South
Dakota
Gestational Diabetes Care Guidelines
Screening
Universal screening is recommended at 24–28 weeks gestation.
- The recommended screening test for GDM is a 1 hour 50 g glucose challenge test (GCT) in non-fasting state. The test is positive if serum/plasma glucose is > or equal to130 mg/dl.
- If screen is positive then diagnostic 100 g 3–hour oral glucose tolerance test (OGTT) is indicated.
- Early screening at the first prenatal visit is indicated for patients with one or more of the following risk factors:
- Obesity (body mass index > 28)
- Age > 40 years
- History of GDM requiring insulin, or history of abnormal glucose intolerance
- Diabetes in first-degree relative
- Polycystic Ovarian Syndrome (PCOS)
- Ethnic groups with high rates of type 2 diabetes (DM) such as Hispanic, American Indian, African American/Black, Asian American, and Pacific Islander.
- Rescreen patients with above risk factors at 24-28 weeks gestation if early 50 g OGCT screen is negative.
- Rescreen patients in the third trimester based on clinical suspicion; for example, presence of macrosomia or polyhydramnios.
- Patients diagnosed with GDM by early screening may have had undiagnosed pre-existing DM and may be candidates for further evaluations not required for GDM (ultrasound fetal structural survey, fetal echocardiography, etc).
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- CDC Diabetes Public Inquiries
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