Many pregnant women don’t know they have choices when it comes to the Glucose Challenge Test (GTC). Here’s what you need to know about some of the questionable ingredients and your alternatives to the glucose drink during pregnancy.
Table of contents
- What is Gestational Diabetes?
- Symptoms of Gestational Diabetes
- How Does the Oral Glucose Tolerance Test Work?
- What’s in the Glucose Drink?
- What Can I Substitute for the Glucose Drink?
Healthcare providers encourage pregnant women to test for Gestational Diabetes between weeks 24 and 28. This test screens women (specifically those with no history of diabetes) for high blood sugar levels during pregnancy.
What is Gestational Diabetes?
Pregnant women produce hormones that cause cells to be more resistant to insulin. Usually, they are able to produce enough insulin to make up for this resistance. However, some pregnant women don’t produce enough insulin or are so insulin resistant that cells aren’t able to effectively extract glucose from the bloodstream so it can safely be stored in cells. This leads to gestational diabetes.
Having elevated blood sugar for long durations of time can be very dangerous for both mother and baby as glucose can transfer to the baby through the placenta.
Gestational diabetes can cause complications like:
- Babies that are larger than normal for their gestational age
- Increased C-section rates
- Shoulder dystocia or birth injury
- Neonatal hypoglycemia or low blood sugar
- Newborn jaundice
- Fetal hyperinsulinemia or excess levels of insulin circulating in the blood
- Likelihood for neonatal intensive care
Symptoms of gestational diabetes can be missed, so glucose screening can be extremely helpful in supporting a healthy pregnancy.
Symptoms of Gestational Diabetes
While the test can be a pain, the purpose behind it is sound. It’s very important to know if you’re at risk for gestational diabetes.
- Sugar in urine (conducted via a test by your doctor or midwife)
- Unusual thirst
- Frequent urination
- Frequent infections of bladder, vagina, and skin
- Blurred vision
Obviously, some of these symptoms are common to pregnancy even without the presence of gestational diabetes, so they cannot be used exclusively to diagnose GD.
How Does the Oral Glucose Tolerance Test Work?
An oral glucose test introduces glucose into the body which then is absorbed into the bloodstream. Cells that have enough insulin or have proper insulin sensitivity will be able to usher glucose into blood cells, lowering blood sugar back down to a healthy range.
If glucose isn’t absorbed properly, blood sugar levels will rise beyond this range. Thus, the purpose of the glucose drink is to measure this to get an indication of how effectively glucose is being processed.
The Oral Glucose Challenge Test (OGCT) for gestational diabetes requires the mom-to-be to drink the glucose solution and wait for one hour. When the hour is up, the mother takes a blood test to measure blood sugar levels.
If the results show that glucose is pushing into an unhealthy range, a follow-up glucose tolerance test (the 3-hour test) will be scheduled. This test requires 8 hours of fasting, consuming only water. Blood samples are taken upon arrival to measure fasting blood sugar. The glucose drink is given again, and blood glucose levels are taken again after one hour, two hours, and three hours.
The results of this test will either lead to another round of testing four weeks later or a gestational diabetes diagnosis.
What’s in the Glucose Drink?
The glucose drink that tests pregnant women for gestational diabetes is a highly concentrated beverage that consists mostly of sugar and water. Glucola, the drink most popular for glucose tolerance testing, contains 50, 75, or 100 grams of sugar.
The listed ingredients for Glucola include:
- dextrose (D-glucose from corn)
- citric acid
- natural flavoring
- food starch modified
- glycerol ester of wood rosin
- brominated soybean oil (banned in Europe, Japan, and India and patented in the US as a flame retardant)
- food dye and coloring: Yellow #6
- Sodium Hexametaphosphate
- Sodium Benzoate
Here’s a deeper look into some of the more questionable ingredients.
Brominated vegetable oil (BVO)
Brominated vegetable oil (BVO) is another questionable ingredient in some flavors of Glucola and other glucose drinks. A July 2022 study by Food And Chemical Toxicology looked at the effects of brominated vegetable oil with rats and found a correlation between BVO and increased levels of inorganic and organic bromine in tissues.
BVO leaves residues that accumulate in body fat, the brain, the liver, and other organs. It was also linked to an increase in cell size and mass of the thyroid. That makes perfect sense as bromine competes with iodine which is essential to thyroid health.
The sugar used in Glucola is dextrose, a type of sugar derived from corn or wheat. Dextrose is what’s known as a “simple sugar” and it causes blood sugar levels to rise quickly.
Sodium benzoate is a kind of salt made by combining benzoic acid and sodium hydroxide. It isn’t a naturally occurring chemical, but it has been deemed as GRAS (generally recognized as safe) for food use.
