19. Gestational Diabetes: Pregnancy Risks, Testing Options, and Alternatives to Glucola Drink

Do you have your gestational diabetes screening coming up? (Usually around 24-28 weeks!)

In this episode, we’ll talk about:

• Why you should even care about if you have gestational diabetes…
• What to anticipate your doctor will recommend for testing and how to choose if it’s right for you…
• Tips to make the glucose test tolerable if you choose it… (remember nothing is mandatory!)
• Testing alternatives like The Fresh Test, instead of the Glucola drink and why you should question this option…

The gestational diabetes test doesn't have to be stressful! Explore your options, whether it's the traditional approach or alternatives like The Fresh Test, because you have the right to make informed decisions that suit your unique needs and preferences!

>>FREE RESOURCE: Download my free 35-page eBook,  A Guide To The Autonomous Hospital Birth You Deserve - by clicking here. Know your rights, make informed choices, and celebrate your dream birth!

References

The Fresh Test--natural glucose beverage alternative

Follow Leslee Flannery on Instagram @gestational.diabetes.nutrition

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Welcome, friends! I am Beth, a certified nurse midwife, doula, and childbirth educator. My philosophy is rooted in autonomy, informed decision making, and positive mindset to help expecting parents plan for a beautiful, stress-free birth. I am here to provide value to YOU through tips and practical advice, either to guide you through pregnancy or to help you prepare for childbirth, postpartum and beyond. There’s no fluff here - only info that adds to your positive experience and saves you stress and uncertainty.

Transcript

Hello, everyone, welcome back to Your Birth Bestie podcast, thank you so much for being here. I am just recording tonight here as I record this from an eventful weekend of solo parenting. I am home with my girls all week long and look forward to brief breaks over the weekend, but this weekend my husband was out of town and it was eventful.

It was the first time I had my two girls who are 3.5 and 1 for two nights, so we had to stay busy for everyone’s sanity. But I’m tired so am enjoying this break here after they are asleep and recording this episode and being with you.

We went to see Laurie Berkner at a kids festival yesterday and went out for ice cream after, today we went to the splash pad and the park, I taught my oldest how to play go fish so we’re probably on our 50th game of that this weekend… all fun summer stuff and I’m loving it all but I’m really just tired, as we all are right.

But anyways I had a lot of fun having a girls weekend with my littles and wanted to use this too as a quick plug if you’re in the thick of it, whatever stage that might be in pregnancy or parenthood (keep in mind I can only speak from experience for up to 3.5 years of age…) but everything is temporary. 

I can remember countless days and nights stressing about wake windows and sleep schedules and thinking I would NEVER get out of this stage and she would NEVER sleep and I’m creating BAD habits and blaming so much guilt… but you know what. I made it through phase after phase after phase and I did have a great weekend and enjoyed time with my girls. 

So those moments when you’re thinking “She will NEVER (do the thing you’re desperate for)” or “They’re ALWAYS gonna (do the thing you’re frustrated about)”.... But it does pass eventually. So if you’re pregnant with your first or maybe in a hard transition with a toddler, I just wanted to say mom-to-mom it does pass, everything is temporary, find the little win if you can, it’s okay to feel frustrated and not love every moment… you’re doing great! And I am grateful for my realization of that this weekend.

BUT let’s now talk about gestational diabetes because that’s why you’re here.

So I am going to give you all the information I think is helpful to know about gestational diabetes during your pregnancy. 

So we’ll talk about... What is gestational diabetes, how it affects your pregnancy, what are the risks... How it’s usually screened for and diagnosed in pregnancy...Some tips to make the glucose test tolerable (if you choose that, because remember everything is a choice and nothing is mandatory)...And then of course, the Glucola drink that you’ve probably heard about isn’t the only option so we’ll talk about alternatives, one being my favorite, The Fresh Test!

So, what exactly is gestational diabetes?

Gestational diabetes affects about 7-10% of all pregnancies and is caused by your body not making enough insulin to keep your blood sugars in a healthy range. The more carbs you take in, the more insulin that needs to be made to balance out everything and with gestational diabetes, that’s not happening as it should.

If you’re pregnant, your blood sugar levels are already a bit higher because of hormones from your placenta and slowing how much insulin gets released to regulate blood sugar after you eat or drink something. Most women can handle the change during pregnancy, but others aren’t able to overcompensate for that slow release of insulin.

If this happens for you, there’s a chance you’ll just have to change the way you eat for the rest of your pregnancy, although medications like insulin may be necessary in some cases. But once you have your baby and your placenta is no longer a part of you, those hormone systems regulate and you are no longer diabetic which is great!

A diagnosis of gestational diabetes can happen for any woman, but there are various factors that put women at a greater risk. These include: obesity, a family history of diabetes, having gestational diabetes during a previous pregnancy, gaining more weight than what’s recommended during pregnancy, being pregnant with multiples, high blood pressure, and a previous diagnosis of PCOS.

