A Healthier Gestational Diabetes Test Alternative

If you followed along with my last pregnancy, you’ll recall that I was required to consume the neon-orange colored glucose drink (not once, but twice!) to test for gestational diabetes.

At the time, it was the only option my doctor would give me, and the way my health insurance worked back then I didn’t have a whole lot of options other than leaving my doctor and opting for a home birth– which we weren’t prepared to do. So I drank the drink and mentally apologized to my growing baby for flooding him with food dyes and preservatives that I would otherwise never consume. What a terrible practice to be forced on so many pregnant women!

glucose tolerance beverage

This time around, I was determined to find a better way. I have a new doctor for this pregnancy, and she knows how I feel about doing things as naturally as possible. (I think it helps that I already have one unmedicated hospital birth under my belt– I feel like doctors believe you more when you have already been through labor.) I told her how terrible my previous glucose testing experience had been, how I received a false positive with the one-hour test, how I felt terrible for nearly a week after my 3-hour test, and how I would really, really, really appreciate another option. And lucky for me, she gave me one.

My Alternative 

Instead of ingesting a corn-derived, artificially-colored drink that I would most likely never consume on a normal basis, I’m simply testing my blood sugar four times a day using a glucose monitor for one week– when I hit the 30-week-mark in my pregnancy. Doesn’t that sound reasonable? What I love about this approach is that I get to see how my body handles the real food I eat on an everyday basis, which seems like it will provide a more accurate result anyway.

testing blood sugar

The only downside is that I hate needles, and poking my finger 4 times a day isn’t fun. But, after the first few times I’ve finally gotten the hang of it and it really isn’t that bad. This alternative simply involves testing my blood first thing in the morning (to get my fasting number), and then I have to test it again 2 hours after each meal I eat, for a total of 4 times each day. After talking to my doctor, this is what I would have to do if I were to skip testing for gestational diabetes, anyway– they would treat me as if I had diabetes to be on the safe side, and I’d have to test my blood sugar 4 times a day until I gave birth.

The only issue I’ve had with this method is that during this pregnancy, I tend to graze all day long. So, I have to consciously NOT eat so that I have 2 hours for my body to process the food I’ve consumed and can get an accurate blood sugar reading. To accommodate the test, I drink my morning smoothie and eat my mid-morning snack of raw nuts all at the same time, so that my body won’t get too hungry while I wait the 2 hours before testing. (I realize it sounds ridiculous that I worry about going 2 hours without food… ha!)

Just for Fun

As it turns out, my glucose numbers are perfect, so I’ve started having a little bit of “fun” while I have this glucose monitor and must poke my finger anyway. By fun, I mean I’ve been trying out different food combinations to see how they affect my glucose levels. For example, yesterday I had an all-fruit meal for breakfast to see if it would spike my blood sugar the way everyone always assumes it will, and in contrast, I had a low-carb breakfast another morning to see how my blood sugar responded to that. Below are my results!

All-Fruit Breakfast

Most experts agree that in a healthy person without diabetes, your blood sugar will spike (regardless of what you eat) 45 minutes to an hour after a meal. This is why you test 2 hours after a meal, because your blood sugar should return to normal by then. I’ve always been taught that fruit digests faster than any other food, and according to my glucose numbers, that theory is correct. My glucose reading after the all-fruit meal, which contained a whopping 92 grams of natural sugar, was by far the lowest glucose number I’ve had all week! I assume that’s because my body was able to process the natural sugar and get it out of my blood stream as quickly as it had entered. This number is actually borderline low, and my body was definitely telling me it wanted more food at this point, but I waited the full 2 hours post-meal because I wanted to be as consistent as possible with these readings.

smoothie in a cup with a straw and testing blood glucoseThis is why I don’t fear fruit. I am curious to see what would happen to my blood sugar if I ate 92 grams of refined sugar in one sitting, but at the same time, I don’t necessarily want to do that to my body or baby to find out. Although, on a side note, when I took the 3-hour glucose test during my first pregnancy, my blood sugar wasn’t nearly that low at the 2-hour mark, so my body definitely struggled to get that processed sugar out of my blood stream when compared to my all-fruit meal above. 

