Screening and Diagnosis of GDM
There is debate regarding the preferred screening protocol for GDM. Some experts recommend universal screening because not all women who develop GDM have risk factors. The ADA policy states that screening may be omitted in low-risk women. A woman is considered low risk if all of the following factors are present: age younger than 25 years; BMI less than 25 before pregnancy; not of Hispanic, African American, American Indian, South or East Asian, or Pacific Islander descent; no first-degree relative with DM; no history of abnormal glucose tolerance; and no history of poor obstetric outcome. The American College of Obstetricians and Gynecologists (ACOG) practice bulletin states that universal screening is the most sensitive and more practical approach, but it notes that low-risk women may be excluded from screening per the ADA recommendation.2 The United States Preventive Services Task Force on Preventive Health Care concluded that there is not enough evidence to support or deny universal screening for GDM.7