But with that said, you may find it strange for perfectly healthy, low-risk women to develop gestational diabetes, but it is possible. It’s also important to know that there are often no obvious signs to suspect you’re diabetic in pregnancy. Some women do have extreme fatigue, increased urge to urinate, extreme dry mouth and constant thirst, nausea after eating, and tingling in the hands and feet. But usually it’s not something we can know whether we have or not.

And to figure out if gestational diabetes is something you have…

There is a screening test done around 24-28 weeks of pregnancy. And there’s a few things to talk about here…

The screening is a one hour test and it is not diagnostic. So that means if you pass or fail it doesn’t mean for sure 100% that you do or do not have gestational diabetes. It IS a test that screens you for whether or not it is recommended to have additional testing… which would then lead to more testing and an actual diagnosis. So this one hour gestational diabetes screen is the glucose challenge test.

This test is going to challenge how well your body can produce insulin in response to the carbs you eat or drink. So I’ll give you the typical scenario… and then a few alternatives to consider.

So typically, you’d be given a sugary drink called Glucola that has 50 grams of glucose. You’d be given this drink by a tech or phlebotomist at your clinic, they will give you 5 min to drink it which isn’t difficult it tastes like flat soda. If you choose this route (and remember there are alternative options I’ll be talking about at the end), I recommend the clear one, not the orange or red fruit punch one if you have the choice, but you’d drink that and then the phlebotomist would make note of the time you finished the drink. A timer would be set for one hour, and at exactly that time you would be called back to have your blood drawn.

You would get your results back in a day or two usually, hoping that the blood sugar reading is less than 140. If it’s greater than that, you would have a positive result and it would be recommended to do a more in-depth 3-hour version to then diagnose gestational diabetes or be clear from that. If the one hour test is greater than 200, you would be diagnosed with gestational diabetes without needing to do the 3 hour test. It would be clear that your body is not releasing enough insulin to manage that extra sugar intake.

And when you’re preparing for the one hour glucose test, you don’t really need to change your diet, because we want to know how your body is functioning as you would normally be eating and drinking. The general recommendation is to avoid high sugar melas like pancakes, juice, or donuts the morning before your test, but you can’t really cheat the test by eating healthy or something the week before. 

Trust me, I’ve been there and didn’t want to have gestational diabetes so in my brain I’m just like I’ll be good for the week before and eat less sugar and more vegetables and trick the test… but it’s not really how that works. Remember too you want to know if you have gestational diabetes, you wouldn’t want to mask something potentially serious like this, right? And I can’t assume that for everyone, but those are my thoughts.

But of course it’s still good to eat lots of vegetables, whole grains, limit high-fat proteins, and drink plenty of water. I also recommend moving after meals like walking for 10 minutes or so, that is good enough. One tip if you do any version of the glucose screening test is to bring a snack with protein with you to your appointment and eat it after your blood is drawn and the test is over to help stabilize your blood sugar from dropping really quickly after that fast rise form the 50 grams of sugar drink.

Some people are just fine and it doesn’t affect them, but if your sensitive, which is especially possible in pregnancy you may experience an increased heart rate, nausea, feeling really thirsty, and overall just unwell due to that sugar “crash”.

And that is the glucose challenge test, but then like everything else I talk about, is this something you’re actually interested in doing because everything is a choice in pregnancy and birth I can’t stress that enough. So the benefits we know of the test are to help determine if we have gestational diabetes, but at what cost? Is it really worth it?

And 25% of women do not pass the 1-hour glucose challenge test and go on to do the 3 hour test. I know it’s a pain for sure, you don’t want to make time for extra tests that take hours and hours, but I’ll talk about how it’s important this is not a test that is skipped in my opinion. 

There are risks of uncontrolled blood sugar during pregnancy if you have gestational diabetes if it isn’t monitored or managed properly can cross the placenta and affect the developing baby as they grow, possibly causing complications over time like… High birth weight increasing birth injury or cesarean birth,  preterm birth and respiratory distress syndrome for baby, low blood sugar which in severe cases may cause seizures in baby, higher risk of obesity and type 2 diabetes later in you or your child’s life, and for mom, increasing the risk of preeclampsia, which is high blood pressure in pregnancy.

So I believe that gestational diabetes isn’t something to fear, it’s just good to know how your body is functioning during pregnancy so you can take proper precautions with diet and exercise and have a really healthy pregnancy.

At a minimum, there should be a discussion about the benefits, risks, and alternatives to glucose testing and what side effects can be, to make an informed decision.

The next thing I wanted to talk more about is the options for testing. You may have heard women declining the diabetes screen because of the ingredients in the Glucola drink that doctor’s offices provide. And you’re not wrong to question it. 

