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

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.

• Authors: Diana A Racusin, Kathleen Antony, Lori Showalter, Susan Sharma, Morey Haymond, Kjersti M Aagaard
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 212 Issue 4 Pg. 522.e1-5 (Apr 2015) ISSN: 1097-6868 [Electronic] United States
• PMID: 25446695 (Publication Type: Clinical Trial, Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Carbohydrates
• Glucola

Topics

• Adult
• Beverages
• Candy
• Carbohydrates
• Cross-Over Studies
• Diabetes, Gestational (diagnosis)
• Female
• Glucose Tolerance Test
• Humans
• Pregnancy
• Sensitivity and Specificity
• Single-Blind Method