Insulin pen needle

Insulin pen needle (Photo credit: Aki Hänninen)

Self-administration of insulin may take plenty of practice but it is important to follow your doctor’s instructions properly. And it doesn’t hurt to let your doctor know if you have a fear of needles either! Hundreds of women all over the world take insulin shots to prevent the possibility of complications in the baby and also to reduce weight gain in the baby and the mother from continually high blood sugars. But remember- even if you are advised to take insulin shots, it’s still important to take care of yourself by following a healthy diet and getting your daily dose of exercise. Although you may find self-injection uncomfortable and even painful, it will all be worth it in the end when you hold your healthy newborn in your arms!

Let me know if you have been told you will need insulin shots, and how you feel about it!  You will get some training from the nurse and doctors about the best way to administer a shot but you will have to get over the poking yourself issue.  You may already be over that with the 4 times daily blood sugar checks, though, and your insulin needle is very small – many women state it doesn’t hurt much at all.

Speaking of being on a gestational diabetic diet to control your blood sugars in conjunction with exercise and other medications – click here to get our book with meal plans and other great information about gestational diabetes.  The book is on amazon, and it’s a great resource with meal patterns and recipes for you.

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I Had Gestational Diabetes, Just Like You

I had gestational diabetes with each of my two pregnancies.  I was older when I became pregnant, my first child at the age of 32.  Fairly well established at my job, and not necessarily sure when I wanted to have a child.  Therefore, my husband and I were somewhat surprised to have a baby coming, but very happy about it.

I have a family history of diabetes, with my mother and grandmothers having Type 2 diabetes.  So, when I got tested at 24 weeks for gestational diabetes in my first pregnancy, I was aware that there was a strong chance I would have gestational diabetes.

Even though I knew it, at first I was kind of mad that I had gestational diabetes, because I felt that I was working so hard to manage my eating and weight gain because I was already a little overweight.  I even thought to myself that I was somewhat mad at my genes that made it more likely.  I was sure that if I just ate right, gestational diabetes would not happen to me, that I could somehow prevent it.

Gestational Diabetes Made Me Feel Like I Had No Control Sometimes

Then I felt guilty for being mad, and for maybe not ALWAYS eating perfectly.  This is something that I think a lot of us feel about everything we do during pregnancy that could affect the baby – as if I should always be perfect and somehow “one” incident of bad behavior is going to be punished.  After all, I have a huge responsibility to take care of the life inside me, and I am somehow failing miserably by having gestational diabetes.  It doesn’t matter that I knew better than to think it was punishment or something I could change.

I was hungry all the time with my first child, and although I was fortunate to not have morning sickness, I did get a stomach ache if I didn’t eat every 3 hours.  I felt like I would throw up, and all I had to do was have a small snack and it would go away.  So, I never skipped meals or snacks!  I sometimes felt like I was in denial because I just didn’t feel like anything changed.  I had to test my blood sugar 4 or 5 times a day and write it down to track, and I was doing really well with my numbers so I usually felt ok even though I had gestational diabetes.  I was scared for a while that I might do something that would harm the baby or cause him to have a problem.  I thought about everything I had done since the pregnancy started, and tried to figure out what I could have done differently.

But I finally accepted it, and moved on to management.  I was lucky enough to take medication and not have to do insulin shots, although sometimes I wish I had because the medication caused me to have kidney problems.  I did walk more and thought about how much I was eating all the time.  My husband was as worried as I was about the control of my gestational diabetes and how it would affect the baby.  Sometimes we forget that we are not the only ones with concerns about our health and the health of our baby.

I managed to gain only a little weight and did deliver a little early due to the kidney problems, but the baby was fine.  He had jaundice and had to stay in the NICU for a couple of weeks but left with no complications from the gestational diabetes.

My 2nd pregnancy was more complicated and the symptoms came on much sooner.  I got tested a lot earlier and started on the gestational diabetes management process much earlier in the pregnancy.  I did feel a lot of guilt about having gestational diabetes again with this child, but I think I accepted it much more quickly than before.  I did not have the hunger that I did with the first child, and actually lost weight but the baby continued to grow at a healthy rate and develop normally.  I managed my blood sugars more carefully, but did end up delivering much earlier and my premature baby was hospitalized for 9 ½ weeks in the NICU (neonatal intensive care unit).  My problems that I had with the first pregnancy came back in a fierce way with the 2nd pregnancy from the gestational diabetes.

Learning More About How To Manage Gestational Diabetes

Even though I am a dietitian, I had never actually been through the process of taking a blood sugar.  I had no idea where to start.  I had to go and see a diabetes nurse just to learn the process of checking my blood sugar and what to do.  My fingers were poked so much that they hurt, and sometimes it was hard to get blood from my fingers at the end of the pregnancy because I had a lot of swelling.

The thing I did have control over was the food, and how much I ate, and how it affected my blood sugar level which in turn affected the baby.  That is what I always remembered when I would be having a hard time, and trying to figure out what to eat and what to buy at the grocery store to meet my gestational diabetes diet.  The mom or wife or other jobs that I had never stopped, they continued to have the same expectations of me.  I still was the one to go to the grocery store, I still had a job, I still had to manage multiple things (including going to get my MBA at night) to fulfill my obligations.  So planning ahead became a huge part of every week so I would not have to run to the grocery store in the middle of the week or eat what I should not eat at work for my gestational diabetes!

And now, I have young children who are healthy and well despite being born a little (or a lot) early.  While the complications can still happen regardless of the care you take, I know it’s important to manage the eating and blood sugars to have the best possible outcomes.  We can’t control everything, but we can manage things better in a pregnancy complicated with gestational diabetes.

I developed a program for moms in a situation like myself, who need guidance and help getting control of our gestational diabetes.  Understanding that not all of the things that I knew as a dietitian will be something that other women know.  I made a daily pattern, daily options for breakfast and lunch (because we usually eat very similar things for breakfast and lunch so you don’t need a complicated schedule or recipes for that).  And it has recipes for dinner meals that you can feed to the entire family without a problem – no one has to know they are managed for your gestational diabetes.  Click and go to our information page to learn more about our gestational diabetes meal plans and patterns.