Low-Carb Breakfast

To compare and contrast with the all-fruit meal, I had a low-carb breakfast the following morning which had only 4 grams of sugar, naturally found in the eggs and cheese. My glucose reading was about average after this meal, not any lower than other normal meals I had eaten this week (94 has been my average post-meal reading), which I found interesting since the whole meal consisted of only 5 grams of carbohydrates and my other meals are much higher in carbs. I wonder if the higher fat content kept even that small amount of sugar in my blood stream longer, as I’ve read that fat could be a culprit behind higher blood sugar readings.

skillet with scrambled eggs and testing blood glucoseTurkey Wrap Lunch

Out of curiosity, I’ve also tried to eat some typical lunches, like a turkey sandwich wrapped up in a tortilla, which contained decent amount of carbs, protein, and fat. I’ve had a busy week running errands over my lunch break, so I picked up this wrap at Whole Foods– it’s made to order with warm turkey, field greens, tomato, red pepper, and avocado wrapped up in a large spinach tortilla. Out of all my meals, this one left me with the highest glucose reading I’ve had all week. (Though any reading under 120 is considered perfectly fine as a post-meal glucose reading when testing for gestational diabetes.)

turkey wrap and blood glucose reading

Note: I’ll probably update this post as I continue to test. Another thing I want to look at is how a cup of coffee might affect my “fasting” glucose number, as I’ve heard that plain black coffee can elevate blood sugar, even without cream or sugar added. I’d also love to see if my fasting number goes down after drinking apple cider vinegar at night, as I recall reading that it has been proven to lower blood sugar.

Other Glucose Test Alternatives

In case you’re curious, here are some other alternatives to the glucose test that I discussed with my doctor, along with why she doesn’t recommend them:

A1c Blood Test. This blood test can give you a look at your blood sugar level average over the last 3 months or so, which is great for testing for diabetes in non-pregnant people. The reason why my doctor doesn’t like this test for determining gestational diabetes, is that this condition typically won’t show up until much later in pregnancy. In fact, that’s why she didn’t even want me to test my blood sugar until I was 30 weeks along, because gestational diabetes might not make an appearance until the last 8 to 10 weeks of pregnancy. So, it doesn’t really matter what my blood sugar average has been over the last 3 months– I could still develop diabetes and it could go undiagnosed if we relied on the A1c test.

Eating an equivalent amount of glucose in food or fresh juice. I’ve heard that some midwives will let their clients eat a certain amount of grapes, orange juice, or jelly beans to get to the 50g of glucose found in the standard orange drink. My doctor wasn’t comfortable with that idea, because she felt there were too many variables involved. Since food can vary, she was afraid I’d be eating too much or too little sugar and wind up with an inaccurate result– which could potentially lead to undiagnosed diabetes, or falsely diagnosed diabetes, neither of which is ideal.

I hope you all find this post useful, and that it might help any pregnant women in the future know that there ARE alternatives to the neon-orange glucose drink, even if you have a very traditional mainstream doctor. If nothing else, I learned this time around that they do make a dye-free drink— which would make me feel a little better about drinking it 3 years ago. Why don’t they make that the standard?

Note: If you have no choice but to take the glucose test, I’ll pass on this tip that my doctor shared with me: Rather than eating a low-carb meal before you take the test, as so many doctors recommend, she actually recommended eating a low-fat, higher-carb meal because the body seems to respond to the test better that way. (Possibly because the blood clears out simple sugars faster than it does fat, as shown by my numbers above?) Since false positives are fairly common with the one-hour glucose test, I wonder if this tip might help to avoid that. Also, it’s not uncommon for fasting numbers to be higher than post-meal numbers, so if I had to do it again, I would definitely eat something 2 hours before taking the one-hour test. (You must fast for the 3-hour one, so it’s not an option there.) I fasted for my one-hour test the last time, and failed it by one or two measly points, but went on to pass my 3-hour test with flying colors.

Reader Feedback: If you’ve ever been pregnant, did your doctor offer you an alternative to the glucose test? I’d love to hear if there are any other options available!

