Twizzlers as a Cost-Effective and Equivalent Alternative to the Glucola Beverage in Diabetes Screening

  1. Kjersti M. Aagaard, MD, PHD1,3
  1. 1General Division, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
  2. 2Divisions of Endocrinology and Nutrition, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
  3. 3Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
  1. Corresponding author: Kjersti M. Aagaard, aagaardt{at}bcm.tmc.edu.

Screening for gestational diabetes mellitus requires an oral glucose challenge test with a 50-g glucola beverage and venous blood sample after 1 h. A “positive screen” is defined as a venous blood glucose of either >130 mg/dL or 140 mg/dL (1,2), and the patient then undergoes a diagnostic fasting 3-h glucose tolerance test (GTT) with a 100-g glucola (1). However, up to 30% of pregnant women cannot tolerate the traditional 50-g glucola beverage (3,4). There are few reports demonstrating viable and cost-effective alternatives, such as commercially available candy. For example, jelly beans have been shown to be better tolerated but with demonstrated lower sensitivity, potentially related to their variability in size and resultant difficulty in calculating glucose load (3,4). We therefore sought to identify whether other forms of candy (such as …

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