All women should be screened for gestational diabetes at 24 weeks of pregnancy, even if they have no symptoms, according to new federal recommendations.
The B-level recommendation from the U.S. Preventive Services Task Force (USPSTF), published in the Annals of Internal Medicine, aligns with that of several other medical organizations, including theAmerican Association of Clinical Endocrinologists, the American Diabetes Association (ADA), and the American College of Obstetricians and Gynecologists (ACOG).
Estimates of the prevalence of gestational diabetes in the U.S. range from 1% to 25%, and associated risks include preeclampsia, fetal macrosomia, and neonatal hypoglycemia.
The task force recommends testing with a 2-hour, 50-g oral glucose challenge test (OGCT) between 24 and 28 weeks. If patients hit or exceed a threshold of 130 mg/dL, they should follow-up with the 2-hour, 100-g oral glucose tolerance test (OGTT).
Other options for screening include a fasting plasma glucose or screening based on other risk factors, but the task force said there's limited evidence on these alternative screening approaches.
If screening does indicate that a woman has gestational diabetes, she should be treated with moderate physical activity, dietary changes, support from diabetes educators and nutritionists, and glucose monitoring, according to the recommendation. Read the report.