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-Diabetes Facts -Diabetes Mellitus Symptoms Type 1 Diabetes Type 2 Diabetes Gestational Diabetes Juvenile Diabetes Diabetes Insipidus Diabetes Symptoms Glucose
Diabetes Diet Diabetes Supply Diabetes Treatment Insulin Diabetes Care Diabetes is the No. 6 leading causes of deaths in the United States, according to 2001 data from the United States National Center for Health Statistics. |
Gestational Diabetes Test - Detection and Diagnosis Detection and Diagnosis Risk assessment for gestational diabetes mellitus should be undertaken at the first prenatal visit. Women with clinical characteristics consistent with a high risk of gestational diabetes mellitus (marked obesity, personal history of gestational diabetes mellitus, glycosuria, or a strong family history of diabetes) should undergo glucose testing (see below) as soon as feasible. If they are found not to have gestational diabetes mellitus at that initial screening, they should be retested between 24 and 28 weeks of gestation. Women of average risk should have testing undertaken at 24 to 28 weeks of gestation. Low-risk status requires no glucose testing, but this category is limited to those women meeting all of the following characteristics:
A fasting plasma glucose level >126 mg/dL (7.0 mmol/L) or a casual plasma glucose >200 mg/dL (11.1 mmol/L) meets the threshold for the diagnosis of diabetes, if confirmed on a subsequent day, and precludes the need for any glucose challenge. In the absence of this degree of hyperglycemia, evaluation for gestational diabetes mellitus in women with average or high-risk characteristics should follow one of two approaches: One-step approach: Perform a diagnostic oral glucose tolerance test (OGTT) without prior plasma or serum glucose screening. The one-step approach may be cost-effective in high-risk patients or populations (e.g., some Native-American groups). Two-step approach: Perform an initial screening by measuring the plasma or serum glucose concentration 1 hour after a 50-g oral glucose load (glucose challenge test [GCT]) and perform a diagnostic oral glucose tolerance test on that subset of women exceeding the glucose threshold value on the glucose challenge test. When the two-step approach is employed, a glucose threshold value >140 mg/dL (7.8 mmol/L) identifies approximately 80% of women with gestational diabetes mellitus, and the yield is further increased to 90% by using a cutoff of >130 mg/dL (7.2 mmol/L). With either approach, the diagnosis of gestational diabetes mellitus is based on an oral glucose tolerance test. Diagnostic criteria for the 100-g oral glucose tolerance test are shown in Table 1, below. Alternatively, the diagnosis can be made using a 75-g glucose load and the glucose threshold values listed for fasting, 1 hour, and 2 hours (Table 2, below); however, this test is not as well validated for detection of at-risk infants or mothers as the 100-g oral glucose tolerance test. Table 1. Diagnosis of gestational diabetes mellitus with a 100-g oral glucose load
Two or more of the venous plasma concentrations must be met or exceeded for a positive diagnosis. The test should be done in the morning after an overnight fast of between 8 and 14 h and after at least 3 days of unrestricted diet (>150 g carbohydrate per day) and unlimited physical activity. The subject should remain seated and should not smoke throughout the test. Table 2. Diagnosis of gestational diabetes mellitus with a 75-g oral glucose load
Two or more of the venous plasma concentrations must be met or exceeded for a positive diagnosis. The test should be done in the morning after an overnight fast of between 8 and 14 h and after at least 3 days of unrestricted diet (>150 g carbohydrate per day) and unlimited physical activity. The subject should remain seated and should not smoke throughout the test. (From National Guideline Clearinghouse) See also Type 1 Diabetes
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