Pregnant moms are skipping the glucose test ‒ but is that safe? (2025)

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When you're pregnant, you can expect – and probably get pretty used to – a lot of prenatal tests. But one screening many moms-to-be dread in particular is the glucose test, which happens around halfway through pregnancy to check for a condition called gestational diabetes (GD).

The glucose test has developed a reputation for being nausea-inducing because it involves swigging a super-sweet drink, and as a result, some moms wonder if they really need to do it.

"Is anyone skipping the glucose tolerance test?" asks BabyCenter Community member CourtneyRivers. "I'm thinking I'll refuse. Anyone else going to do that?"

While it's understandable to shudder at the idea of downing a sickly-sweet beverage, here's what ob-gyns want you to know before skipping this screening.

What is the glucose test?

The glucose test, also sometimes called the glucose challenge test or glucose screening test, is a way for your ob-gyn to determine if you have gestational diabetes. "This is similar to adult-onset diabetes, but it's limited to pregnancy," explains Christina Han, M.D., an ob-gyn and professor of clinical obstetrics and gynecology at the David Geffen School of Medicine at UCLA. "It happens because your placenta is pumping out healthy pregnancy hormones, but these hormones are making it hard for you to use the sugars in your bloodstream."

As a result, sometimes too much glucose (a.k.a. sugar) remains in your blood, and for some moms-to-be, their body isn't producing enough insulin to keep levels in check. This is a sign that you may have gestational diabetes. The condition usually develops about halfway through a pregnancy, typically around 24 weeks, says Sherry Ross, M.D., an ob-gyn in Santa Monica, California. That's why the American College of Obstetricians (ACOG) recommends all pregnant women take the glucose test between weeks 24 and 28.

The test is performed in two stages: First, you drink a sweet beverage, typically glucola that contains 50 grams of sugar. An hour later, your provider will draw blood from your arm and test the sample to see if your blood sugar levels are normal. (You'll probably get the results a day or two later.) If those levels seem high, your doctor will likely recommend a second test.

This time, you'll have to fast for eight to 14 hours before your appointment. You'll drink a beverage with 100 grams of sugar, then wait three hours to have your blood drawn and tested again. If the results from this test show high blood sugar, you'll be diagnosed with gestational diabetes.

The good news is that if you do get a gestational diabetes diagnosis, the condition is manageable, says Dr. Han. But it's critical to get tested and diagnosed. The potential complications of untreated gestational diabetes can be serious for you and your baby.

"If you're unable to clear the sugar from your bloodstream, then this indicates that the baby may receive too much sugar during the pregnancy," she says. That can lead to changes in your little one's size and potential challenges during labor, such as a higher risk of a C-section and heavy bleeding after delivery.

Why are moms refusing the glucose test?

Some moms-to-be have varying concerns about the glucose test that they are flagging in the Community and across social media:

They don't think they could have GD

A common reason for wanting to skip it? "Some don't think there is any way they would have diabetes," says Dr. Ross. As a result, they might feel like there's no point in going through the hassle of taking yet another test, especially one that takes a while and could make them nauseous.

Gestational diabetes does not discriminate.

– BabyCenter Community user Jordanburley

There are certainly some factors that can increase your chances of having gestational diabetes – being overweight, not getting enough exercise, or having high blood pressure are a few examples. But one reason why the glucose test is so important is because the condition is known to develop in moms-to-be with no risk factors at all.

"This is my fourth gestational diabetes pregnancy, [and] I've never had symptoms," says BabyCenter Community user Dallyitup. "I eat healthy, have a healthy weight and BMI, and exercise five days a week."

They think the glucose test drink will make them nauseous

Other moms worry that the glucola will upset their stomach. "I have had severe emetophobia for 17 years, which is the fear of throwing up," says Community user ManningsMom. "I have heard so many people say how awful the test is and how sick they got."

Some research does suggest that as many as 30% of pregnant women may have trouble tolerating the drink. But it can help to keep in mind that the 10-ounce bottle "is similar to the sugar content of a regular soda," Dr. Ross points out. To manage nausea, she recommends asking for the drink chilled and drinking it a little more slowly.

They're concerned about the drink's taste or ingredients

Some moms-to-be say they’d prefer to avoid certain ingredients (like food coloring) in the glucola test, and still others are worried about the unappetizing taste. For both of these concerns, some moms are working with their doctors to order something called The Fresh TestOpens a new window, a new Food & Drug Administration-registered alternative to the standard glucose beverage.

The Fresh Test has a shorter ingredient list and claims to be better-tasting. “[It] tasted amazing, like lemonade you’d get from the fair, and it never made me feel icky," says Community user Brittany32323.

While your ob-gyn's office will provide you with the glucola beverage, you'd have to purchase The Fresh Test on your own ahead of your appointment. This can be a good option for moms-to-be who are particularly focused on taste or ingredients, says Dr. Ross. "The Fresh Test has been positively vetted and approved by medical organizations as an alternative to the traditional gestational diabetes testing," she says.

Insurance typically doesn't cover The Fresh Test, but you can use an HSA or FSA card to pay for the drink, which costs up to $27 (depending on the formulation you need), plus shipping.

They're nervous about the blood draw

Finally, some women have a fear of getting their blood drawn, which is an important part of the test. And unfortunately, multiple prenatal tests and procedures (like the NIPT and routine IVs) involve needles.

If the idea makes you a bit squeamish, there are ways to feel more comfortable. "I'm terrible with getting blood drawn and I always lie down; that helps," says user Beachygirl82. "I also picture ocean waves at my favorite beach. I got blood drawn this week and was fine."

Also worth trying, according to Dr. Ross, is asking your doctor if they can use a smaller needle. "Bringing in a friend or partner to hold your hand, listening to soothing music, or practicing focused or mindful breathing also helps distract from the blood draw," she adds.

Are there any safe alternatives to the glucose test?

All of the concerns above are valid, but it's still worth getting tested for gestational diabetes. And while there are some medically acceptable alternatives to the glucose test out there, such as The Fresh Test mentioned above, many others are unfortunately not considered acceptable substitutes. "The issue is that many have not been studied to make sure that they are indeed equivalent to the original method," explains Dr. Han.

For example, you may have heard about some moms-to-be who request soda or candy instead of glucola since they're better-tasting and easier to eat. And there's actually been some research on this: In a 1995 studyOpens a new window, scientists found that 18 jelly beans might be a reasonable alternative to the glucose drink, while a more recent study in 2013Opens a new window showed comparable results when pregnant women ate 10 Twizzlers. But these studies were small, and more research is needed to confirm whether the more-delicious methods can reliably test for gestational diabetes.

“Other forms of glucose, in foods, gels, or powders, are not standardized to ensure the person is being given the exact amount of glucose,” says Dr. Ross.

The hemoglobin A1Cblood test is another commonly discussed alternative among moms. This test involves drawing blood to determine a person's blood glucose levels over a three-month period without requiring you to drink a sugary beverage. It can catch other forms of diabetes, but it's not considered as good of an option during pregnancy because of the way red blood cells get processed when you're pregnant, Dr. Han explains. It isn't considered sensitive or accurate enough to catch the gestational form of diabetes.

The bottom line? The glucose test is still the gold standard, and the only definitive way to check whether you have gestational diabetes. And while skipping it might seem tempting, especially if you're prone to nausea right now, it's still really important to get this test.

Gestational diabetes can develop without any symptoms or risk factors, and even if you've been fine in prior pregnancies. "[My past] three pregnancies, I passed the one-hour glucose test, [but] now I'm on my fourth pregnancy and I failed it," says user Jordanburley. "Gestational diabetes does not discriminate."