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Screening for gestational diabetes mellitus. A perspective in 1998
1Women and Infants Hospital, Brown University School of Medicine, Providence, Rhode Island 02905, USA. stephen_carr@brown.edu
Diabetes Care
|August 15, 1998
Summary
This review examines gestational diabetes mellitus (GDM) screening using statistical approaches. It discusses current universal screening methods, alternative tests, and advancements in glucose meter precision for better GDM management.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Clinical Chemistry
Background:
- Gestational diabetes mellitus (GDM) diagnosis historically relied on statistical definitions.
- Current screening practices for GDM warrant a statistical re-evaluation.
- Universal screening is recommended for pregnant women between 24-28 weeks gestation.
Purpose of the Study:
- To review data supporting current universal screening for GDM.
- To discuss the pros and cons of various GDM screening thresholds.
- To explore alternatives to the standard 50-g 1-h oral glucose challenge test.
Main Methods:
- Review of existing data on GDM screening protocols.
- Analysis of diagnostic thresholds for the 50-g 1-h oral glucose challenge.
- Evaluation of alternative screening methods and portable glucose meter technology.
Main Results:
- Current recommendations support universal GDM screening at 24-28 weeks via the 50-g 1-h oral glucose challenge.
- Various thresholds for abnormality present distinct advantages and disadvantages.
- Portable blood glucose meters show improved precision, suggesting potential for clinical use.
Conclusions:
- Statistical approaches remain relevant for defining and screening GDM.
- Optimizing screening thresholds and considering alternative methods can improve GDM detection.
- Advancements in glucose monitoring technology may enhance GDM management strategies.