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Am J Obstet Gynecol. 2015 Apr;212(4):522.e1-5. doi: 10.1016/j.ajog.2014.11.010. Epub 2014 Nov 13.

Candy twists as an alternative to the glucola beverage in gestational diabetes mellitus screening.

Author information

1
Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX.
2
Divisions of Endocrinology and Nutrition, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX.
3
Division of Maternal-Fetal Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX; Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX. Electronic address: aagaardt@bcm.tmc.edu.

Abstract

OBJECTIVE:

Screening for gestational diabetes mellitus commonly uses an oral glucose challenge test with a 50-g glucola beverage and subsequent venous puncture. However, up to 30% of pregnant women report significant side-effects, and the beverage is costly. We hypothesized that equivalent glucose loads could be achieved from a popular candy twist (Twizzlers; The Hershey Company, Hershey, PA) and tested it as cost-effective, tolerable alternative with a test of equivalency.

STUDY DESIGN:

The glucose equivalent of the 50-g glucola was calculated as 10 candy twists. We initially used a triple crossover design in nonpregnant patients whereby each subject served as her own control; this ensured the safety and equivalency of this load before using it among pregnant subjects. We then recruited pregnant women with an abnormal screening at 1 hour (glucose challenge test) in a double crossover design study. Subjects consumed 10 candy twists with a 1-hour venous blood glucose assessment. All subjects subsequently completed the confirmatory 3-hour glucose tolerance test. Sensitivity, specificity, positive predictive values, negative predictive values, false-referral rates, and detection rates were calculated.

RESULTS:

At ≥130 mg/dL, the sensitivity (100%) was the same for candy twists and glucola. However, the false-referral rate (82% vs 90%), positive predictive value (18% vs 10%), and detection rate (18% vs 10%) were improved for candy twists when compared with the 50-g glucola beverage.

CONCLUSION:

Our results indicate that strawberry-flavored candy twists are potentially an equally effective screening test, compared with the gold standard glucola beverage but lead to fewer false-positive screens and therefore could be a cost-effective alternative.

KEYWORDS:

diabetes mellitus; gestational diabetes mellitus; screening

PMID:
25446695
DOI:
10.1016/j.ajog.2014.11.010
[Indexed for MEDLINE]

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