I think alternative forms of the test are fine, so long as they provide a strict enough challenge. And as long as blood sugar is monitored at more than just a one hour period. Plenty of people don't spike at one hour, especially with food.
But I do take issue with the whole "50g of glucose is unrealistic" idea. I felt that way when I first learned about the test. But then I actually had to start on the GD diet, and I realized...50g is nothing. All carbs ultimately break down into glucose. And it is SCARY how easy it is to rack up 50g of carbs. That's just 2 flour tortillas. 2 slices of white bread. A tiny serving of pasta. Most people are probably eating WAY more than that at any given time unless they're already eating a diabetic diet.
The test doesn't expect the body to react to straight glucose the way it would for food, in any case. The target they'd want you under for a meal with equivalent carbs is lower. And in a perfectly normal person, it shouldn't make any difference. Straight glucose in a normal person should stimulate insulin production like crazy. And if it doesn't, you might not be full blown GD, but you ARE experiencing increased insulin resistance. Which could present a problem if you're eating any carb heavy meals. The only way to know for sure would be to monitor.
I don't think the test is perfect. But, I also don't think too many people being diagnosed as GD is a problem. Eating well and watching your sugars may be a pain, but it won't do any harm. The real issue, to my mind, is that it's treated as a high risk diagnosis by so many doctors and sets up so many potential interventions, even when it's borderline or mild.
Originally Posted by Jaimee
I'm still skeptical of this explanation given to you. No one normally ingests 50g of glucose in a matter of minutes. Glucose is not the sugar that is found in most foods- it is a monomer of other forms of sugar like sucrose. Sucrose and fructose (found in fruits, is a monomer like glucose) must be converted into glucose in the body to be used/stored. The body has many metabolic controls for these processes, which further help control the levels of glucose in your blood. So even if the amount needed to affect your body decreases as you progress in your pregnancy, it's still not natural to ingest straight glucose and the body can easily over react to it when it would not over react to other forms of sugar ingested. I stand by alternative forms of the test to increase accuracy.