Are women positive for the One Step but negative for the Two Step screening tests for gestational diabetes at higher risk for adverse outcomes?

Objective. To compare the prevalence and pregnancy outcomes of GDM between those screened by the “one-step” (75 gm GTT) and “two-step” (100 gm GTT) methods. Methods. A prospective study was conducted on singleton pregnancies at low or average risk of GDM. All were screened between 24 and 28 weeks, using the one-step or two-step method based on patients’ preference. The primary outcome was prevalence of GDM, and secondary outcomes included birthweight, gestational age, rates of preterm birth, small/large-for-gestational age, low Apgar scores, cesarean section, and pregnancy-induced hypertension. Results. A total of 648 women were screened: 278 in the one-step group and 370 in the two-step group. The prevalence of GDM was significantly higher in the one-step group; 32.0% versus 10.3%. Baseline characteristics and pregnancy outcomes in both groups were comparable. However, mean birthweight was significantly higher among pregnancies with GDM diagnosed by the two-step approach (3204 ± 555 versus 3009 ± 666 g; p=0.022). Likewise, the rate of large-for-date tended to be higher in the two-step group, but was not significant. Conclusion. The one-step approach is associated with very high prevalence of GDM among Thai population, without clear evidence of better outcomes. Thus, this approach may not be appropriate for screening in a busy antenatal care clinic like our setting or other centers in developing countries.

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264: The one-step method for screening and diagnosis of gestational diabetes: is it really better?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2012.10.429 ◽

2013 ◽

Vol 208 (1) ◽

pp. S120-S121

Author(s):

Janelle Foroutan ◽

Barak Rosenn ◽

Katarzyna Suffecool ◽

Kimberly Herrera ◽

Anna Fuchs ◽

...

Keyword(s):

Gestational Diabetes ◽

Step Method ◽

One Step ◽

The One ◽

Screening And Diagnosis

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The Prevalence of Gestational Diabetes Mellitus in Pregnant Women Referred to Amir al-Mu'minin Hospital of Gerash City, Fars Province, Iran

International Journal of Medical Laboratory ◽

10.18502/ijml.v8i3.7322 ◽

2021 ◽

Author(s):

Elham Rezaee ◽

Fariba Mohammadi ◽

Mohammad Javad Boozhmehrani ◽

Parisa Bagheri

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Health Care Providers ◽

Adverse Outcomes ◽

Screening Tests ◽

Fars Province ◽

Care Providers ◽

Significant Difference

Background and Aims: The increasing number of pregnant women being diagnosed as having gestational diabetes mellitus (GDM) and lead health care providers to develop reliable screening protocols and know the exact worldwide epidemiology of the disease. This study seeks to obtain data that will help to improve the epidemiologic knowledge about this disease. Materials and Methods: This cross-sectional study was performed on 953 pregnant women seeking routine prenatal screening tests. Participants participate with using Carpenter-Coustan criteria in the study. Statistical analysis was performed using SPSS software. Results and Conclusions: Among 953 pregnant women , 38 participants (4%) were detected to have GDM . Fifty percent of patients in the study were overweight .The data showed a significant difference in the mean age between the diabetic and non-diabetic groups. The high prevalence of GDM in young Iranian pregnant women may emphasize the need for early diagnosis and treatment to avoid adverse outcomes associated with GDM.

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Controversias actuales en el diagnóstico de la diabetes mellitus gestacional

Revista Colombiana de Endocrinología, Diabetes & Metabolismo ◽

10.53853/encr.2.3.89 ◽

2017 ◽

Vol 2 (3) ◽

pp. 5-13

Author(s):

José Fernando Botero Arango ◽

Claudia Monsalve Arango ◽

Alex Ramírez Rincón ◽

Natalia Aristizabal Henao ◽

José Luis Torres Grajales ◽

...

Keyword(s):

Gestational Diabetes ◽

Universal Screening ◽

International Association ◽

Study Groups ◽

Large For Gestational Age ◽

Maternal Hypertension ◽

One Step ◽

Newborn Complications ◽

The One ◽

Diabetes And Pregnancy

La diabetes gestacional es una condición que se reconoce por primera vez en el embarazo y está asociada a serias complicaciones maternas, fetales y perinatales en el corto y largo plazo. El tema más controversial ha sido la forma para realizar el diagnóstico por la existencia de múltiples criterios diagnósticos. Esta situación se ha vuelto más compleja en los últimos años a partir de la implementación de la estrategia de un paso, propuesta por la International Association of Diabetes and Pregnancy Study Groups (IADPSG, por sus iniciales en inglés), cuya aplicación aumentó la incidencia de la enfermedad hasta un 17,8% en comparación con la estrategia tradicional de dos pasos (tamización y prueba confirmatoria), con la que la incidencia siempre se había estimado entre 6 y 7%. La evidencia actual no ha demostrado que el enfoque de un paso sea superior a la estrategia de dos pasos, en términos de complicaciones, costos y salud pública. Dados los beneficios de la intervención, por disminución de la incidencia de desenlaces adversos como macrosomía, distocia de hombros, recién nacidos grandes para la edad gestacional e hipertensión materna, se justifica la realización del tamizaje universal en las gestantes.Abstract Gestational diabetes is any glucose abnormality first recognized in pregnancy. It has been associated with maternal, fetal and newborn complications. Which diagnostic method to use has been a source of controversy (75 gram OGTT vs the two step approach 50 gram followed by 100 gram OGTT). Since the recommendations made by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) of using the 75 gram OGTT it has been argued that the incidence would rise from approximately 6-7% to 17,8%. There is no evidence that the one step strategy is superior to the two step approach in terms of reduction of complications or from an economical stand point. Regardless of the method used to make the diagnosis it has been shown that treatment of GDM (gestational diabetes) decreases the incidence of large for gestational age, shoulder distocia, macrosomia and maternal hypertension. Universal screening should be recommended to all pregnant patients.

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