Screening for gestational diabetes: an evidence-based approach

The primary goal of medicine should be to improve the health of patients. Evidence-based medicine is the utilization of evidence from studies published in the medical literature to help clinicians make decisions with and for their patients. Ideally the evidence should be patient-oriented, demonstrating improvements in actual patient outcomes, not just physiologic parameters or other intermediate endpoints. This concept is important in making decisions about screening tests, since this is how clinicians can determine if the screening test will actually improve patients' (and in the case of obstetrics, the neonates') outcomes. The purpose of this article is to examine screening for gestational diabetes from this perspective, discuss the current recommendations, and make suggestions for its utilization in clinical care.