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It is my understanding that using ADA GDM screening guidelines would NOT result in a significant increase in GDM numbers. When screening & testing is performed during the first trimester, at the first prenatal visit as recommended, the diagnosis would be occult DMII not GDM.
This diagnosis in the first trimester of pregnancy and its treatment is significantly different from screening/diagnosis/treatment of GDM at 24-28wks. Uncontrolled hyperglycemia during the first trimester poses increased risk of many complications including birth defects. This is NOT the case with GDM.
I realize that your article addresses the differences in 24-28 wk OGTT testing, but early screening is so important for the patient population our clinic sees. I wish ACOG would recommend the ADA early screening recommendations!
Anne Willingham, RN, BSN
Seattle, WA
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