Although persuasive arguments against routine screening for gestationa
l diabetes mellitus (CDM) have been made, it is widely but not univers
ally performed as a part of antenatal care. There is no international
agreement on methods or criteria used for screening (or for diagnosis)
, and administered glucose-load methods have significant practical dif
ficulties in a busy antenatal clinic setting. However, recent evidence
supports the concept of an increased level of importance being given
to a diagnosis of CDM, with interest in the fetal and neonatal origins
of adult disease being added to the short-term obstetric and fetal co
ncern during pregnancy. A second generation fructosamine test, correct
ed for total protein, has been evaluated as a practical alternative to
glucose screening for GDM in a busy, multi-ethnic antenatal clinic. T
his achieved a 79.4 % sensitivity and a 77.3 % specificity for a diagn
osis of CDM confirmed by a glucose tolerance test using Carpenter's mo
dified criteria. In view of the organizational simplicity of this samp
le/test requirement, a wider evaluation is suggested together with a r
e-evaluation of clinical outcome criteria rather than blood glucose le
vels alone.