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Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

Jelly Beans instead of Glucola for GD Screen

We used the 16 regular sized jelly beans for our 50 gram glucose load and it went way easier in the moms. The routine was(is)--fast for 3 hours, 16 jelly beans, blood draw in exactly 1 hour. Worked fine, and most moms chose that over the liquid.

[from ob-gyn-l]

I'm dubious of this. We tried to do the same thing with 3 Musketeers Bars when was in residency, but the absorption was different. Patient states that her last pregnancy she choked on the glucola. I told her that studies have shown no difference if you dilute the carbohydrate drink, but Jelly Beans?

I would think that Three Musketeers would have fat, which could inhibit absorption, as opposed to jelly beans, which are essentially fat-free. If I recall, the jelly beans had to be Brach's brand in order to make sure the size and number were accurate.

I have always considered the 50 gm carbohydrate drink imprecise, so I'm not too concerned about the jelly beans being imprecise. We have been giving patients the option for the past year or so. Some prefer the jelly beans, especially when they have had nausea or even vomiting in response to the drink in the past. Also, it is convenient to give them jelly beans at 24 weeks, with instructions to eat them 60 minutes before their 28 week appointment.

I just heard Steve Gabbe discuss this at our district meeting (actually, last October). He uses it occasionally. The problem, though, is the study was only validated with Brach's jelly beans. In addition, they have to be eaten within 2 minutes. Only half of his residents could eat 18 jelly beans completely within 2 minutes.

Is it necessary to chew or can they be swallowed whole?

We began using jelly beans this year, and have not noted any problems with our patients' ingesting 18 jelly beans in 2 minutes. There are a lot of satisfied women that were grateful they weren't required to drink "the orange stuff". We had a run of 3 pregnant women vomiting in the lab waiting area and our lab director initiated the jellybeans. We are tracking our positive/ negative rates.

Oh, yes, and we always encourage chewing.

We've been offering the 18-regular-sized-jelly beans-after-3-hours-of-fasting-draw-the-blood-1-hour-later glucose test at 28 weeks (our back-ups are REAL attached to screening) and most moms prefer it a lot over the 50 mg orange pop route.