Pregnancy Glucose Test Alternatives for Gestational Diabetes

Gestational diabetes often has no noticeable symptoms, which is why testing is a routine part of prenatal care. Your provider will usually recommend testing between 24 and 28 weeks of pregnancy.^1,2,3

The process often starts with drinking a glucose beverage and having your blood drawn an hour later. Your results help your provider decide whether you need further testing for gestational diabetes.^2,3

Some pregnant women dislike the drink’s taste or have concerns about its ingredients or side effects. If you’re looking for an alternative, it helps to know whether you need a different drink or a different testing approach. Those are separate conversations to have with your provider.

What Is the Pregnancy Glucose Test?

Your provider may order a glucose challenge test to screen for gestational diabetes or an oral glucose tolerance test to diagnose it. In the common two-step approach, an elevated result on the one-hour screening test is followed by a three-hour diagnostic test.⁵

First, you drink the glucose screening beverage containing 50 grams of sugar; typically, glucola is the drink of choice. You don’t have to fast for this test. Then, an hour later, your blood is drawn to examine your blood glucose level. If your blood glucose reaches or exceeds your provider’s screening cutoff, commonly 130, 135, or 140 mg/dL, you may need a glucose tolerance test.^5,24,28

The three-hour glucose tolerance test requires fasting beforehand; follow your provider’s instructions. Your blood is drawn before you drink a beverage containing 100 grams of glucose, then again one, two, and three hours afterward. Your provider reviews the results to determine whether you have gestational diabetes.^2,5

Some practices use a different approach: a fasting, two-hour test with 75 grams of glucose. Your provider will tell you which testing approach they use.²⁸

Related: Glucose Test During Pregnancy: Everything You Need To Know

Is There an Alternative to the Three-Hour Glucose Test?

If you cannot tolerate the three-hour test, ask your provider about an individualized testing plan. Home blood sugar monitoring may be considered in some circumstances, but it is not an established, interchangeable replacement for everyone.^28,29

If your concern is the drink’s flavor or ingredients, ask whether your lab accepts another glucose beverage. Changing the drink does not eliminate the test’s timed blood draws.^5,11

Potential Glucose Test Alternatives

The options below serve different purposes. The Fresh Test is another glucose beverage, while home monitoring changes how blood sugar is assessed. Candy has also been studied, but the research does not make it a routine substitute. Discuss the specific option with your provider and lab before changing your test.^8,9,11,29

The Fresh Test

Some providers and labs accept The Fresh Test as an alternative glucose drink. It comes as a powder or a ready-made beverage. The lemon-mint powder contains dextrose, crystallized lemon, and mint; the ready-made beverage also contains water.¹¹

The Fresh Test comes in different glucose amounts, so confirm the exact product and dose your provider and lab accept before buying it.¹¹

A small comparison study found that all 10 participants preferred it to another glucose beverage, but none of the participants were pregnant.¹⁸

Check your insurance coverage before purchasing, since you may need to pay for the drink yourself.

Jellybeans and Twizzlers

Small studies have examined jellybeans and Twizzlers as alternatives to the drink used for a 50-gram glucose screening test.^8,9 However, the Twizzlers study involved nonpregnant participants, so it does not establish how well this option works during pregnancy.⁹

These studies do not establish candy as a substitute for the three-hour diagnostic test. Do not replace your prescribed drink with a counted portion of candy unless your provider and lab have specifically arranged that testing method.^8,9

At-Home Blood Sugar Monitoring

Your provider may consider home blood sugar monitoring if the usual glucose test is unsuitable, including after certain bariatric surgeries.^14,22,23 At-home testing involves a finger prick to collect a drop of blood, which a glucometer uses to measure your glucose level.^19,20

Your provider will tell you when to check your blood sugar, how many days to test, and how to submit your readings. Home monitoring has been proposed for specific situations, but it is not a universally validated replacement for an oral glucose tolerance test.²⁹

Before choosing this approach, ask:

• How often will I need to check my blood sugar?
• Will my insurance cover the meter, test strips, and lancets?
• What should I do if I miss a reading?
• How will you interpret the results and decide whether I need further testing?

Common Concerns About the Glucola Beverage

Artificial Dyes and Food Additives

Ingredients vary by product and flavor. If you have an allergy or want to avoid a particular dye or additive, ask your provider or lab for the ingredient list of the drink they use.

You may also encounter older concerns about brominated vegetable oil (BVO). The FDA revoked its authorization for use in food in 2024, with a compliance deadline of August 2, 2025.⁴

Side Effects

Some women report experiencing side effects after consuming glucola, including nausea, dizziness, and fatigue.³

If you have had bariatric surgery, tell your provider before testing. Certain procedures can affect both tolerance of the glucose drink and interpretation of the results, so a different testing plan may be needed.^22,23,29

Can I Refuse the Glucose Test When Pregnant?

You can decline recommended testing. Your provider should explain the benefits, risks, and available alternatives so you can make an informed decision.³⁰

Even healthy, active women can develop gestational diabetes, and it often has no noticeable symptoms. Screening can identify the condition so you and your provider can discuss treatment.^1,13

It’s also important to consider the possible complications of gestational diabetes. These can include:^7,10,12

• Higher birth weight or larger baby size, which increases the risk of needing a C-section delivery
• Higher incidence of birth injury (such as shoulder dystocia) to the baby since they’re larger
• Increased risk of preeclampsia in the mother
• A premature or early birth, which can involve breathing difficulties for the baby
• Low blood sugar (hypoglycemia) in the baby, which can cause seizures in severe cases
• Increased risk of type 2 diabetes in the mother later in life
• Increased chance of newborn jaundice and possible neonatal intensive care

If you have concerns about the glucose screening process, talking openly with your provider can help you make the most informed decision for your pregnancy.

Related: 5 Questions (And Answers) About Gestational Diabetes

Talk With Your Provider About Testing Options

If you’re worried about the glucose drink, tell your provider what concerns you: the taste, an ingredient, or a previous reaction. Ask whether another drink is accepted or whether your medical history calls for a different testing plan.

Before your appointment, confirm which test you’re having, whether you need to fast, and what to do if you cannot finish the drink. Knowing what to expect can make the process feel more manageable.