The glucose screening test is a routine part of prenatal care for many pregnant women. Also called the glucose challenge test or GCT, it screens for gestational diabetes around 24-28 weeks of pregnancy.
Gestational diabetes affects up to 9.2% of pregnancies and can lead to complications if left untreated. That’s why the glucose screening test is recommended as a standard part of prenatal care.
But is it mandatory? Can you actually refuse the glucose test during pregnancy if you want to?
The short answer is yes, you can refuse the glucose screening test. While it’s an important test, it is ultimately your choice whether to take it or not.
This beginner’s guide covers everything you need to know about refusing the glucose test when pregnant, including:
- The glucose screening test is recommended but not legally required during pregnancy. You can refuse it if desired.
- Refusing the GCT means you’ll likely have to take the more time-consuming glucose tolerance test instead.
- Talk to your doctor about your reasons for refusing and alternative screening options. Be aware of potential risks.
- Lifestyle changes like healthy eating and exercise can help prevent gestational diabetes without traditional screening.
- Work with your provider to make an informed decision on glucose testing that you feel comfortable with.
Understanding the Glucose Screening Test
The glucose screening test is done between 24 and 28 weeks of pregnancy for most women. It involves drinking a super sweet glucose drink and getting your blood drawn an hour later to measure blood sugar levels.
The glucose drink contains about 50 grams of sugar, which is more than a can of soda. The point is to see how your body processes a glucose load.
If blood sugar is under 130-140 mg/dL, the test is negative and you likely don’t have gestational diabetes. Higher levels mean you’ll need to take the 3-hour glucose tolerance test to diagnose gestational diabetes.
The glucose screening test is not diagnostic on its own. Its purpose is to flag those at higher risk who need further testing. About 15% of women who take it get a positive result and undergo the glucose tolerance test.
The GCT takes about an hour plus waiting room time. The glucose drink can make some women feel sick, shaky, or lightheaded. But it poses no significant risks and is considered very safe during pregnancy.
Reasons Women Refuse the Glucose Test
So why would an expectant mom refuse the glucose screening test? Here are some common reasons:
Don’t want to drink the glucose solution – Some women dislike the idea of drinking such a sickly sweet, syrupy solution on an empty stomach. The high sugar concentration can cause nausea for some.
Fear of side effects – Dizziness, nausea, vomiting, and feeling shaky or unwell after drinking the glucose solution prevents some women from taking the GCT.
Want to avoid extra blood draws – Drawing blood is uncomfortable for many pregnant women, so they want to limit extra needle sticks.
Concern about false positives – About 85% of women who get a positive on the 1-hour GCT will pass the 3-hour glucose tolerance test and not have gestational diabetes. The false positive rate concerns some women.
Don’t want to spend extra time – The 1-hour test plus waiting room time is a larger time commitment versus a regular prenatal checkup.
Avoid drinking sugary drinks – Some health-conscious women avoid soda, juice and other sugary drinks normally, so drinking the glucose solution goes against their habits.
Worry about impact on baby – A small number of women worry that the glucose could impact the baby, although there’s no evidence of this.
Preference for alternative screening – Some women would prefer to screen for gestational diabetes through diet and exercise changes alone, rather than traditional testing.
Bad experience with past pregnancies – If the GCT made a woman throw up or feel awful in a previous pregnancy, she’s more likely to refuse it again.
Of course, there are many valid reasons to accept glucose screening as well. But it’s understandable why some pregnant women are tempted to decline it.
Is Refusing the Glucose Test Allowed?
Now for the crucial question – are you actually allowed to refuse the glucose test during pregnancy if you want to?
The answer is yes.
The glucose screening test is recommended, but there are no laws requiring it. You have the right to decline any prenatal test, including the GCT. It is ultimately the expectant mom’s choice.
With that said, your doctor will likely strongly encourage the glucose screening test. And refusing it has some implications you’ll need to discuss with your prenatal team.
Even though the GCT itself poses little risk, untreated gestational diabetes does impact mom and baby. So your provider needs to ensure proper monitoring if you decline screening.
You’ll also likely have to take the oral glucose tolerance test instead, as it provides more definitive diabetes screening.
What Happens If I Refuse the Glucose Test?
Declining the standard glucose challenge test means your doctor can’t rely on those results to assess your risk of gestational diabetes.
But they still need to thoroughly screen for it, since high blood sugar in pregnancy requires careful management.
Here’s what typically happens if you refuse the 1-hour GCT during prenatal care:
Your provider will want to understand your reasons for declining. Make sure to have an open discussion about your concerns regarding the glucose drink, false positives, etc. so your doctor understands your motivation.
You’ll likely need to take the 3-hour glucose tolerance test (GTT) instead. This diagnostic test requires fasting, drinking a glucose solution, and having blood drawn four times over 3 hours. It definitively diagnoses gestational diabetes rather than just screening for risk like the GCT.
