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Gestational Diabetes Care Guidelines

Screening

Universal screening is recommended at 24-28 weeks gestation.

  • The recommended screening test for GDM is a 1 hour 50 g glucose challenge test (GCT) in non-fasting state. The test is positive if serum/plasma glucose is > or equal to130 mg/dl.
  • If screen is positive then diagnostic 100 g 3-hour oral glucose tolerance test (OGTT) is indicated.
  • Early screening at the first prenatal visit is indicated for patients with one or more of the following risk factors:
    • Obesity (body mass index > 28)
    • Age > 40 years
    • History of GDM requiring insulin, or history of abnormal glucose intolerance
    • Diabetes in first-degree relative
    • Polycystic Ovarian Syndrome (PCOS)
    • Ethnic groups with high rates of type 2 diabetes (DM) such as Hispanic, American Indian, African American/Black, Asian American, and Pacific Islander.
  • Rescreen patients with above risk factors at 24-28 weeks gestation if early 50 g OGCT screen is negative.
  • Rescreen patients in the third trimester based on clinical suspicion; for example, presence of macrosomia or polyhydramnios.
  • Patients diagnosed with GDM by early screening may have had undiagnosed pre-existing DM and may be candidates for further evaluations not required for GDM (ultrasound fetal structural survey, fetal echocardiography, etc).

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