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High-carb breakfast ideas for glucose tolerance test?

Answered on August 19, 2014
Created October 21, 2012 at 3:31 PM

I'm 28 weeks pregnant and have a pretty open-minded midwife - however, since both my dad and his dad are type 2 diabetics, she wants me to do the oral glucose tolerance test. I don't have to fast, and I think it's a 1-hour test. The options she gave me for this are:

  1. Eat a normal (high protein, high fat) breakfast, then shoot either the glucola or 16 jellybeans, wait an hour, draw blood; or
  2. Eat a high-carb (in her words, "load up on pancakes and syrup") breakfast before coming in and draw blood (I'm guessing as soon as I get there, or about an hour after eating)

I'm still debating which approach to take - the thought of eating so many jellybeans makes me queasy but I'd anticipate a pretty nasty sugar crash if I don't have protein and fat first thing in the morning.

If I do go the breakfast route, obviously I'm not going to eat traditional pancakes and syrup, and I'm pretty sure my version of pancakes (eggs, almond/coconut flour, flax) wouldn't give me the sugar spike they're looking for. Incidentally, she tells me the high sugar spike is necessary to make sure that my insulin can "do its job".

So - any ideas for a paleo-ish breakfast that would affect the body in such a way? I'm thinking bananas, rice (I've been doing more PHD for my pregnancy, so I haven't been low-carb)...?

2ea24c22690b54e938229b140dcf60f7

(158)

on October 23, 2012
at 03:27 AM

I ate apples, bananas, potatoes, etc while I was pregnant, but it still turned out to be fairly low carb. I bombed my OGTT after taking it against my better judgement. I sat through stupid appointments with the dietitian who could only tell me to "eat more carbs" because she didn't know what else to say. When testing my sugars 4x a day, they were almost always perfect (I had one high reading, but it went down quickly). I would suggest trying to test sugars 4x a day for a week, and using those readings as an indicator of GD. Most midwives would be ok with that, and that is what I will offer to

8d454fc50d6d58643d6f8b0d1e7ea8ea

(2830)

on October 23, 2012
at 02:19 AM

I'm not low carb - I've been eating lots of potatoes, rice, apples and bananas my entire pregnancy. The advice on doing regular glucose monitoring in the event that I fail is helpful - I absolutely do not want to do a fasting 3 or 5 hour OGTT.

8d454fc50d6d58643d6f8b0d1e7ea8ea

(2830)

on October 22, 2012
at 01:52 PM

Thanks - I found your suggestion really helpful. I experimented today with a higher-than-usual carb breakfast and I just want to go back to bed. I'm thinking getting the protein and fat on board early on will fare me better even if it means shooting glucola later (I don't think I could manage that many jellybeans :))

6120c989fd5b69f42a0834b69b87955b

(24553)

on October 22, 2012
at 04:04 AM

There are soooo many variables when someone throws out a term like "big breakfast" that I can see why my midwives abandoned the 50g non-fasted test, hardly seems scientific.

64433a05384cd9717c1aa6bf7e98b661

(15236)

on October 22, 2012
at 03:45 AM

Ah, thanks. To base test results on instructions such as "big breakfast" seems odd to me ;)

Ef7214374ddcf81d9ef03c8863bbd7c2

on October 22, 2012
at 03:06 AM

I second refusing the test. I refused it at my last pregnancy and the doctors gave me a lot of grief over it but couldn't make me take it - well, obviously. :)

6120c989fd5b69f42a0834b69b87955b

(24553)

on October 22, 2012
at 02:46 AM

@ Jeff, there are two kinds of OGTTs that they do. One is 50g glucose, taken shortly after a big breakfast with one blood draw, and the other is 75-100g taken after fasting with 2-3 blood draws.

61844af1187e745e09bb394cbd28cf23

(11058)

on October 22, 2012
at 12:16 AM

Refuse the test. Period.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 21, 2012
at 04:58 PM

Interesting about the jellybeans though!