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Comments

Alys

I had a midwife (hospital birth) for my second baby and that test was optional to do. You have to be healthy, low risk snd have normal blood pressure but they didn’t pressure us at all. For my first I had an OB and I did drink it for the test but I never even thought to ask if it was optional at all. I’m not sure if it is optional because we don’t deal with health insurance companies since in Canada we havr free health care, interesting though. All the best in the rest of your pregnancy.

Jennifer

Why not just decline the test of have not had any risk factors or better yet opt for a home birth? You eat extremely healthy. I’m delivering any day now with baby number 6 and I’ve declined the test in 4 different states under the care of doctors and midwives. I’d never consume such an awful drink. I took a hypoglycemic test once which is quit similar and it was grueling. But sound while pregnant seems insane. At least with the machine you are getting some more accurate reading, but one can over analyze it all and miss all joy of being pregnant. Just my thoughts!

    Megan Gilmore

    I have a friend in New York who was kicked out of her doctor’s practice for declining the test, and then she had no choice but to have a home birth because no other doctor would have her without taking the glucose drink. I personally don’t want to have a home birth, though I have a few friends who prefer it that way. To each their own! I actually relax more at the hospital, so that’s where I prefer to give birth, especially after my perfect experience last time around. Congrats on your newest baby!!

Julie

As someone who had GD, I was prepared to go nuts after reading this post, but your alternative method is actually a good one! I had absolutely no risk factors, healthy diet, perfect weight gain, exercise, and honestly didn’t even crave sugar when I was pregnant, yet had it not been for a test, I would have missed something so important. I’ve read a lot of bloggers suggesting to eat something else instead, but the orange stuff provides a controlled amount of glucose. Yes, they should work on standardizing something much healthier to consume, but I do NOT agree when I hear that “oh, my midwife said I could ditch the test because I have no risk factors” or “I just ate oatmeal instead.”

GD can cause many complications to the placenta and baby at birth and for the rest of his/her life. The risk of missing it is just too much, even if it means a false positive and going through another test. Testing your blood sugar the way someone who is diagnosed would is a good method, though for all the reasons you state (you can’t eat whenever you want) might make it tough for some. Still, if I were to be pregnant again, I would start this early knowing that it’s likely I’d have it again and don’t need to wait for the test.

    Jennifer

    Just to clarify, my midwives or doctors never suggested that I could decline it as that would be illegal, however, they can inform you that you have a right to decline testing. I declined it based on having taking the test and it literally messed me up and it was negative. As a patient you have the right to decline most, if not all of the testing offered. Let’s remember, that in other parts of the world they fare just fine in pregnancy as it is a natural process that God created. I am very comfortable with my trust fully in Him for this process to go well. I’ve delivered in hospitals with and without intervention and others at home. My greatest concern is women not be bullied but rather have the birth they would like to have. I’m happy for you that the test had a positive outcome, I just have a totally different perspective on American medicine, the body, soul and mind putting my trust first and foremost in my maker!

    Anne

    I totally agree with you, Julie!

Heather

I had a hospital birth with a midwife and was not only offered, but encouraged to do the four times daily blood test over the drink. I had to do it twice during my pregnancy. And, like you I found it a great way to experiment with how different foods impacted me and what best balanced my blood sugar. Win-win: no terrible drink and I learned a lot!

Tpaz

Your posts are always fantastic, but having been diabetic for years, I just wanted to point out a common misconception. While simple sugars like fruit, chocolate, sugar or honey reach their peak in your body at 1 hour, a normal meal consisting of carbs, fat and protein takes about 2 hours. In the case of a full balanced meal, it takes about 4 hours for blood sugar levels to return to normal.

Charles Rose

That is hugely interesting and encouraging. I didn’t even think to carb up the week before. I thought being in ketosis and having increased insulin sensitivity would insulate me from a giant shot of sugar. I was hopefully wrong and everything is fine. I’m weighing and tracking all my food starting tonight and checking my blood sugar fasting and after every meal. Experiment time!!! I’ll update this post in a few weeks and we’ll see how it goes. Im going to do some research into the reliability of the test. Thank you so much, sincerely.

