Marquette G P, Klein V R, Repke J T, Niebyl J R
Obstet Gynecol. 1985 Aug;66(2):181-4.
To study cost-effective screening criteria for gestational diabetes, a prospective study of 1012 patients was completed. All patients underwent a glucose screen between 26 and 30 weeks of gestation, consisting of a 50-g oral glucose load followed by a one-hour plasma glucose determination. Patients with a glucose screen greater than or equal to 130 mg/dL were studied with a standard three-hour oral glucose tolerance test. The incidence of gestational diabetes was 2.4% (24 of 1012). Only one gestational diabetic was identified with a glucose screen below 150 mg/dL. Twenty-two of the 24 cases were at least 24 years old. Twenty-one of the 24 (88%) gestational diabetes had a glucose screen greater than or equal to 150 mg/dL and were 24 years old or greater. The cost of the diagnosis in these latter patients was 40% of the cost of diagnosis of universal screening with a threshold of 130 mg/dL. It is concluded that screening with a threshold of 150 mg/dL only patients who are at least 24 years old should be considered an alternative to universal screening.
为研究妊娠期糖尿病的经济有效的筛查标准，完成了一项对1012例患者的前瞻性研究。所有患者在妊娠26至30周期间接受了葡萄糖筛查，包括口服50克葡萄糖负荷，随后测定一小时血浆葡萄糖。葡萄糖筛查结果大于或等于130毫克/分升的患者接受了标准的三小时口服葡萄糖耐量试验。妊娠期糖尿病的发病率为2.4%（1012例中的24例）。只有1例妊娠期糖尿病患者的葡萄糖筛查结果低于150毫克/分升。24例患者中有22例年龄至少为24岁。24例妊娠期糖尿病患者中有21例（88%）的葡萄糖筛查结果大于或等于150毫克/分升且年龄在24岁及以上。这些患者的诊断成本是阈值为130毫克/分升的普遍筛查诊断成本的40%。结论是，仅对年龄至少为24岁的患者采用150毫克/分升的阈值进行筛查应被视为普遍筛查的替代方法。
