GESTATIONAL DIABETES - DO LEAN YOUNG CAUCASIAN WOMEN NEED TO BE TESTED

OBJECTIVE - The American Diabetes Association has recommended that pre gnant women with low-risk factors need not be tested for gestational d iabetes mellitus (GDM). The aim of this study was to determine the pre valence of GDM in women with low-risk factors and to see if the pregna ncy outcomes of women with GDM from a low-risk group were different fr om the outcomes of other women with GDM.RESEARCH DESIGN AND METHODS - Over an 18-month period, all pregnant women were offered a test for GD M using a 75-g glucose tolerance test at the beginning of the 3rd trim ester. GDM was diagnosed if the 2-h glucose level was greater than or equal to 8.0 mmol/l. The prevalence of GDM was determined in women wit h defined low-risk factors (Caucasian ethnic origin, age <25 years, an d BMI <25 kg/m(2)). The pregnancy outcomes of women with GDM from a lo w-risk group were compared with those of other women with GDM. RESULTS - From a tested population of 2,907 women, 573 were identified as com ing from a low-risk group. The prevalence of GDM in this low-risk grou p was 2.8%. The pregnancy outcomes of women with GDM from a low-risk g roup were no different from the pregnancy outcomes of other women with GDM, with respect to frequency of insulin use, units of insulin per d ay, morbidity, emergency caesarian section, and the percentage of both large- and small-for-gestational-age babies. In our population, if lo w-risk women were excluded, 80% of women would still require testing a nd nearly 10% of all cases of GDM would be missed. CONCLUSIONS - Women from a low-risk group have a 2.8% prevalence rate of GDM. The pregnan cy outcomes of women with GDM from a low-risk group are similar to the outcomes of other women with GDM. Concerning the use of the 75-g gluc ose tolerance test in pregnancy, the recommendation not to test women from a low-risk group requires further evaluation in different populat ions before it can be endorsed.