New ADA Recommendation for Gestational Diabetes Unveiled

Previous American Diabetes Association recommendation, for all pregnant women, was to undergo screening for gestational diabetes. This approach had, however overestimated diabetes frequency in low risk population, and in contrast it underestimated it in high risk population.

Now, if the pregnant has low risk of diabetes, no screening is recommended. The low risk is defined as having all of the features below:

• Age <25 years

• Weight normal before pregnancy

• Member of an ethnic group with a low prevalence of diabetes

• No known diabetes in first-degree relatives

• No history of abnormal glucose tolerance

• No history of poor obstetrical outcome

On the other hand if the pregnant has high risk, she should be screened for diabetes as soon as possible after the confirmation of pregnancy. Criteria for very high risk are:

• Severe obesity

• Prior history of GDM or delivery of large-for-gestational-age infant

• Presence of glycosuria

• Diagnosis of PCOS

• Strong family history of type 2 diabetes

• If early screening does not yield any problem, them the pregnant must undergo routine gdm screening at 24-28 weeks of gestation