The Glucola sugar drink has several ingredients that many people try to avoid… especially in pregnancy we want to know what goes into our body. These include 50g of dextrose sugar, an ingredient in corn syrup, “natural flavor” which is an umbrella term similar to “fragrance” when looking for non-toxic products. Companies can put multiple ingredients under this term without disclosing what is added under the “natural flavor”. 

Brominated soybean oil which is banned in Europe and Japan because it can inhibit thyroid function, irritate the membranes lining body cavities and the surfaces of your organs, and can cause neurological symptoms. Artificial colors and dyes that are being studied for inflammatory effects and have been thought to cause migraines and allergies. The preservative, sodium benzoate , and sodium hexametaphosphate, used as a texturizer. There are several ingredients with potential adverse effects, so is something to be aware of.

And this list may be surprising to you, but remember that the glucola drink in pregnancy is optional. It’s common and standard and heavily pushed by your provider and I also believe I personally would want to know if I had gestational diabetes since it’s something that I likely wouldn’t have signs and symptoms of, but would place me and my baby at risk. BUT please know, if you would also like to test, the Glucola drink is not the ONLY way to test.

So one alternative is tracking your blood sugars for two weeks at home with a finger poke, 2 hours after each meal. According to the American Diabetes Association, the target for women testing blood glucose levels during pregnancy should be 120 or less 2 hours after meal. Also known as a 2 hour postprandial reading.

But if that doesn’t sound appealing because of the multiple pokes or taking two weeks to test, there are other alternatives as well.

You can try an organic candy alternative consisting of 50 grams of sugar. These options do not contain the same 50 grams of dextrose sugar like in the Glucola drink, but it’s unclear whether the different sugar types can lead to missed diagnoses of gestational diabetes because different sugars have different effects on blood sugar levels. Many candies of course too have other ingredients and dyes just like glucola as well if that is the concern. The most important part is to find an alternative that is 50g of sugar. This can be difficult to exactly transfer to the recommended 50 grams of glucose though because for example, Twizzlers has corn syrup, wheat flour, sugar in the form of sucrose, and cornstarch. According to Racusin 2013, one disaccharide sucrose molecule is composed of one-half glucose and one-half fructose. So each gram of sugar in Twizzlers would only have half the desired effect. So, there are flaws to this as well.

But some alternatives you may hear about are eating 60 organic jelly beans, buying organic dextrose and dissolving it in 8 ounces of water, 6 ounces of organic orange juice and 1 banana, 16 ounces of orange juice, 10-12 ounces of non-GMO grape juice, 10 ounces of non-GMO apple juice, or my preferred method that I would 100% do if I have another baby, is The Fresh Test. And I am not an affiliate or influenced in any way to share this product with you, but just from personal experience and the research I’ve done this option is great!

And what The Fresh Test is, it’s a diagnostic glucose beverage to be used to screen for gestational diabetes. They offer both a powdered version and premixed one. For the powder, you just mix it with 10 ounces of water until it's dissolved, drink it over less than 5 minutes and have your blood drawn one hour later.

There are only three ingredients including: non-GMO organic dextrose, crystallized lemon, and organic peppermint leaf to help with nausea and taste. The cost is $17 for one 50g pack. It is FDA registered and gluten, dairy, and latex free. And if you’re interested, you can find more info at thefreshtest.com or on instagram @thefresthtest. These links are in the show notes as well. 

I just think it’s a really amazing option with clean ingredients, I’ve heard it tastes great just like lemonade, and and wish I would have known about it sooner for my own use too!

So, I just wanted to wrap this up and say, please don’t be afraid of the test because you’re afraid of the results. It’s important for you and your baby. Know your options and choose what is right for you. The Fresh Test and the two hour postprandial blood sugar readings for two weeks are both really great options! And if you are diagnosed with gestational diabetes, it may feel overwhelming and scary BUT I have resources there for you to check out as well. 

Leslee Flannery at Gestational Diabetes Nutrition is a registered dietician that specializes in helping women with gestational diabetes lower their blood sugar and deliver a healthy baby! She has resources to learn how to portion and pair carbs, enjoy sweets without the sugar spike, lower fasting blood sugar, incorporate supplements, exercise, hydration, sleep, and stress management to lower blood sugar, and also postpartum expectations. She has a wealth of information and you should definitely go and check out her page @gestationaldiabetesnutrition if you’re interested! 

Gestational diabetes is an area where additional tests and medication is often recommended, so having the support and resources to manage this in a way that you feel comfortable is so important. Not just going along with the status-quo. Lead with intention for sure!

Thank you so much for listening to Your Birth Bestie podcast. If you’ve found this information helpful, I would so appreciate you taking two seconds to rate the show! It is the best way to support me and also help me reach more women all over to ensure they are also well-informed to have an autonomous pregnancy and hospital birth experience! I appreciate you for being here and I will see you next week!