II. Indication: Gestational DiabetesScreening Test
- All pregnant patients at 24-28 weeks gestation
- Test with initial Prenatal Labs if indicated
- Overweight patient
- Family History of Diabetes Mellitus
- Age over 30 years
- Prior history of Glucose Intolerance
- Prior pregnancy complication
- Fetal Macrosomia
- Intrauterine Fetal Demise (Stillborn)
- Pregnancy Induced Hypertension (PIH)
- Polyhydramnios
- Congenital defect
III. Protocol
- Patient ingests 50 gram oral Glucose (e.g. Glucola Drink)
- Serum Glucose measured after 1 hour
IV. Interpretation
- Serum Glucose >130 mg/dl (7.2 mmol/L) suggests gestation diabetes
- Obtain Glucose Tolerance Test 3 hour if positive
- Empiric Gestational Diabetes Management for GCT >200 mg/dl (without a 3 hour GTT)
V. Efficacy: Using cut-off of 130 mg/dl
- Test Sensitivity: 99% (85% if 140 mg/dl cut-off used)
- Test Specificity: 77% (86% if 140 mg/dl cut-off used)