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 21, 2012
at 04:58 PM

I'd probably just shoot the glucola since I'm not familiar with the other methods.

8d454fc50d6d58643d6f8b0d1e7ea8ea

(2830)

on October 21, 2012
at 04:22 PM

There have been studies that show that glucola and jellybeans are comparable...the high-carb breakfast I'm not sure about.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 21, 2012
at 04:17 PM

I agreee....what OP is talking just sounds bizzaro to me.

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8 Answers

5
4b5be253ac1981c690689cab7e4bf06d

(3043)

on October 22, 2012
at 03:38 AM

The glucose tolerance test isn't that useful when on a lower carb diet. But, gestational diabetes can be pretty bad.

Ask if you can do other things to show your blood sugar levels are fine. You can buy a glucose monitor for around $10 (and they usually have mail in rebates). I would offer to track your blood sugar over two days: morning fasting, 1 and 2 hours after you eat. Your midwife can see that with your normal eating, your blood sugar is fine (or, if it isn't, you can be more careful during the rest of your pregnancy.)

5
Ae8946707ddebf0f0bfbcfc63276d823

(9402)

on October 21, 2012
at 04:22 PM

Tell midwife that you're doing a high carb breakfast and then just eat whatever you want for breakfast. I suspect if you're posting here, you're already eating properly. You're best off if the blood test does not give anyone an excuse to try to manage your diet with conventional wisdom or worse try to put you on insulin


Someone gave a downvote. Because I'm not answering the question? Or because I'm suggesting lying to midwife? I will say that my wife was diagnosed with gestational diabetes when she was pregnant with our second based on a fasting blood sugar of 94. This meant she had to attend nutrition counseling where they recommended she eat whole grain carbs 5 times daily to keep her blood sugar level. She also had to check her blood sugar 3 times a day for the rest of her pregnancy. Not a huge deal, but surely a hassle, especially considering the backwards advice they'd give if there was ever a problem.

Based on the midwife's recommended breakfast of pancakes and syrup, I can guess that she would not be able to give much help in terms of nutrition, especially given OP's seemingly good understanding of what it means to eat healthy, so I would definitely either refuse to do blood sugar test or at least not ingest a bunch of refined carbs in support of the test. Honestly, who cares how your body responds to a breakfast of pancakes and syrup or eating a bunch of jellybeans, if you don't plan to eat that way during your pregnancy anyway? I stand by that.

3
64433a05384cd9717c1aa6bf7e98b661

(15236)

on October 21, 2012
at 03:37 PM

The fact that they are giving you those two options is really confusing. If they're basing your test results on a set range, it has to depend on a pre-set amount of sugar. Also, high protein breakfast can raise your blood sugar, especially if you're insulin resistant because protein causes an insulin and glucagon release. A proper OGTT should be done fasted.

8d454fc50d6d58643d6f8b0d1e7ea8ea

(2830)

on October 21, 2012
at 04:22 PM

There have been studies that show that glucola and jellybeans are comparable...the high-carb breakfast I'm not sure about.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 21, 2012
at 04:17 PM

I agreee....what OP is talking just sounds bizzaro to me.

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 21, 2012
at 04:58 PM

Interesting about the jellybeans though!

3846a3b61bc9051e4baebdef62e58c52

(18635)

on October 21, 2012
at 04:58 PM

I'd probably just shoot the glucola since I'm not familiar with the other methods.

6120c989fd5b69f42a0834b69b87955b

(24553)

on October 22, 2012
at 02:46 AM

@ Jeff, there are two kinds of OGTTs that they do. One is 50g glucose, taken shortly after a big breakfast with one blood draw, and the other is 75-100g taken after fasting with 2-3 blood draws.

2
3491e51730101b18724dc57c86601173

(8395)

on October 23, 2012
at 12:32 AM

My understanding is that you will get a FALSE positive on an oral GTT unless you "carb up" for at least 3 days before the test. There is a small degree of physiological insulin resistance that happens when you don't eat a lot of carbs, and it takes your body a few days to readjust.

