GTT: glucose tolerance test; ADA: American Diabetes Association; ACOG: American College of Obstetricians and Gynecologists; BMI: body mass index; A1C: glycated hemoglobin; GCT: glucose challenge test; USPSTF: United States Preventive Services Task Force.
* ADA and ACOG define patients at increased risk of overt diabetes based on:UpToDate includes older age as a risk factor for early testing and uses age 40 years as the threshold.
¶ There is no consensus on the type of test to administer. Options include any of the following:
Refer to the UpToDate topic on screening and diagnosis of diabetes mellitus in pregnancy for detailed information on types of tests and interpretation.
Δ Both ADA and ACOG suggest early pregnancy testing for undiagnosed type 2 diabetes in patients with risk factors. Some clinicians screen all patients by obtaining an A1C with the routine prenatal laboratory tests. By contrast, a USPSTF guideline concluded available evidence was insufficient to assess the balance of benefits and harms of screening asymptomatic pregnant patients for glucose intolerance before 24 weeks of gestation.
◊ Either a one-step or two-step diabetes screening test can be used.
§ Postpartum, a fasting plasma glucose test is a reasonable alternative to the GTT but does not allow for diagnosis of impaired glucose tolerance; A1C can also be substituted in patients in whom obtaining a fasting specimen is especially inconvenient, but it performs less well in postpartum patients because of increased peripartum red cell turnover. For subsequent testing, refer to the UpToDate topic on screening and diagnosis of diabetes mellitus in pregnancy.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