In a recommendation published in the Annals of Internal Medicine, the U.S. Preventive Services Task Force (USPSTF) has recommended that every pregnant woman be screened for gestational diabetes at 24 weeks of pregnancy, even if she has no symptoms.
This USPSTF recommendation is shared by other medical organizations, among them the American Diabetes Association (ADA), the American Association of Clinical Endocrinologists, and the American College of Obstetricians and Gynecologists (ACOG), MedPage Today reports. The ADA has been recommending universal diabetes screening for a number of years.
While estimates of the prevalence of gestational diabetes range from 1 percent to 25 percent of all pregnancies, the risks to both mother and fetus were factors in the task force’s recommendation for universal screening. The risks include preeclampsia (a rapid rise in blood pressure that can lead to seizure, stroke, multiple organ failure and death of the mother and/or baby), fetal macrosomia (higher than average birth weight), and neonatal hypoglycemia. To screen for gestational diabetes, the task force recommends a 2-hour, 50-g oral glucose challenge test (OGCT) between 24 and 28 weeks of pregnancy, according to MedPage Today. Patients who hit or exceed a threshold of 130 mg/dL, should have a follow-up 2-hour, 100-g oral glucose tolerance test (OGTT).
When screening indicates that a pregnant woman has gestational diabetes, she should be treated through dietary changes and moderate physical activity, and she should receive support from diabetes educators and nutritionists, and should have glucose monitoring, MedPage Today reports. The USPSTF concluded that there is insufficient evidence to assess risk and benefits of screening before 24 weeks of pregnancy.
The USPSTF categorized this as a B-level recommendation, meaning that the task force recommends the service because there is “high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial,” according to the USPSTF web site.