Gestational diabetes screening: The low-cost algorithm

Mukesh M. Agarwal, Bernhard Weigl, Moshe Hod

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)


The American Diabetes Association has endorsed the demanding recommendation by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) that every pregnant woman should undergo the oral glucose tolerance test (OGTT) for the screening of gestational diabetes mellitus (GDM). The aim of this study was to find out if the fasting plasma glucose (FPG) and newer emerging technologies could simplify the cumbersome IADPSG algorithm. Two FPG thresholds (of the OGTT) were used to rule in and rule out GDM in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort (n = 23316) and a population at high risk for GDM (n = 10283). For the HAPO cohort and the high-risk population, respectively, FPG thresholds of: (a) ≥5.1 mmol/L (specificity 100%) independently ruled in GDM in 1769 (8.3%) women and 2975 (28.9%) women; and (b) ≤4.4 mmol/L ruled out GDM in 11526 (49.4%) women (84.1% sensitivity) and 2228 (21.7%) women (95.4% sensitivity). Use of the FPG independently could have avoided 13295 (57.0%) and 5203 (50.6%) OGTTs in the 2 groups. The initial FPG - by significantly reducing the number of cumbersome OGTTs needed - can make the IADPSG recommendations more acceptable worldwide. The number of GDM women missed is population dependent. For low-resource countries, alternative newer and cheaper tests in development hold an exciting future.

Original languageEnglish
Pages (from-to)S30-S33
JournalInternational Journal of Gynecology and Obstetrics
Issue numberSUPPL. 1
Publication statusPublished - Nov 2011
Externally publishedYes


  • Fasting glucose
  • Gestational diabetes
  • Low-resource countries
  • Screening

ASJC Scopus subject areas

  • Obstetrics and Gynaecology


Dive into the research topics of 'Gestational diabetes screening: The low-cost algorithm'. Together they form a unique fingerprint.

Cite this