When I got pregnant with my first child, I began reading about all of the things I should avoid eating, drinking, or doing while pregnant. And I started wondering why those things were safe when I wasn’t pregnant (turns out most of them aren’t). I stopped drinking soda entirely, avoided food and drinks that had artificial colors or preservatives, and stopped using commercial body products.
Then I started to read about what most pregnant women drink for the gestational diabetes test and I was confused. Glucola, the glucose drink used for the gestational diabetes test, is full of additives that have not been proven safe for consumption while pregnant. Why are pregnant women practically forced to drink this flat soda? Is there a healthier alternative?
What is gestational diabetes?
Gestational diabetes is insulin resistance that happens during pregnancy. Biologically it’s normal (and good) for women to have some degree of insulin resistance during pregnancy, because it protects the fetus from periods of food scarcity.
However, our bodies don’t know that food scarcity is rare in our modern society. If you combine this slight insulin resistance with the high sugar and carb diet many Americans eat, you are likely to find gestational diabetes in some women.
Though the slight insulin resistance during pregnancy is normal, gestational diabetes does carry risks. According to Dr. Aviva Romm:
Elevated blood sugar creates a condition in the body called “oxidative stress” and in pregnancy, which is already a state of somewhat increased oxidative stress, this can lead to high blood pressure, preeclampsia, and preterm birth. Also, babies born to overweight or diabetic moms have a much higher lifetime likelihood of developing chronic health problems associated with obesity and diabetes.
Why the gestational diabetes test is important
Since gestational diabetes can be dangerous, all women are subjected to routine gestational diabetes testing whether they are at risk or not. The risk factors for GD are being over 25 years of age, having a personal or family history of diabetes, having a BMI of 30 or higher, or being from a non-white race. (source)
As you can see, most women will have at least one of those risk factors and if you do, it’s a good idea to know what your blood sugar is up to. That doesn’t mean that you have to submit to a routine gestational diabetes test (the oral glucose challenge test) or that you have to drink the glucola. There are other options, which we’ll talk about later.
Problems with the gestational diabetes test
During the oral glucose challenge test (OGCT) you will be asked to drink a glucose drink, also known as glucola, which contains 50g of glucose. You will have to drink it within 5 minutes, and then have your blood drawn 1 and 2 hours afterwards to assess how your body handles sugar.
The glucose challenge test is not a diagnostic test, and if you “fail” it you don’t necessarily have GD. You’ll have to go through a second 3 hour long oral glucose tolerance test (OGTT) for a diagnosis (and drink more glucola).
The ingredients in glucola are questionable
Brominated vegetable oil is in some glucola drinks. It’s used as an emulsifier for the flavoring of the drink. There have been cases of people becoming very sick from ingesting BVO on a regular basis and in large amounts.
BVO is not FDA approved. It was removed from the “generally considered safe” list in the 70’s, pending more research, but the research hasn’t been done. BVO is banned in India, Japan, and Europe, which is a sign that we should be looking more closely at this additive.
The food dyes in glucola drinks concern me too. There has been a lot of research showing the risks of ingesting petroleum-based food dyes. These risks include cancer, hyperactivity, and a number of allergic reactions. Food dyes are also regulated or banned in other countries.
Dextrose is another ingredient in glucola that has me asking questions. Dextrose is where the 50g of glucose come from, and it is almost always derived from corn (it will often say so on the label). Most corn products in the US are made from GMO corn, so dextrose is almost guaranteed to be GMO.
If glucola was the only way to diagnose gestational diabetes, then I would obviously take the risk of glucola over the risk of gestational diabetes–but it’s not. More on the alternatives later.
The glucose challenge test is not very accurate
It’s unclear how accurate the OGCT is. Only 76% of women who have GD will be diagnosed. On the other hand, about 25% of women who are diagnosed won’t actually have GD (and will be unnecessarily specified as high risk). (source)
Timing can also play a part in the accuracy of the test. According to this study, taking the test at 8am is more likely to get you a pass than any other time of day. Also, blood glucose levels rise as a pregnancy progresses: levels at week 28 will naturally be higher than those at 24 weeks, but the same test is used at both times. (source)
Many women are instructed by healthcare professionals to carb load for a few days before their test. There is evidence to suggest that the body adapts to the amount of carbs that it consumes. That means that by carb loading before the test, you’re getting your body used to the high levels of sugar that you’re about to consume for your test.
