A screening procedure for diabetes in pregnancy

A screening system for detection of diabetes in pregnancy was carried out in a geographically well-defined unselected population of 2 457 pregnant women all living in the community of Copenhagen. The screening was based on clinical criteria for potential diabetes consisting of previous delivery of a large baby, a family history of diabetes and obesity combined with examination of glucosuria and determination of the fasting blood glucose concentration. It was possible to follow up 95% of all pregnancies. One hundred and ninety women had a positive screening determination and among these women, 24 (1%) were found to have diabetes in pregnancy. It was established that a fasting blood glucose concentration of 4.1 mmol/l was the ideal cut-off point for referring potential diabetics to an oral glucose tolerance test (OGTT). The screening procedure is easy to administer and acceptable for the pregnant woman. The screening OGTT should be performed in the second or third trimester as only one woman had diabetes detected in the first trimester in this study.