Screening for gestational diabetes in Sicily

OBJECTIVE: To establish the prevalence of gestational diabetes in a univers ally screened population living in Messina, Sicily, as the first step in ev aluating the cost:benefit ratio of screening for carbohydrate intolerance i n pregnancy. STUDY DESIGN: Between October 1989 and A March 1995, 1,000 pregnant women u nderwent screening for gestational diabetes with a 50-g, one-hour glucose c hallenge test. All the risk factors were registered. RESULTS: Two hundred sixty subjects had a value of greater than or equal to 135 mg/dL and underwent a full three-hour oral glucose tolerance test. Of them, 46 (4.6%) met the Carpenter-Coustan diagnostic criteria for gestation al diabetes. CONCLUSION: The apparent incidence of gestational diabetes (1.2%) prior to screening was only 25% of the incidence determined with the protocol of uni versal screening (4.6%). If we assume that timely diagnosis and treatment o fgestational diabetes provides an important opportunity to improve obstetri c outcome and reduce perinatal morbidity, and since women with gestational diabetes are at increased risk of developing diabetes Inter, the knowledge that the true prevalence is almost four times that previously reported is a determinant of a future evaluation of the cost:benefit ratio of screening universally for gestational diabetes.