So, the tests accuracy is reliant on the amount and kind of food that pregnant women typically eat or on what they choose to eat for a few days before the test.
Instead of eating a lot of sugar to prepare my body to eat a lot of sugar for the test, I decided to eat my regular diet and tested my blood sugar based on my regular diet.
Alternatives to the standard gestational diabetes test
Improve diet and lifestyle (in advance)
Since gestational diabetes is a sign that you may be at risk for diabetes in the future, a preconception and prenatal healthy lifestyle is the best prevention. That means avoid a diet high in sugar and processed foods and eat a real food diet instead, and get plenty of exercise. (source)
Though treatment of gestational diabetes does result in better birth outcomes, testing for, or a diagnosis of, gestational diabetes does not (source).
Once a pregnant woman is diagnosed with gestational diabetes, she is told to follow a healthy diet and exercise regularly (and check blood sugar regularly). All pregnant women (and people in general) should be advised to do those things, so many women decide to skip the test and just follow those guidelines.
Even with a healthy lifestyle you may still want to test. If you do, there are alternatives to the OGCT and OGTT.
Consider your blood results
A fasting plasma glucose test at the first prenatal appointment (a blood draw after fasting for 8 hours) was shown to be as accurate as the OGCT (source). However, another study found it to have a high false positive rate. You may want to include this test in your screening, but not rely on it exclusively.
Check Hemoglobin A1c in the first trimester
If you’re in the first trimester of your pregnancy, you may want to ask your doctor or midwife for a the hemoglobin A1c test. The HbA1c test in the first or early second trimester was shown to effectively detect diabetes for all women who had it, and also a group of women who had high risk for adverse pregnancy outcomes. (source)
Monitor your blood sugar
You can also choose to monitor your blood sugar at home for a few days or a week at 24 weeks and around 32 weeks. If you are diagnosed with gestational diabetes, you will be asked to monitor your blood glucose at home anyway. So why not just skip the OGCT or OGTT and go right to monitoring? (hint: you can.) (source)
Consider natural alternatives to glucola
If you want to or have to take the OGCT, there are natural alternatives to drinking glucola. Ask your doctor for alternatives to the glucola drink. Many will have a list of effective alternatives but they won’t necessarily offer it without your asking first. If they don’t have a list, you can ask specifically about the following ideas.
- Jelly beans are similarly effective for the OGCT as glucola, and you can choose the source. According to this source, 53 jelly beans will equal the 50g of glucose needed. Get organic, GMO-free jelly beans here.
- Glucolift is a natural, non-GMO, artificial colors & flavors free glucose tablet. It’s made for people with type 1 diabetes who need to raise their blood sugar regularly throughout the day. Each tablet contains 4g of glucose, so you would have to take 12.5 tablets to equal 50g of glucose.
- Some midwives or doctors will let you eat a (very specific) real food breakfast before your test. Often it includes eggs, toast, fruit, and juice. Because you can’t be sure exactly how much glucose is in real food (a ripe banana has more sugar than an unripe one) you may still want to monitor at home to be sure.
With both of my pregnancies I chose to do a random glucose screening. I ate my normal breakfast and then had my blood glucose tested about an hour after I ate. At the time I was happy with that solution, because I wasn’t spilling sugar in my urine and I wasn’t eating a high-carb diet.
If I were to do it again, I would choose to test at home for a few days to get a more comprehensive idea of my blood glucose levels. I could also check after a few different meals and get an idea of which foods raised my blood sugar more than others. That way, if there were certain foods that raised my blood glucose levels too much, I could avoid them and continue a healthy pregnancy.
What was your experience with the gestational diabetes test?
After getting caught up in the go, go, go, and buy, buy, buy, of modern living, I found myself unhappy and exhausted. I soon embraced a slower life and now write about simple living at PurposefullySimple.com.