1. The 2019 Flemish consensus on screening for overt diabetes in early pregnancy and screening for gestational diabetes mellitus
- Author
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Leen Pierssens, Ann Debie, Joke Muyldermans, Paul Van Crombrugge, Anissa Meskal, Katrien Theetaert, Els Dufraimont, Roland Devlieger, Peggy Calewaert, Luk Buyse, Sylva Van Imschoot, Chantal Mathieu, Katrien Benhalima, Griet Vandenberghe, Siska Vandamme, Caro Minschart, S. Verstraete, Sandy De Spiegeleer, Johan Wens, Chris Vercammen, Hannah Ryckeghem, Johan Verhaeghe, Christophe De Block, Vesalius College, History, Physiotherapy, Human Physiology and Anatomy, and Human Physiology and Sports Physiotherapy Research Group
- Subjects
Counseling ,medicine.medical_specialty ,endocrine system diseases ,Overt diabetes ,Pregnancy in Diabetics ,Bariatric Surgery ,Early pregnancy factor ,Type 2 diabetes ,Gestational diabetes mellitus ,Obesity, Maternal ,03 medical and health sciences ,0302 clinical medicine ,Belgium ,Pregnancy ,Diabetes mellitus ,medicine ,Glucose challenge test ,Humans ,Mass Screening ,030212 general & internal medicine ,Societies, Medical ,biology ,Obstetrics ,business.industry ,screening ,Diabetes in pregnancy ,nutritional and metabolic diseases ,Prenatal Care ,General Medicine ,Fasting ,Glucose Tolerance Test ,medicine.disease ,female genital diseases and pregnancy complications ,Gestational diabetes ,Diabetes, Gestational ,Pregnancy Trimester, First ,Diabetes Mellitus, Type 1 ,Diabetes Mellitus, Type 2 ,consensus ,030220 oncology & carcinogenesis ,biology.protein ,Female ,pregnancy ,type 2 diabetes ,Human medicine ,Preconception Care ,business - 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. ispartof: ACTA CLINICA BELGICA vol:75 issue:5 pages:340-347 ispartof: location:England status: published
- Published
- 2019