Detection up with one-step gestational diabetes screening
Kisti P. Fuller, M.D., from the University of Connecticut John Dempsey Hospital in Farmington, and Adam F. Borgida, M.D., from Hartford Hospital in Connecticut, assessed the relative benefits of the two-step (50-g, one-hour glucose test followed by a 100-g, three-hour oral glucose tolerance test [OGTT] for those screening positive) and the one-step (75-g, two-hour test) GDM screening tests. The study was conducted at an inner-city, tertiary-care hospital, which changed its routine from the two-step to the one-step process and included data for 812 patients.
The researchers found that 458 patients underwent two-step testing (16.4 percent required OGTT) and 257 patients underwent one-step testing. Seven percent of the patients who underwent two-step testing ultimately tested positive for GDM after OGTT, compared with 11.7 percent who underwent one-step screening. Overall, 9.9 percent were not compliant with one-hour screening, compared with 16.4 percent who were not compliant with two-hour screening (P = 0.007). No between-group differences were seen for mode of delivery, average birth weight, or Apgar score, or in the rates of neonatal outcomes.
"The one-step, two-hour screening for GDM appears to be associated with an increased rate of GDM, despite decreased rates of screening, without improving maternal or neonatal outcomes," the authors write.
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