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Related Concept Videos

Diabetes Mellitus: Type 2 and Gestational01:22

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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The Wilcoxon signed-rank test for matched pairs evaluates the null hypothesis by combining the ranks of differences with their signs. It essentially tests whether the median of the differences in a population of matched pairs is zero. Since the test incorporates more information than the sign test, it generally yields more trustable conclusions. This test also does not require the data to follow a normal distribution, but two conditions must be met for it to be applicable: (1) the data must...
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Measuring blood pressure is a fundamental skill in healthcare that aids in diagnosing and monitoring hypertension and other cardiovascular conditions. An aneroid sphygmomanometer, commonly used in clinical settings, offers a manual and precise method for blood pressure measurement. The technique for using this instrument involves specific steps that must be carefully executed to ensure accuracy. The following detailed description outlines a two-step technique for assessing blood pressure using...
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Related Experiment Video

Updated: Nov 4, 2025

One-step Metabolomics: Carbohydrates, Organic and Amino Acids Quantified in a Single Procedure
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One-step or 2-step testing for gestational diabetes: which is better?

Donald R Coustan1, Alan R Dyer2, Boyd E Metzger3

  • 1Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI.

American Journal of Obstetrics and Gynecology
|May 23, 2021
PubMed
Summary

The study questions the conclusion that 1-step gestational diabetes mellitus screening is not beneficial, citing methodological concerns and a lack of power to detect population health impacts.

Keywords:
O’Sullivandiagnosisfastinggestational diabetes mellitusglucoseglucose tolerancescreening

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Public Health

Background:

  • The 2-step protocol is standard for gestational diabetes mellitus (GDM) detection in the US, involving a glucose challenge followed by an oral glucose tolerance test (OGTT).
  • The International Association of Diabetes and Pregnancy Study Groups advocates a 1-step approach using a single diagnostic OGTT.
  • Both methods have implications for diagnosis rates and healthcare resource allocation.

Purpose of the Study:

  • To critically evaluate a recent randomized controlled trial comparing 2-step and 1-step GDM screening protocols.
  • To address concerns regarding the trial's methodology and conclusions on the relative benefits of each approach.

Main Methods:

  • Analysis of a randomized controlled trial comparing 2-step and 1-step GDM screening.
  • Review of the trial's reported outcomes, sample size calculations, and participant adherence to assigned protocols.

Main Results:

  • The trial concluded no significant difference in adverse short-term pregnancy outcomes between the 2-step and 1-step GDM screening protocols.
  • Concerns were raised about the trial's power to detect differences, participant crossover, and potential confounding factors influencing outcome reporting.

Conclusions:

  • The study suggests the trial's conclusions may be premature due to methodological limitations, potentially obscuring the benefits of the 1-step GDM screening approach.
  • Further research with adequate power is needed to ascertain the true population health impact of the 1-step GDM diagnostic protocol, considering both short- and long-term maternal and offspring outcomes.