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New Clinical Rec Says Evidence Insufficient to Support Routine Screening for Gestational Diabetes. Physicians, Patients Should Make Case-by-Case Decisions
American Family Physician, 06/17/09

Mitchell D - According to new guidance the AAFP has approved for inclusion in its recommendations for clinical preventive services, insufficient evidence exists to support routine screening for gestational diabetes mellitus. The commonly used 50-gram, one-hour glucose challenge test, or GCT, has high specificity and low sensitivity. An abnormal 50-gram GCT result is typically followed by a 100-gram, three-hour oral glucose tolerance test, or OGTT. Two or more abnormal values on the OGTT are considered a diagnosis of diabetes.
The USPSTF said that until there is better evidence on screening for gestational diabetes, physicians should discuss screening with their patients and make case-by-case decisions. The task force said several groups of women are at increased risk of developing gestational diabetes, such as those who:

• are obese;
• are older than 25;
• have a family history of diabetes;
• have a history of gestational diabetes; or
• are Hispanic, Native American, Asian or black.

The more risk factors they have, the higher the chance that they'll have gestational diabetes, and the higher the chance that a positive test won't be a false-positive.

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