Screening for gestational diabetes mellitus

BMJ 1999;319:798-799 ( 25 September )

Editorials

Screening for gestational diabetes mellitus

A simple test may make it easier to study whether screening is worthwhile

Papers p 812

The first 150 words of the full text of this article appear below.

Gestational diabetes mellitus is a concept that arouses considerable controversy. It is defined as "carbohydrate intoleranceof varying degrees of severity with onset or first recognitionduring pregnancy."¹ Rather than predicting the developmentof diabetes later in life, as proposed originally,² the mainpurpose of identifying gestational diabetes is to detect womenat risk of adverse perinatal outcomes, such as macrosomia, neonatalmetabolic abnormalities, birth trauma, and caesarean section. ¹ ³ ⁴ Evidence of the effectiveness of universal screening for gestationaldiabetes on these outcomes is still lacking.⁵ However, recentrandomised studies indicate that women who are intensively managedcan achieve near normal rates of macrosomia and neonatal hypoglycaemia.^5-7

Those who do not favour screening for gestational diabetes claim, among other things, that the current screening and diagnosticstrategies are cumbersome. In this issue of the BMJ Perucchiniet al propose a protocol which could counter this argument: theysuggest using a fasting . . . [Full text of this article]

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Using fasting plasma glucose concentrations to screen for gestational diabetes mellitus: prospective population based study: Daniele Perucchini, Ursin Fischer, Giatgen A Spinas, Renate Huch, Albert Huch, and Roger Lehmann
BMJ 1999 319: 812-815. [Abstract] [Full Text] [PDF]