Glucose Tolerance Testing: What are your options?

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Why are we worried about Gestational Diabetes?

The rise in obesity rates have have been significant in the United States, and with it – the rates of Diabetes and Gestational Diabetes have also risen. 5-7% of pregnant people are diagnosed with GDM.

Elevated blood sugar can cause a wide range of issues and complications for both the pregnant person and the baby. Hypertension, preterm birth, macrosomia, neonatal hypoglycemia, jaundice, and preeclampsia. Babies born to diabetic mothers have a higher chance of having issues later in life, and those people diagnosed with GDM have a 50% chance for developing Diabetes later in life.

What are the current guidelines?

The current guidelines recommend a two-step approach to testing for GDM between 24-28 weeks of pregnancy- the glucose challenge test, then if you fail that one, you’ll move on to the glucose tolerance test. The first step in standard testing is drinking Glucola (a drink with 50 grams of sugar), then having your blood drawn one hour after you finish the drink. If you’re sugar level is higher than the normal limit, you’ll be asked to do the GTT. The GTT is typically another round of Glucola (but with 100 grams of sugar), then a blood draw at three hours.

If you have a higher sugar level than the normal limit, you’ll be diagnosed with gestational diabetes.

Do I have other options if I don’t want to drink Glucola?

Yes. Yes, you do!

As always, this is not medical advice and you should always have an open discussion with your provider about any concerns that you have.

Firstly, it’s important to note that you have the right to choose the testing option of your preference. Here are a few alternative options:

  • Glucose testing at home. This is a commonly used alternative. It’s simple, and only requires that you’re willing to prick your finger several times to get a clear picture of how your body is tolerating your normal diet. You’ll want to work with your provider to determine what ideal testing times and numbers are for you.
  • Naked Smoothies or organic grape juice. Several practices in our area are using alternatives like this, because you’re still getting the 50 grams of sugar required for the blood draw for the glucose challenge test.
  • Jellybeans – you eat 28 Brach’s jellybeans, which is the equivalent of 50 grams of sugar. Then, you have your blood drawn. There was some evidence that this method may not be reliable, but other evidence states that is a reliable alternative and is preferred by pregnant people.
  • Some practices, specifically out of hospital, utilize a carb heavy breakfast menu paired with a blood draw.

There are plenty of alternative options for screening for Gestational Diabetes, so you’ll want to pick a couple options to present to your care provider and ask their opinion on the methods.

It’s important to note that you also have the right to decline testing, if that’s what you want to do. Again, it’s incredibly important to have open discussions with your care provider about your desires and preferences for your maternity care and birth.

Other Considerations:

If you’re on a low carb or low sugar diet, you might have a false positive for the tests. Many providers suggest carb loading for a few days prior to the test, so the increase in sugar isn’t such a shock to your body.

Screening for Gestational Diabetes is an important part of safe maternity care, but there is more than one avenue for an accurate picture and risk assessment.

Links for additional information:

ACOGs GDM guidelines

EBB: Diagnosing GDM

 

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