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Routine screening of women with a glucose challenge test may find more women with gestational diabetes than only screening women with risk factors. [37] Hemoglobin A 1c (HbA1c) is not recommended for diagnosing gestational diabetes, as it is a less reliable marker of glycemia during pregnancy than oral glucose tolerance testing (OGTT).
Some tests are designed to discover problems which primarily affect the health of the mother, such as PAPP-A to detect pre-eclampsia or glucose tolerance tests to diagnose gestational diabetes. Screening can also detect anatomical defects such as hydrocephalus, anencephaly, heart defects, and amniotic band syndrome.
The glucose tolerance test was first described in 1923 by Jerome W. Conn. [4]The test was based on the previous work in 1913 by A. T. B. Jacobson in determining that carbohydrate ingestion results in blood glucose fluctuations, [5] and the premise (named the Staub-Traugott Phenomenon after its first observers H. Staub in 1921 and K. Traugott in 1922) that a normal patient fed glucose will ...
Glucose loading test (GLT) – screens for gestational diabetes; if > 140 mg/dL, a glucose tolerance test (GTT) is administered; a fasting glucose > 105 mg/dL suggests gestational diabetes. [20] Most doctors do a sugar load in a drink form of 50 grams of glucose in cola, lime or orange and draw blood an hour later (plus or minus 5 minutes).
Screening for diabetes during pregnancy continues to require fasting and glucose-tolerance measurements for gestational diabetes at 24 to 28 weeks gestation, although glycated hemoglobin may be used for screening at the first prenatal visit. [37]
Pre-gestational diabetes can be classified as Type 1 or Type 2 depending on the physiological mechanism. Type 1 diabetes mellitus is an autoimmune disorder leading to destruction of insulin-producing cell in the pancreas; type 2 diabetes mellitus is associated with obesity and results from a combination of insulin resistance and insufficient insulin production.
A level below 5.6 mmol/L (100 mg/dL) 10–16 hours without eating is normal. 5.6–6 mmol/L (100–109 mg/dL) may indicate prediabetes and oral glucose tolerance test (OGTT) should be offered to high-risk individuals (old people, those with high blood pressure etc.). 6.1–6.9 mmol/L (110–125 mg/dL) means OGTT should be offered even if other ...
Fetuses of mothers who developed gestational diabetes mellitus (GDM) grow faster already before the time GDM was diagnosed (women are typically screened at 28 weeks of gestation), suggesting that screening for GDM should be performed earlier (at 24 weeks). [11]