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Practice Guideline
. 2020 Oct;75(5):340-347.
doi: 10.1080/17843286.2019.1637389. Epub 2019 Jul 1.

The 2019 Flemish consensus on screening for overt diabetes in early pregnancy and screening for gestational diabetes mellitus

Katrien Benhalima  1 , Caro Minschart  1 , Paul Van Crombrugge  2 , Peggy Calewaert  1 , Johan Verhaeghe  3 , Siska Vandamme  3 , Katrien Theetaert  3 , Roland Devlieger  3 , Leen Pierssens  4 , Hannah Ryckeghem  2 , Els Dufraimont  5 , Chris Vercammen  6 , Ann Debie  6 , Christophe De Block  7 , Griet Vandenberghe  8 , Sylva Van Imschoot  9 , Sabine Verstraete  10 , Luk Buyse  10 , Johan Wens  11 , Joke Muyldermans  12 , Anissa Meskal  13 , Sandy De Spiegeleer  14 , Chantal Mathieu  1
Affiliations
Practice Guideline

The 2019 Flemish consensus on screening for overt diabetes in early pregnancy and screening for gestational diabetes mellitus

Katrien Benhalima et al. Acta Clin Belg. 2020 Oct.

Abstract

Screening for gestational diabetes mellitus (GDM) is important to improve pregnancy outcomes and to prevent type 2 diabetes after pregnancy. The 'International Association of Diabetes and Pregnancy Study Groups' (IADPSG) recommends a universal one-step approach with the 75 g oral glucose tolerance test (OGTT) for screening of GDM. The IADPSG recommendation remains controversial due to the important increase in GDM prevalence and increased workload. After review of the latest evidence and based on data from the 'Belgian Diabetes in Pregnancy' study, members of the Diabetes Liga, the Flemish associations of general physicians (Domus Medica), obstetricians (VVOG), midwives (VVOB), diabetes nurse educators (BVVDV) and clinical chemists (RBSLM) have reached a new consensus on screening for GDM in Flanders. This new consensus recommends universal screening for overt diabetes when planning pregnancy or at the latest at first prenatal contact, preferably by measuring the fasting plasma glucose by using the same diagnostic criteria as in the non-pregnant state. In women with impaired fasting glycaemia, but also in normoglycemic obese women and women with a previous history of GDM, lifestyle counselling is advised with screening for GDM with a 75 g OGTT at 24 weeks. In all other women, we recommend a two-step screening strategy with a 50 g glucose challenge test (GCT) at 24 weeks followed by a 75 g OGTT when the glucose level 1 hour after the GCT ≥130 mg/dl. Diagnosis of GDM is made using the IADPSG criteria for GDM. Postpartum screening for subsequent glucose abnormalities should be advocated and organized for every woman with GDM.

Keywords: Gestational diabetes mellitus; consensus; pregnancy; screening; type 2 diabetes.

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