Gestational Diabetes Screen (ACOG Recommendations)

Screening test for gestational diabetes.

The American College of Obstetricians and Gynecologists (ACOG) recommends that all pregnant women be screened for gestational diabetes mellitus (GDM)—whether by patient history, clinical risk factors, or with a 50-gram, one-hour loading test at 24 to 28 weeks of gestation to determine blood glucose levels—and suggests relying on the result of the 100-gram, three-hour oral glucose tolerance test for diagnosis (often referred to as a "two-step" method).²

The American Diabetes Association (ADA)³ released standards that vary from the ACOG recommendations. The ADA recommends a simplified "one-step" approach to the screen and diagnosis of gestational diabetes mellitus with a 75-gram, two-hour glucose tolerance test. The LabCorp test according to the ADA recommendations is Gestational Glucose Tolerance Screening and Diagnostics Test (Two-hour, ADA Recommendations) [101000]. A glucose tolerance screen glucose threshold >139 mg/dL after a 50-gram load identifies approximately 80% of women with gestational diabetes mellitus, while the sensitivity is further increased to approximately 90% by a threshold >129 mg/dL. Perform a diagnostic 100-gram oral glucose tolerance test (102004) on a separate day on women who exceed the chosen threshold on 50-gram screening.

1. LabCorp internal studies.

2. American College of Obstetricians and Gynecologists. Committee on Practice Bulletins—Obstetrics. Practice Bulletin N° 137: Gestational diabetes mellitus. Obstet Gynecol. 2013 Aug; 122(2 Pt 1):406-416. PubMed 23969827

3. American Diabetes Association. Standards of Medical Care in Diabetes—2015: Summary of revisions. Diabetes Care. 2015 Jan; 38(Suppl 1):S4. PubMed 25537706