What a moment at the Pregnancy Clinic earlier!

[Lauren]

I was waiting for an appointment in the antenatal clinic earlier when I overheard this gem. A lady at 24 weeks pregnant had just drink her syrupy drink for her test for gestational diabetes. A nurse came over to her to go through some paperwork (she had opted into a study). The lady said she was so thirsty and really wanted water. The nurse said of course, there's a water fountain over there, and that she would wait for her to have a drink if she wanted.
The lady then said that the nurse who gave her the sugary drink told her she couldn't have a drink of water until after the glucose test was over, as the water might "shift the glucose"...

Just going to let that statement sit there. Imagine the possibilities if that were true!!

 

[trophywench]

definite case of Yeah but No but ... there, my experience tells me!

Of course when your BG suddenly shoots up high you suddenly feel mega thirsty and because of that, well done, proves your body is actually working right.

 

[John Gray]

The lady then said that the nurse who gave her the sugary drink told her she couldn't have a drink of water until after the glucose test was over, as the water might "shift the glucose"...

Perhaps the nurse really meant "dilute" the glucose dose, thus perhaps causing the rate of absorption of glucose into the bloodstream to slow down?
Or am I under-thinking?!

 

[Proud to be erratic]

I think dilute is a fair interpretation. During my DAFNE course in late '22, the DSN leading the course made the point that when hypo or close ro hypo and managing the low with a fast acting response - it was important to not dilute the fast release glucose with other slower release carbs. The fast release treatment should be given sufficient time to do its job, before potentially diluting it's effectiveness.

She also pointed out that the "too soon" extra carbs were potentially creating the roller coaster effect from overreacting to the event, rather than a modest later snack to consolidate the hypo or low response treatment. That made sense to me.

 

[Robin]

I think dilute is a fair interpretation. During my DAFNE course in late '22, the DSN leading the course made the point that when hypo or close ro hypo and managing the low with a fast acting response - it was important to not dilute the fast release glucose with other slower release carbs. The fast release treatment should be given sufficient time to do its job, before potentially diluting it's effectiveness.

She also pointed out that the "too soon" extra carbs were potentially creating the roller coaster effect from overreacting to the event, rather than a modest later snack to consolidate the hypo or low response treatment. That made sense to me.

But..but…but…When you eat slower acting foods, they have fibre or fat in them, which when mixed with the fast acting glucose in your stomach will slow the absorption through the stomach wall down. If you just drink water after eating glucose, or drinking a concentrated syrupy mixture, it would just be like drinking lucozade (when it used to be full sugar) or coke, or orange juice, which is what is recommended. Surely we wouldn’t be recommended to drink diluted glucose if it was slower than chewing a jelly baby?

 

[Proud to be erratic]

But..but…but…When you eat slower acting foods, they have fibre or fat in them, which when mixed with the fast acting glucose in your stomach will slow the absorption through the stomach wall down. If you just drink water after eating glucose, or drinking a concentrated syrupy mixture, it would just be like drinking lucozade (when it used to be full sugar) or coke, or orange juice, which is what is recommended. Surely we wouldn’t be recommended to drink diluted glucose if it was slower than chewing a jelly baby?

But .... if water is added to the syrupy drink too soon, the test is at risk of that syrupy drink being diluted. I imagine. I guess it hinges around the timings. So I still think dilution is a fair interpretation and that Nurse saying don't drink water was exercising due caution. Just not clear if "shift" was correctly heard and if it was, then it was an awkward choice of vocabulary.

NB: nowadays we need to drink a lot more Lucozade to get the same effect as a lesser amount of Coca-Cola. I still find JBs or Haribos are rapid and effective for me, in preference to a liquid which comes in either a (too) small measured volume or (too) large.

 

[Lauren]

But .... if water is added to the syrupy drink too soon, the test is at risk of that syrupy drink being diluted. I imagine. I guess it hinges around the timings. So I still think dilution is a fair interpretation and that Nurse saying don't drink water was exercising due caution. Just not clear if "shift" was correctly heard and if it was, then it was an awkward choice of vocabulary.

NB: nowadays we need to drink a lot more Lucozade to get the same effect as a lesser amount of Coca-Cola. I still find JBs or Haribos are rapid and effective for me, in preference to a liquid which comes in either a (too) small measured volume or (too) large.

This is interesting. I did wonder if the patient might have misheard or perhaps the nurse had meant something slightly different but not explained it well.