[When should we screen for gestational diabetes?].

AIM

Consider the arguments for screening outside the classical period of 24-28 SA.

MATERIALS AND METHODS

A literature search between 1990 and 2010 was performed using the Pubmed and Cochrane database. Foreign societies guidelines were also consulted.

RESULTS

Screening for gestational diabetes is recommended between 24 and 28 weeks of pregnancy, when glucose tolerance deteriorates. However, for patients with certain risk factors, the increasing prevalence of type 2 diabetes in women of childbearing age requires earlier screening. Fasting blood glucose should be measured at the first visit during pregnancy for these patients. The diagnostics threshold is the same as for patients who are not pregnant, i.e. blood glucose > 1.26 g/L. On the other hand, the interest of screening for gestational diabetes at the beginning of pregnancy in the case of certain risk factors is not supported by prospective studies. It is therefore not recommended to perform an OGTT in early pregnancy in order to diagnose gestational diabetes. The search for a gestational diabetes, regardless of screening policy recommended, has to be performed between 24 and 28 weeks gestational age. There are no reasons to consider a new search for gestational diabetes at later stages.