Vaginitis, cervicitis, and cervical length in pregnancy

Objective: This study tested the hypothesis that a standardized dose of jelly beans could be used as an alternative sugar source to the 50-g glucose beverage to screen for gestational diabetes mellitus. Study Design: One hundred sixty pregnant women at 24 to 28 weeks’ gestation were recruited for a prospective study to compare 2 sugar sources for serum glucose response, side effects, preference, and ability to detect gestational diabetes mellitus. Patients were randomly assigned to consume 50-g glucose beverage or 28 jelly beans (50 g simple carbohydrate). Serum glucose values were determined 1 hour later. The test was later repeated with the other sugar source. Finally, a 100-g 3-hour oral glucose tolerance test was performed. Participants completed a questionnaire recording subjective outcome variables. American Diabetes Association criteria were used to interpret all test results. Results: Among 136 participants completing the study no significant differences were found between 1-hour serum glucose values (116.5 ± 27 mg/dL with 50-g glucose beverage, 116.9 ± 23.6 mg/dL with jelly beans; P = .84), frequency of discrepant results (P = .47), sensitivity, specificity, or predictive value. Jelly beans yielded fewer side effects (38% with 50-g glucose beverage, 20% with jelly beans; P<.001) and were preferred by 76% of participants (P< .001). Five cases (3.7% incidence) of gestational diabetes mellitus were diagnosed, 3 with 50-g glucose beverage alone, 1 with jelly beans alone, and 1 with both sugar sources. Conclusions: Jelly beans may be used as an alternative to the 50-g glucose beverage as a sugar source for gestational diabetes mellitus screening. The 2 sources provoke similar serum glucose responses. Patients report fewer side effects after a jelly bean challenge than after a 50-g glucose beverage challenge. (Am J Obstet Gynecol 1999;181:1154-7.)