Cost-effective approach to office screening for gestational diabetes

Gestational diabetes is a common problem during pregnancy. There are numerous screening programs, all of which are costly and time consuming. During a 6-month period, 50 patients were screened for gestational diabetes with a standard 50-g oral glucose load, and 1 hour later a capillary blood specimen was evaluated by means of a reflectance meter and a venous sample was evaluated in the hospital laboratory. We found that the capillary blood glucose determination was accurate, but we recommend that specific cutoff values for each meter be established for each facility. By using the glucose reflectance meter, 90% of patients will not require laboratory studies, which results in significant cost savings. Besides cost savings, the immediate results obtained by a reflectance meter allow for prompt identification of an abnormal screen and prompt scheduling for further evaluation of glucose intolerance during the pregnancy.