Diagnostic Strategies for Gestational Diabetes Mellitus: Review of Current Evidence
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Purpose of Review
Currently, the diagnosis of gestational diabetes mellitus (GDM) lacks uniformity. Several controversies are still under debate, especially on the method of screening and diagnosis. This review focuses on recent literature and provides current evidence for the screening and diagnosis of GDM.
Selective screening would miss a significant number of women with GDM. In contrast, universal screening has been shown to be cost-effective, compared with selective screening, and is recommended by many medical societies. For the diagnostic methods for GDM, most observational cohort studies reported that the one-step method is associated with improved pregnancy outcomes and is cost-saving or cost-effective, compared with the two-step method, although these findings should be confirmed in the upcoming randomized controlled trials which compare the performance of one-step and two-step methods. On the other hand, the methods of early screening or diagnosis of GDM are varied, and current evidence does not justify their use during early pregnancy.
In conclusion, current evidence favors universal screening for GDM using the one-step method. Early screening for GDM is not favorably supported by the literature.
KeywordsGestational diabetes mellitus Screening Diagnostic strategy Risk factor modeling Oral glucose tolerance tests
Compliance with Ethical Standards
Conflict of Interest
Chun-Heng Kuo and Hung-Yuan Li declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
All reported studies with human subjects performed by the authors have been previously published and complied with the ethical standards of institutional research committee and with the Helsinki declaration and its amendments.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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