Kim

I’m due for the test in a few weeks and was so sick having it with my first child. I also do not like all those chemicals!!!! My Dr will not do any alternatives!

Theresa

I knew a woman who had to consume 2 pieces of white wonder bread before her glucose test, instead of ingesting the liquid! Apparently 2 slices of white wonder bread has more sugar than fruit and a lot of candy bars. Not sure what came of that but it’s just kind of interesting.

Lindsay

Love this post! With my first, my doctor was completely supportive of my natural birth plan but encouraged me to just suck it up and do the hour glucose test drink against my better judgment (they did offer the dye free one). He had been so easy going with my every request that I decided to go along with it but just knew I would fail based on the fact that my body would have no idea how to handle that much processed sugar in one sitting! As I suspected I failed miserably and after letting him know I wasn’t comfortable with the 3 hour test he gladly suggested the glucose monitor method. While I showed no symptoms of gestational diabetes he stressed how important it was to be certain and if he couldn’t clear it on my file I’d be treated as if I had gestational diabetes when I got to the Hospital – certainly not what I wanted. I’m 24 weeks pregnant and this second time around will skip the drink all together!

Steph in CH

It’s interesting to hear how this works in the States! I’m in my 3rd pregnancy in Switzerland, and have taken the glucose test every time around 24 weeks. Here, though, it starts with a fasting blood draw at 8 am, after which you have to drink (and eat, the mixture is so thick!) the glucose in 5 minutes. It’s undyed and unflavored, although my doctor allows her assistants to add lemon to it. There are 2 more blood draws, one 1 hour after finishing and one 2 hours after. I’d love to skip it, but my husband worked in diabetology and knows too much about all the risks. 🙂

Lindsay P

I was diagnosed with GD while pregnant with my son about two years ago after failing the 1-hour glucose test by 4 points and getting sick during the 3-hour test. I had no other risk factors (no family history of diabetes, I was healthy, thin and very active, and had only gained a few pregnancy pounds), so needless to say, I was shocked. Having to schedule my food intake around the testing times and pricking my fingers 4 times a day for 12 weeks was awful, but in the end it really opened my eyes as to how food affects my body and my husband and I COMPLETELY changed our diets because of it. We now eat way less carbs and sugar and try to eat vegan when we cook at home, so I am so thankful for websites and cookbooks like yours! I’ll definitely ask my doctor about skipping the horrible drink and doing the glucose test the way you are if I have another child.

Caitlin

I just had a baby (in Winnipeg, Canada) and declined the gestational diabetes test as it made me sick last time and I’m low risk. I am glad to hear that your doctor gave you another option but I can’t help but feel annoyed by the system. If one is informed of the risk of declining a test and still chooses to decline, how is this not acceptable? Is it that health insurance won’t cover you if you decline tests? We own our own bodies bodies and should be allowed to make decisions of what goes into and/or is done to them.

DessertForTwo

This is life changing. I ate SO healthy during my pregnancy (I didn’t even eat an ounce of sugar until the last 2 weeks…surprising coming from me, i know!), and I cringed when I read the ingredients in the glucose drink. And worst of all–I got the red one. All I could think about was RED DYE. I was heart-broken to have to drink it. Next time, I’m insisting that I will not drink that disgusting drink full of preservatives and dyes. THANK YOU SO MUCH FOR THIS <3

Karen

They say that in the second trimester (when moms typically feel beat) that they should start making and freezing meals for when baby comes. When I had my son I didn’t do this because my husband said he would do all the cooking. Little did I know how ravenous I. Would be. I ended up eating not so good food merely because I had the most insatiable appetite. (Lots of bread) I had never been so hungry ever. Do you do any meals before the date? What are ur recommendations to have bountiful meals that are both a. Cost effective. B.Instant freezer meals And c.Filling? I know you’ve done freezer meals before but postpartum freezer meals are a bit different because you need to eat all the time.