This preservative is found in a lot of foods. As common as it is, there’s cause for concern over studies that imply it could be linked to ADHD and other health conditions.
There is also legitimate cause for concern when sodium benzoate is combined with ascorbic acid and makes benzene – a chemical linked to higher cancer risk. It’s speculated that heat and light could also cause sodium benzoate to convert into benzene. Benzene is one of the byproducts found in many of the recently recalled sunscreen products.
Sodium hexametaphosphate is used as an emulsifier and a texturizer in foods. Sodium hexametaphosphate is a member of the phosphate family, and phosphates are known to sequester calcium which can lead to calcium deposits in the kidneys. It’s suspected that sodium hexametaphosphate may also convert into phosphoric acid which could cause excess acidity in the body.
Glucola Side Effects
Some of the side effects reported from Glucola include nausea, vomiting, bloating, and diarrhea, as well as headache, dizziness, and fatigue.
The health risks of these ingredients are associated with regular and consistent exposure, so being exposed to a single bottle, or even three, may not concern some mothers-to-be. But if you don’t typically put these chemicals in your body or choose not to expose your developing baby to them, it’s wise to consider alternatives to the glucose drink during pregnancy.
That said, these ingredients are in soda and many processed foods. So, if you already eat processed foods, this may not be a concern for you.
There’s also the matter of ingredients with potential unhealthy side effects being used in a drink for pregnant women in the first place.
What Can I Substitute for the Glucose Drink?
One of the most commonly asked questions about the OGCT is “What happens if I throw up during the glucose test?”
Mild nausea can be an ever-present condition throughout pregnancy. So it’s a valid concern when you’re expected to chug a bottle full of syrupy sugar and chemicals on an empty stomach.
These options are healthier for your body, less likely to cause side effects, and may be a little more gentle on your digestive system.
The Fresh Test
One product called The Fresh Test is a natural alternative to Glucola. It’s a powder that contains 50g of glucose and has only three ingredients; crystallized lemon, dextrose, and mint. It’s gluten-free, non-GMO, and organic. The dextrose is only made from either tapioca or corn.
Fortunately, you can test for gestational diabetes without a glucose drink; natural or not. The whole premise of the test is to measure blood sugar an hour after consuming 50g of glucose. Natural alternatives to Glucola found online include orange juice, grape juice, or orange juice plus a banana.
Other science-backed alternatives to the glucose drink during pregnancy include:
Another study from 1999 looked at jelly beans as an alternative for glucose testing. One group of pregnant women were given jelly beans while the other group was given Glucola and blood glucose was measured. Then the participants did the test with the other glucose source.
Finally, a 3-hour glucose test was performed on all participants. The study found that there weren’t any significant differences between blood serum levels one hour later. They did see, however, that jelly beans had fewer side effects and were preferred by 76% of participants.
If you normally eat clean, make sure you opt for organic, non GMO jelly beans.
There have been studies to explore the efficacy of glucose test alternatives. A study on non-pregnant women published in Diabetes Care found that 10 strawberry-flavored Twizzlers were equivalent to a 50g glucola drink for screening for diabetes. This was expanded on with another study actually done with pregnant women.
This study looked at glucose testing for pregnant women with twizzlers versus Glucola. The results found that Twizzlers actually provided more accurate test measurements than Glucola.
Twizzlers contain corn syrup and artificial flavors, so same as with jelly beans – look for organic licorice candy products instead.
Dr. Aviva Romm, a longtime midwife and herbalist and now Yale-graduate doctor, shares alternatives to glucose drinks on her blog. Her advice is that women claim their right to read labels before agreeing to a test. She also says that women have the right to be screened for gestational diabetes using their preferred method, and even have the right to decline the test if they so choose.
Dr. Romm says that in place of the glucose drink test, women may opt for a hemoglobin A1C test by the beginning of the second trimester.
Another glucose drink alternative she provides is combining a healthy diet with random glucose testing via a finger-prick test that can be done at home. She also recommends the jelly bean test. Of course, all of this should be discussed with a doctor or midwife for more information that supports the best care of mother and baby.
Future Saliva Tests
New science may have the potential to throw out the need for Glucola entirely. A study published in 2021 looked at measuring glucose tolerance via visfatin; an enzyme in saliva that’s involved with glucose metabolism and inflammatory processes. Scientists found that levels of visfatin in saliva were significantly higher in participants with gestational diabetes. Another study published in 2020 found that high levels of the protein chemerin may indicate gestational diabetes.
With further research, saliva samples or other testing could be the future of gestational diabetes screening.
In the meantime, expectant mothers can discuss alternatives to the glucose drink during pregnancy with their birth providers. Providing a summary of natural alternatives for the glucose test will be a great starting point for a discussion about what’s best for mom and baby.
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