Consensus panel proposes new diagnostic criteria for gestational diabetes
To start, discard the 1-hour glucose loading test and the 3-hour OGTT, a global group says. Are you going to sign on, or remain an “OBskeptitrician”?
The panel recommends that, at 24 to 28 weeks’ gestation, a 2-hour, 75-g OGTT be performed following an overnight fast on all women not previously diagnosed with overt diabetes or GDM during the first-trimester testing. Based on the results of the 75-g OGTT, diabetes would be diagnosed if the fasting venous plasma glucose is ≥126 mg/dL. You would diagnose GDM if the 1-hour fasting venous plasma glucose is ≥180 mg/dL or the 2-hour result is ≥153 mg/dL.
Although the panel did not recommend applying the following piece of information in clinical practice, it noted that, if the fasting venous plasma glucose is ≤80 mg/dL in the first trimester, 1) it is unlikely that the patient will have an adverse pregnancy outcome attributable to hyperglycemia and 2) it might be possible to avoid the second-trimester OGTT in this select group
These proposals probably won’t end the back-and-forth
Proponents and skeptics are likely to continue their back-and-forth about the right approach to diagnosing and treating GDM. It’s likely that additional research is needed to more firmly establish a quantitative relationship between the newly proposed criteria for diagnosing GDM, and various fetal, childhood, and maternal outcomes. In addition, more research is needed to identify the most cost-effective approach to diagnosing and treating GDM.
When it comes to GDM, are you an OBskeptitrician or an OBconvert?