    Megan Gilmore

    I didn’t make any of the freezer meals I had planned to my first time around because my son arrived too early! I agree– postpartum is the hungriest I’ve ever been in my entire life. I pretty much survived on the most calorie-dense smoothies I could make along with these Date Energy Balls that I would keep in the freezer for anytime I needed a snack! This time around I’ve actually already got freezer meals stocked up because my second cookbook focuses on budget-friendly fast meals– many of which I’ve tested as freezer and slow cooker meals. Unfortunately, my publisher won’t let me share those recipes yet, so I have to wait until February when the book releases! But a few recipes on my site that currently freeze well are my Cauliflower Pizza Crust (I always have at least 2 crusts in my freezer for a quick meal), along with my Cauliflower Fried Rice, Sweet Potato Noodles, and Coconut Curry, which have freezer directions here: https://detoxinista.com/2015/09/easy-vegetarian-freezer-meals/

    You might also want to make a few salad dressings ahead of time and freeze those, because I found myself craving salads and wraps last time, and they are super easy and fast to prepare if you have a dressing ready to go. My favorites are the Raw Apple Cider Vinaigrette and Creamy Tahini Dressing. Hope that helps!

rebekah

I just had my 8th baby and I am 39. So I am considered a more risky pregnancy. I was able to find a midwife with this baby and it was such a blessing! I too shared my concerns with her about the glucose test and they let me do the glucose testing at home as well for 2 weeks. Hopefully as more and more women voice their concerns for that nasty orange drink more docs will realize how unhealthy and ridiculous it is! With my previous children I drank the nasty stuff without even a thought. It is a shame how brainwashed and thoughtless we are as a society. It is time for an awakening.

Stacy

When I was pregnant, all processed sweets made me sick (even homemade ones). Even the thought of drinking the sugary dyed syrup made me want to puke. My midwife was totally fine with me not doing this test, and instead I did a fasting blood draw, went and had breakfast, then came back two hours post breakfast for another blood draw. That was it. I’m sure if I had started showing any signs of gestational diabetes after that, she would have re-checked, but all else went pretty well.

Debbie S

My midwife suggested the same thing for my 3rd baby (after taking the orange drink for baby 1 and 2)–I did the fasting glucose and then 2 hours after each meal and I kept a detailed food journal which was very interesting. I started experimenting as well with different foods. She had wanted to monitor my results for two weeks, but they were such good readings that after a week she said I could stop. Now I’m nearly to 30 weeks with baby #4 and definitely will do the same thing. I agree that this is a very accurate way to monitor blood sugar levels as long as you’re eating the way you normally do!…and much safer than just declining any testing altogether. Thanks for your website–I’ve been loving your recipes!

Laura

I told my OB that I didn’t want to drink that stuff, since glucose gives me migraines. No problem, she said. She just had me do a fasting blood test (i.e. no breakfast, get blood drawn in the morning). I was worried about my results because I’d been craving fruit and orange juice all through the second trimester, but my numbers were perfectly normal. This doctor is a regular OB-GYN at a regular hospital albeit in a Seattle suburb, so maybe there’s a bit of an east coast/west coast divide.

Lisa

Hi Megan. My name is Lisa. I am on my 8th baby (23 weeks almost). Things are going fairly well. I am 46 years old always having gestational diabetes with every pregnancy. They are not requiring the glucose test at my request. I’ve been testing my sugars 4 times daily. The only issue I’m having is with my fasting numbers…just slightly high. I DONT , I repeat DONT WANT TO HAVE TO TAKE MEDS :).
I’m not up to 1/3 of the numbers high where they start being concerned, but I’m close. Starting tonight I’m going to start taking a 30 minute walk in the evening and for a bedtime snack I’m going to eat a baby bel and 1/2 cup low glycemic full fat premium ice cream with a handful of almonds on top. And right before I head to bed I’m going to take 2 T ACV. Can you give me some input and or tips that might help me. Thank you Megan 🙂

Meghan

This is a wonderful post!! I took the first glucose test & failed it, which seems to be the norm for many women! This lead me to get informed about the risks associated with GD. I too feel our society is broken in the way we fear monger & standardize procedures that are never questioned, just obeyed. I’ll be declining the second (2hr test here in Canada) & opting to test my own blood sugars at home. I wonder if they’ve ever ran statistics on the detriments of micromanaging & scaring pregnant women into conforming to their procedures? Thank you for this!!

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