Screening for Gestational Diabetes Mellitus

Clinical Recommendations

The Women’s Preventive Services Initiative recommends screening pregnant women for gestational diabetes mellitus after 24 weeks of gestation (preferably between 24 and 28 weeks of gestation) in order to prevent adverse birth outcomes. Screening with a 50-g oral glucose challenge test (followed by a 3-hour 100-g oral glucose tolerance test if results on the initial oral glucose challenge test are abnormal) is preferred because of its high sensitivity and specificity.

The Women’s Preventive Services Initiative suggests that women with risk factors for diabetes mellitus be screened for preexisting diabetes before 24 weeks of gestation—ideally at the first prenatal visit, based on current clinical best practices.

Implementation Considerations

Women’s Preventive Services Initiative recommends screening pregnant women for gestational diabetes mellitus after 24 weeks of gestation to prevent adverse birth outcomes. Risk factors for diabetes mellitus that may help identify women for early screening include, but are not limited to, those identified by the Institutes of Medicine (now National Academies of Science, Engineering, and Medicine). The optimal test for screening prior to 24 weeks of gestation is not known. However, acceptable modalities may include a 50-g oral glucose challenge test, a 2-hour 75-g oral glucose tolerance test, a hemoglobin A1c test, a random plasma glucose test, or a fasting plasma glucose test. If early screening is normal, screening with a 50-g oral glucose challenge test should be conducted at 24 to 28 weeks of gestation as described above.

*These are the recommendations of the WPSI and not necessarily of any individual participating organization.