Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Recommended screening protocols for gestational diabetes mellitus (GDM) in pregnant women:
- At the booking appointment, assess risk factors for GDM including BMI above 30 kg/m2, previous macrosomic baby weighing 4.5 kg or more, previous gestational diabetes, family history of diabetes (first-degree relative), and ethnicity with a high prevalence of diabetes. Women with any of these risk factors should be offered testing for GDM NICE NG3.
- Do not use fasting plasma glucose, random blood glucose, HbA1c, glucose challenge test, or urinalysis for glucose to assess risk of developing GDM NICE NG3.
- For women with previous gestational diabetes, offer early self-monitoring of blood glucose or a 75-g 2-hour oral glucose tolerance test (OGTT) as soon as possible after booking (first or second trimester), and a further 75-g 2-hour OGTT at 24 to 28 weeks if the first OGTT is normal NICE NG3.
- For women with other risk factors, offer a 75-g 2-hour OGTT at 24 to 28 weeks gestation NICE NG3.
- Consider further testing to exclude GDM in women with glycosuria of 2+ or above on one occasion or glycosuria of 1+ or above on two or more occasions during routine antenatal care NICE NG3.
- Diagnose GDM if fasting plasma glucose is 5.6 mmol/l or above, or 2-hour plasma glucose is 7.8 mmol/l or above following the OGTT NICE NG3.