Abstract
Background
The American Diabetes Association has endorsed the International Association of Diabetes and Pregnancy Groups (IADPSG) recommendation that every pregnant woman should undergo the 75 g oral glucose tolerance test (OGTT) to screen for gestational diabetes mellitus (GDM).
Purpose
To find the cost and workload implications of switching from the current two-step screening of GDM to the one-step IADPSG approach.
Methods
The cost (US $) and laboratory workload units (WLU) were calculated for three possible strategies: (1) 50 g glucose screen, if positive, followed by the 100 g OGTT; (2) universal 75 g OGTT; and (3) screening with the initial fasting plasma glucose of the OGTT.
Results
For the 1,101 pregnant women screened in 1 year, the cost of the three strategies was $ 31,985, $ 55,250 and $ 35,875, respectively; the laboratory burden was 28,975 WLU, 18,662 WLU and 12,215 WLU, respectively.
Conclusions
Switching to the one-step, strategy 2 (IADPSG) would increase the cost by 42 % but decrease the laboratory workload by 36 % compared to the two-step, strategy 1. However, an initial screen by the fasting plasma glucose of the OGTT is the ideal strategy, both in terms of cost and laboratory workload.
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Agarwal, M.M., Dhatt, G.S. & Othman, Y. Gestational diabetes in a tertiary care hospital: implications of applying the IADPSG criteria. Arch Gynecol Obstet 286, 373–378 (2012). https://doi.org/10.1007/s00404-012-2324-4
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DOI: https://doi.org/10.1007/s00404-012-2324-4