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A screening procedure for diabetes in pregnancy.
Diabete & Metabolisme
|August 1, 1985
Summary
This study developed an effective screening system for gestational diabetes in pregnant women. A fasting blood glucose level of 4.1 mmol/l identified 1% of women with diabetes, enabling timely intervention.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Public Health
Background:
- Gestational diabetes mellitus (GDM) poses risks to both mother and fetus.
- Effective screening strategies are crucial for early detection and management of GDM.
- Previous screening methods have varied in accuracy and accessibility.
Purpose of the Study:
- To implement and evaluate a community-based screening system for GDM in Copenhagen.
- To identify optimal clinical criteria and biochemical markers for GDM screening.
- To assess the feasibility and acceptability of the screening protocol.
Main Methods:
- A prospective screening of 2,457 pregnant women in Copenhagen using clinical criteria (large baby history, family history of diabetes, obesity) and biochemical tests (glucosuria, fasting blood glucose).
- Established a fasting blood glucose cut-off of 4.1 mmol/l for referral to an oral glucose tolerance test (OGTT).
- Follow-up of 95% of pregnancies to determine GDM diagnosis.
Main Results:
- The screening identified 190 women with positive results, leading to the diagnosis of 24 cases (1%) of GDM.
- A fasting blood glucose concentration of 4.1 mmol/l proved to be an effective threshold for referral to OGTT.
- The screening procedure was found to be easy to administer and well-accepted by pregnant women.
Conclusions:
- The developed screening system is effective and practical for detecting GDM in a general pregnant population.
- The recommended fasting blood glucose cut-off of 4.1 mmol/l optimizes the identification of GDM cases.
- Screening is most effective when performed in the second or third trimester due to the low detection rate in the first trimester.