Gestational Glucose Tolerance Screening and Diagnostic Test (Two-hour, ADA Recommendations)

Screening and diagnosis of gestational diabetes.

American Diabetes Association Standards of Medical Care in Diabetes recommendations:²

• Screen for undiagnosed type 2 diabetes at the first prenatal visit in those with risk factors using the standard nongestational diagnostic criteria.

• In pregnant women not known to have diabetes, screen for gestational diabetes mellitus (GDM) at 24 to 28 weeks of gestation using the Gestational Glucose Tolerance Screening and Diagnostic Test (Two-hour, ADA Recommendations).

• Screen women with GDM for persistent diabetes 6 to 12 weeks postpartum using nonpregnant OGTT criteria, hemoglobin A_1c (102525), fasting plasma glucose (001818), or a 75-gram, two-hour oral glucose tolerance test (101200), two specimen WHO glucose tolerance test).² Women diagnosed with GDM should, in subsequent pregnancies, be re-evaluated.

• Women with a history of GDM should have lifelong screening for the development of diabetes or prediabetes at least every three years.

Note: The American Diabetes Association (ADA) released recommendations that vary from the American College of Obstetrics and Gynecology (ACOG) recommendations. The ADA recommends the current (101000) simplified “one-step” for screening and diagnosis of gestational diabetes mellitus using a 75-gram, two-hour glucose tolerance test. he ACOG recommendations³ use a 100-gram, three-hour glucose tolerance test (102004).

1. LabCorp internal studies.

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

3. 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