What are the American Diabetes Association recommendations for gestational diabetes mellitus (GDM) screening?

Updated: Apr 29, 2020
  • Author: Thomas R Moore, MD; Chief Editor: George T Griffing, MD  more...
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Answer

Answer

The sensitivity of gestational diabetes mellitus testing depends on the threshold value used for the 50-g glucose challenge. Current recommendations from the American Diabetes Association "Standards of Medical Care in Diabetes--2010" [6, 7] and the American College of Obstetricians and Gynecologists (ACOG) [60] note that a threshold value of 140 mg/dL results in approximately 80% detection of gestational diabetes, whereas a threshold of 130 mg/dL results in 90% detection. A potential disadvantage of using the lower value of 130 mg/dL is an approximate doubling in the number of OGTTs performed.

In updated guidelines, the American Diabetes Association recommends use of either the 1-step or the 2-step screening method (recommended by the National Institutes of Health), advising that both tests are acceptable screens. The revised guidelines also include a new section on medical nutrition therapy and an expanded section on neuropathy. [61, 62]


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