There are many things about pregnancy that are uncomfortable, from back aches and nausea to mood swings and fatigue, but, by far, my least-favorite part of pregnancy is glucose screening. This simple and common test, which can help to predict gestational diabetes, involves fasting for a brief period of time and then chugging a sickeningly sweet drink containing fifty grams of glucose. An hour later, the doctor or midwife draws blood to check the blood sugar levels of the mom-to-be, to find out if she needs further testing. No one likes doing it, so moms are often left wondering: are there any alternatives to the glucose drink?
I was a little alarmed when I brought up the glucose screening test to my friends and found out that many of them had skipped the glucose drink altogether in favor of “alternative” methods for checking for gestational diabetes. A few had simply chosen not to be tested for gestational diabetes, while others had their blood sugar tested after eating a large meal or drinking a glass of juice. This might seem like it’s just fine, but these alternatives tests for gestational diabetes aren’t a good idea.
The Cochrane Collaboration, a nonprofit group that evaluates studies and helps to draw conclusions from them, looked at women who used alternative tests for gestational diabetes, and didn’t find the most reassuring results. Although the studies they examined were too small and unreliable to draw definite conclusions, it doesn’t seem that alternative screening methods are nearly as accurate or sensitive as the glucose drink for checking for gestational diabetes. Since they usually contain an uncertain amount of glucose, often with other ingredients that could affect the way the body uses and absorbs sugar, it’s impossible for doctors and midwives to know exactly what is and isn’t a normal reading in a pregnant woman who just ate a large meal or a candy bar.
Proponents of alternative screening methods for gestational diabetes often point to the fact that low-risk moms don’t necessarily need to be screened for gestational diabetes, and that’s true enough. The American College of Obstetrics and Gynecology acknowledges that about one in ten pregnant women could skip the test altogether, but, since 90% of moms-to-be need screening, it’s simply more convenient to test all moms and not just a few. Most moms who forgo the glucose drink also aren’t as “low-risk” as they might believe.
According to the American College of Obstetrics and Gynecology, a mom is only low-risk for gestational diabetes if she is white, has no history of diabetes of any kind, has never given birth to a bigger-than-average baby, has a body mass index (or BMI) below 25, and is less than 25 years old. Many women might think that they’re low-risk, but relatively very few actually are. All it takes is being a little overweight or in your late 20s and you’re already at an elevated risk for getting gestational diabetes.
The risks of having undiagnosed (and untreated) gestational diabetes are too serious to ignore. Babies born to moms with untreated gestational diabetes are often dangerously large, making vaginal delivery difficult or impossible, and putting them at a high risk for health problems down the road. They’re also more likely to be born early, which carries its own set of severe complications, or to have low blood sugar or jaundice as newborns. All of these problems can be very serious, so it’s not a good idea to skip the gestational diabetes screening test or to use any unreliable alternatives to the glucose drink. Ultimately, as gross as the glucose drink is, it’s an important way to help ensure your safety and the safety of your unborn baby.