I was reading someone's blog last night (sorry, I can't remember whose) about which tests she chose and which tests she refused during her pregnancies, and among them was the OGTT, because of the high number of false positives in people who don't eat a lot of carbs. She negotiated with her birth team to permit her to monitor her fasting and post prandial blood glucoses for a two week period around 26 to 28 weeks in lieu of the OGTT. And she was fine.

If you have gestational diabetes, it WILL show up with diligent blood glucose monitoring. But if you fail the 1 hour OGTT because of a false positive you won't be certain it's false, so then you'll have to submit to a 3 or 5 hour test and a lot more monitoring.

8d454fc50d6d58643d6f8b0d1e7ea8ea

(2830)

on October 23, 2012
at 02:19 AM

I'm not low carb - I've been eating lots of potatoes, rice, apples and bananas my entire pregnancy. The advice on doing regular glucose monitoring in the event that I fail is helpful - I absolutely do not want to do a fasting 3 or 5 hour OGTT.

2
2436f4e6d010656b346629a77e9599dd

on October 22, 2012
at 04:27 AM

When I was pregnant the first time, I did the nasty glucose drink thing and it made me feel awful all day (I wasn't doing paleo, but was really strict about sugar and refined starches). So this most recent time around, I told my OB I didn't want to do it. She instead had me come in three times before eating breakfast, did a quick glucose test with one of those monitors diabetics use, then had me eat whatever normal thing I ate for breakfast and then checked again one hour later. It was kind of a pain going into the office three times, but it seemed to work fine and I didn't have to eat anything nasty. Maybe you could propose something like that to your midwife?

1
6120c989fd5b69f42a0834b69b87955b

(24553)

on October 22, 2012
at 02:58 AM

If it is the 50g post breakfast one, go for the big meaty breakfast, with vegetables, and beans if you eat them (per the recommendation of my midwife to stabilize blood sugar). That one isn't too rough, and I think the lower carb breakfast will keep you more stable feeling.

I did the 50g one last pregnancy and had a huge salad with a can of tuna and a half can of beans for breakfast with loads of olive oil and vinegar dressing, and did just fine.

This pregnancy they changed protocols using only the fasted test, and I bombed the 75g fasting one. I'm now wondering how I would have done either repeating the 50g non-fasted test, or if I would have also failed the 75g fasted one last pregnancy. Or if maybe I didn't eat enough in the way of carbs in the week leading up to the test this time.

I wish you luck.

6120c989fd5b69f42a0834b69b87955b

(24553)

on October 22, 2012
at 04:04 AM

There are soooo many variables when someone throws out a term like "big breakfast" that I can see why my midwives abandoned the 50g non-fasted test, hardly seems scientific.

64433a05384cd9717c1aa6bf7e98b661

(15236)

on October 22, 2012
at 03:45 AM

Ah, thanks. To base test results on instructions such as "big breakfast" seems odd to me ;)

8d454fc50d6d58643d6f8b0d1e7ea8ea

(2830)

on October 22, 2012
at 01:52 PM

Thanks - I found your suggestion really helpful. I experimented today with a higher-than-usual carb breakfast and I just want to go back to bed. I'm thinking getting the protein and fat on board early on will fare me better even if it means shooting glucola later (I don't think I could manage that many jellybeans :))

0
34a6b6c806d15d904965288e3e8307ab

on April 24, 2014
at 02:05 PM

  1. I just took the one hour OGTT after carbing up for 2 days (cereal, bread, pizza) and eating an egg with butter and avocado this morning. It wasn't too bad but I'm home now and am wondering what I should do to ameliorate the affects of that terrible dose of sugar and the past two days of not so great eating. Should I fast? Eat something fatty?

0
34a6b6c806d15d904965288e3e8307ab

on April 24, 2014
at 02:04 PM

just took the one hour after carbing up for 2 days and eating an egg with butter and avocado this morning. It wasn't to bad but I'm home now and am wondering what I should do to ameliorate the affects of that terrible dose of sugar. Should I fast? Eat something fatty?

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