C. Nelsonpiercy et Eam. Gale, DO WE KNOW-HOW TO SCREEN FOR GESTATIONAL DIABETES - CURRENT PRACTICE IN ONE REGIONAL HEALTH AUTHORITY, Diabetic medicine, 11(5), 1994, pp. 493-498
Citations number
NO
Categorie Soggetti
Endocrynology & Metabolism","Medicine, General & Internal
To review current practice for screening and diagnosis of gestational
diabetes (GDM) in the North East Thames health region, clinical direct
ors and other relevant individuals in all 17 obstetric units within NE
Thames were interviewed personally. Additional information was obtain
ed from local midwives, diabetologists, and chemical pathologists. Thi
rteen centres had a formal policy for screening and diagnosis of GDM.
One centre ran two policies. Six of 18 centres performed a routine blo
od glucose (BG) screen on all pregnant women, proceeding to OGTT eithe
r on the basis of raised BG alone (3 centres), or on the basis of rais
ed BG and/or clinical risk factors (3 centres). Of the remainder, 10 p
erformed a diagnostic test (OGTT or equivalent) in all those with risk
factors, and 2 via an intermediate screening BG. The choice and inter
pretation of screening and diagnostic tests varied considerably. Six c
entres used random BG, with cut-off ranging from > 5.8 mmol l-1 to > 9
.0 mmol l-1, one used a single fasting BG > 5.0 mmol l-1, and another
a 50 g oral glucose challenge (1 h level > 8.0 mmol l-1). Diagnosis of
GDM was based on a 75 g (13 centres) or a 50 g OGTT (2 centres), whil
e 1 used a standard mixed meal, and another a timed post-prandial gluc
ose sample. Timing of tests ranged from booking to 36 weeks gestation
and the diagnostic cut-off levels for GDM varied (fasting: 5.0-8.0 mmo
l l-1; 2 h: 6.0-1 0.1 mmol l-1). There is no consensus concerning scre
ening and diagnosis of GDM in the NE Thames region. This may reflect u
ncertainty about the value of screening for this condition.