Your doctor may suggest alternative screening methods. For instance, they may propose checking fasting and post-meal blood sugars for a week instead. Though this still involves finger sticks for blood sampling.
You’ll need extra blood sugar monitoring throughout pregnancy. This includes regular at-home fasting and post-meal testing if you decline formal glucose testing.
Your doctor may recommend dietary changes. A diet lower in sugars and complex carbs is important for those not undergoing glucose screening.
You may have additional growth scans. Your provider will want to closely monitor fetal growth patterns when mom’s glucose levels aren’t known.
You’ll need early, frequent testing when baby is born. Babies of moms with untreated gestational diabetes have a higher risk of low blood sugar after birth. Expect early feeding and extra blood sugar checks for your newborn.
The implications are serious if gestational diabetes goes undiagnosed. Work closely with your OB/GYN or midwife to make sure blood sugar is well-controlled with thorough monitoring, even if you refuse traditional screening.
Questions to Ask When Refusing the Glucose Test
To make an informed decision on glucose testing in pregnancy, it’s important to have open conversations with your prenatal care team.
Here are some suggested questions to ask when declining the standard glucose screening test:
- Why do you recommend the glucose test during pregnancy?
- What are the risks of refusing it?
- Will I have to take the 3-hour glucose tolerance test instead?
- Are there alternative blood sugar screening options?
- How often will I need to monitor my blood sugar levels at home?
- What signs and symptoms should I watch out for?
- What dietary changes do you suggest?
- How will you monitor fetal growth if I don’t do glucose screening?
- What extra care will my baby need after birth if I refuse testing?
- What happens if I develop gestational diabetes without knowing it?
Discussing concerns transparently with your doctor allows them to provide the best care even when refusing standard recommendations. It also helps you make a decision on glucose screening you feel comfortable with.
Lifestyle Changes to Prevent Gestational Diabetes
Some women want to take preventive measures to reduce gestational diabetes risk rather than undergo glucose screening.
The best way to do this is through healthy lifestyle habits during pregnancy:
Follow an optimal pregnancy diet. Focus on lean proteins, fruits, vegetables, whole grains, legumes, nuts and healthy fats. Limit sweets, refined carbs and sugary drinks which spike blood sugar. Spread protein and carb intake evenly throughout the day.
Exercise regularly. Get at least 150 minutes of moderate exercise like brisk walking each week. This helps control blood sugar and promote insulin sensitivity.
Aim for healthy weight gain. Gaining too much during pregnancy raises diabetes risk. Aim for 25-35 pounds of weight gain if you started at a normal BMI.
Manage stress. High cortisol from chronic stress contributes to insulin resistance. Try prenatal yoga, meditation and other relaxation techniques to lower stress.
Get enough sleep. Lack of sleep disrupts metabolism and blood sugar control. Strive for 7-9 hours nightly.
Stay well hydrated. Drink plenty of water instead of sugary drinks. Dehydration can alter blood glucose levels.
Take a vitamin D supplement. Optimizing vitamin D intake improves insulin function and blood sugar regulation.
Making proactive lifestyle modifications goes a long way towards reducing gestational diabetes risk naturally. However, many doctors still recommend formal glucose screening as well to be safe.
Work with your provider to determine if lifestyle changes alone are sufficient or if you need additional blood sugar monitoring. Track fasting and post-meal blood sugars regularly at home regardless.
Talk to Your Doctor About Glucose Screening Options
While technically optional, the glucose screening test detects gestational diabetes in many women who lack symptoms. Untreated, high blood sugar puts mom and baby at risk.
Work with your prenatal care provider to make an informed decision about glucose testing that balances your preferences with medical recommendations.
Be open about your reasons for wanting to refuse the GCT. See if alternatives like at-home monitoring or the glucose tolerance test are reasonable compromises.
Lifestyle measures can also lower your risk naturally, but additional blood sugar checks are wise.
Ideally, you’ll feel empowered to make the glucose screening choice that is healthiest for you and baby while aligned with your beliefs and values. Just be sure risks are mitigated through careful monitoring if declining standard testing.
Stay engaged with your OB/GYN or midwife throughout pregnancy to ensure blood sugar is well-managed, regardless of your decisions on gestational diabetes screening.
The Bottom Line
The glucose challenge test is commonly recommended during pregnancy to screen for gestational diabetes risk. However, it is ultimately mom’s choice whether to accept or refuse this screening test.
Declining the GCT has implications that need to be addressed through open conversations with your prenatal team. Extra blood sugar monitoring and lifestyle adjustments are key to controlling diabetes risk.
Work together to make a decision on glucose testing you feel comfortable with while keeping mom and baby’s health the top priority.