American Diabetes Association

Table 1—

Screening strategy for detecting GDM

GDM risk assessment: Should be ascertained at the first prenatal visit

Low risk: Blood glucose testing not routinely required if all of the following characteristics are present:
- Member of an ethnic group with a low prevalence of GDM
- No known diabetes in first-degree relatives
- Age <25 years
- Weight normal before pregnancy
- Weight normal at birth
- No history of abnormal glucose metabolism
- No history of poor obstetric outcome
Average risk: Perform blood glucose testing at 24–28 weeks using either:
- Two-step procedure: 50 g glucose challenge test (GCT) followed by a diagnostic oral glucose tolerance test in those meeting the threshold value in the GCT.
- One-step procedure: Diagnostic oral glucose tolerance test performed on all subjects.
High-risk: Perform blood glucose testing as soon as feasible, using the procedures described above if one or more of these are present:
- Severe obesity
- Strong family history of type 2 diabetes
- Previous history of: GDM, impaired glucose metabolism, or glucosuria

If GDM is not diagnosed, blood glucose testing should be repeated at 24–28 weeks or at any time a patient has symptoms or signs that are suggestive of hyperglycemia.

Reproduced with minor modifications from Metzger et al. (9). “Weight normal at birth” is an additional low-risk criterion that must now be met.

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