Gestational diabetes screening: Difference between revisions
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==Overview== | ==Overview== | ||
The most useful method for GDM screening is to perform 50 gram Glucose Test in 24-28 weeks of pregnancy in low risk mothers. High risk pregnancies should be screen earlier, even in the first prenatal visit. | |||
==Screening== | ==Screening== | ||
Screening can be performed during the first prenatal visit especially, if mother has [[Gestational diabetes risk factors|risk factors]] for GDM. If the result is negative or test was not done during prenatal care, 24-28 weeks is the best time for screening mothers.<ref name="pmid26696675">{{cite journal |vauthors= |title=2. Classification and Diagnosis of Diabetes |journal=Diabetes Care |volume=39 Suppl 1 |issue= |pages=S13–22 |year=2016 |pmid=26696675 |doi=10.2337/dc16-S005 |url=}}</ref><ref name="pmid24424622">{{cite journal |vauthors=Moyer VA |title=Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement |journal=Ann. Intern. Med. |volume=160 |issue=6 |pages=414–20 |year=2014 |pmid=24424622 |doi=10.7326/M13-2905 |url=}}</ref> | Screening can be performed during the first prenatal visit especially, if mother has [[Gestational diabetes risk factors|risk factors]] for GDM. If the result is negative or test was not done during prenatal care, 24-28 weeks is the best time for screening mothers.<ref name="pmid26696675">{{cite journal |vauthors= |title=2. Classification and Diagnosis of Diabetes |journal=Diabetes Care |volume=39 Suppl 1 |issue= |pages=S13–22 |year=2016 |pmid=26696675 |doi=10.2337/dc16-S005 |url=}}</ref><ref name="pmid24424622">{{cite journal |vauthors=Moyer VA |title=Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement |journal=Ann. Intern. Med. |volume=160 |issue=6 |pages=414–20 |year=2014 |pmid=24424622 |doi=10.7326/M13-2905 |url=}}</ref> | ||
===50 gram Glucose Test=== | ===50 gram Glucose Test=== | ||
Regardless of fasting status of mother, 50 gram glucose is loaded and 1 hour later, plasma glucose level should be measured. Measures greater than 130 mg/dL are considered positive. | * Regardless of fasting status of mother, 50 gram glucose is loaded and 1 hour later, plasma glucose level should be measured. Measures greater than 130 mg/dL are considered positive. Considering 130 mg/dl threshold has 88% to 99% sensitivity and 66% to 77% specificity.<ref name="pmid23712349">{{cite journal |vauthors=Donovan L, Hartling L, Muise M, Guthrie A, Vandermeer B, Dryden DM |title=Screening tests for gestational diabetes: a systematic review for the U.S. Preventive Services Task Force |journal=Ann. Intern. Med. |volume=159 |issue=2 |pages=115–22 |year=2013 |pmid=23712349 |doi=10.7326/0003-4819-159-2-201307160-00657 |url=}}</ref> | ||
Considering 130 mg/dl threshold has 88% to 99% sensitivity and 66% to 77% specificity.<ref name="pmid23712349">{{cite journal |vauthors=Donovan L, Hartling L, Muise M, Guthrie A, Vandermeer B, Dryden DM |title=Screening tests for gestational diabetes: a systematic review for the U.S. Preventive Services Task Force |journal=Ann. Intern. Med. |volume=159 |issue=2 |pages=115–22 |year=2013 |pmid=23712349 |doi=10.7326/0003-4819-159-2-201307160-00657 |url=}}</ref> | |||
*Next step is to confirm the diagnosis by performing a 100 gram 3 hour Glucose Test. | *Next step is to confirm the diagnosis by performing a 100 gram 3 hour Glucose Test. | ||
Revision as of 19:32, 28 November 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
The most useful method for GDM screening is to perform 50 gram Glucose Test in 24-28 weeks of pregnancy in low risk mothers. High risk pregnancies should be screen earlier, even in the first prenatal visit.
Screening
Screening can be performed during the first prenatal visit especially, if mother has risk factors for GDM. If the result is negative or test was not done during prenatal care, 24-28 weeks is the best time for screening mothers.[1][2]
50 gram Glucose Test
- Regardless of fasting status of mother, 50 gram glucose is loaded and 1 hour later, plasma glucose level should be measured. Measures greater than 130 mg/dL are considered positive. Considering 130 mg/dl threshold has 88% to 99% sensitivity and 66% to 77% specificity.[3]
- Next step is to confirm the diagnosis by performing a 100 gram 3 hour Glucose Test.
2016 American Diabetes Association Standards of Medical Care in Diabetes (DO NOT EDIT)[4]
Screening for Gestational Diabetes (GDM)
| "1. Test for undiagnosed type 2 diabetes at the first prenatal visit in those with risk factors, using standard diagnostic criteria. (Level of Evidence: B)" |
| "2. Test for gestational diabetes mellitus at 24–28 weeks of gestation in pregnant women not previously known to have diabetes. (Level of Evidence: A)" |
| "3. Screen women with gestational diabetes mellitus for persistent diabetes at 6–12 weeks postpartum, using the oral glucose tolerance test and clinically appropriate nonpregnancy diagnostic criteria (Level of Evidence: E)" |
| "4. Women with a history of gestational diabetes mellitus should have lifelong screening for the development of diabetes or prediabetes at least every 3 years. (Level of Evidence: B)" |
| "5. Women with a history of gestational diabetes mellitus found to have prediabetes should receive lifestyle interventions or metformin to prevent diabetes. (Level of Evidence: A)" |
References
- ↑ "2. Classification and Diagnosis of Diabetes". Diabetes Care. 39 Suppl 1: S13–22. 2016. doi:10.2337/dc16-S005. PMID 26696675.
- ↑ Moyer VA (2014). "Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement". Ann. Intern. Med. 160 (6): 414–20. doi:10.7326/M13-2905. PMID 24424622.
- ↑ Donovan L, Hartling L, Muise M, Guthrie A, Vandermeer B, Dryden DM (2013). "Screening tests for gestational diabetes: a systematic review for the U.S. Preventive Services Task Force". Ann. Intern. Med. 159 (2): 115–22. doi:10.7326/0003-4819-159-2-201307160-00657. PMID 23712349.
- ↑ "Standards of Medical Care in Diabetes-2016: Summary of Revisions". Diabetes Care. 39 Suppl 1: S4–5. 2016. doi:10.2337/dc16-S003. PMID 26696680.