Atkins Diabetes Revolution by Robert C. Atkins Page A

and reason for coming to see him, Dr. Atkins almost without exception performed a five-hour glucose and insulin tolerance test (GTT). This is not a standard test, as it is time-consuming and expensive. Nevertheless, he believed the GTT is the best way to find out how your body reacts to carbohydrates. A single test such as fasting blood sugar is like a snapshot; the GTT is like making a movie of your metabolism.
    It is through observing the results of thousands of patients and correlating the results with their reported symptoms that Dr.Atkins came to fully understand the importance of controlled-carbohydrate nutrition in the prevention of diabetes and heart disease and in the treatment of the other chronic health problems that plague us today. By observing the changes in blood sugar and insulin levels that occur during the test, he learned just how early on we can diagnose those at risk for developing the metabolic syndrome. He also learned how, with proper education and intervention, we can not only prevent the metabolic syndrome, but also stop the progression to prediabetes and Type 2 diabetes.
    If after reading this far you think that you might have the metabolic syndrome or prediabetes, you need to be your own patient advocate and have a serious discussion with your doctor about performing the full five-hour glucose tolerance test.
    DISCUSSING THE GTT WITH YOUR DOCTOR
    If your doctor tells you you don’t need the glucose tolerance test, what should you say? We suggest that you ask your doctor to order the test anyway. Offer to pay the bill ahead of time. Call your insurance carrier and obtain a letter indicating the company will cover the cost (if it will).You could also offer to pay a deposit and ask for the bill to be filed with your insurance carrier. Most physicians will agree to order the test if the cost doesn’t directly affect them. Some insurance plans will charge a physician for ordering a test not considered “medically necessary.” In that case, your only choice is to pay the bill yourself.You may be able to negotiate a discount for cash payment.
    PREPARING FOR THE GTT
    For the results of your oral glucose tolerance test to be accurate, you will need to start preparing a few days in advance. The test is only accurate if you’ve been eating 150 or more grams of carbohydrate a day for several days running. Of course, if you’re following the standard American diet, you’re eating that much and more and you won’t have to change your diet to prepare for the test. If you’ve been following a low-carbohydrate eating plan, however, you’ll have to go off it and eat at least 150 grams of carbs each day for four days. Is that a reason to eat a whole bunch of jelly doughnuts? No way. Use those carb grams on the best possible foods, such as whole grain breads, fruit, potatoes, legumes, and starchy veggies. Spread the carbs evenly across your meals,and eat them with foods that contain protein and fat.
    Before the test, you must fast for 12 hours. It’s okay to drink as much water as you want during this time. You’ll also be able to drink water during the test, but you won’t be able to eat (or smoke). Some prescription medications, such as thiazide diuretics, beta-blockers, oral contraceptives, steroids, and some psychotropic medications, can affect the results of your test. Be sure to tell your doctor about all your medications in advance and discuss whether any will affect the test.
    DOING THE GTT
    As we just discussed, if you are currently restricting carbs, to ensure an accurate result on the glucose tolerance test, you’ll have to prepare a few days in advance by eating more carbs. The GTT has three components: It measures blood sugar levels, insulin levels, and the presence or absence of sugar in the urine. The first blood sample, taken before you drink the glucose solution, measures what’s called your baseline fasting blood sugar and insulin.A urine specimen is also tested for the presence of