January 15, 2014 — All pregnant women who have not been diagnosed with diabetes should be screened for gestational diabetes after 24 weeks of pregnancy, even if they do not display symptoms, according to a recommendation issued Monday by the U.S. Preventive Services Task Force, Reuters reports (Seaman, Reuters, 1/13).
According to CQ HealthBeat, USPSTF issued a "B" recommendation for the screening, meaning that the panel agreed with reasonable certainty that the screenings would offer moderate net benefits of reducing maternal and fetal complications after 24 weeks of pregnancy (Adams, CQ HealthBeat, 1/13). Under the Affordable Care Act (PL 111-148), health plans must cover preventive services and treatments without a copayment or deductible if they are rated "A" or "B" by USPSTF (Women's Health Policy Report, 1/10).
The panel also noted there is no substantial evidence supporting a recommendation of screening for gestational diabetes before 24 weeks.
The new recommendation is an update to a 2008 statement that concluded there was not enough evidence at the time to recommend for or against such gestational diabetes screenings (Reuters, 1/13).
Under the new recommendation, physicians should test for gestational diabetes using a two-hour, 50-gram oral glucose challenge test between 24 weeks and 28 weeks. If a woman's glucose level reaches or exceeds a limit of 130 mg/dL, physicians should follow up with a two-hour, 100-gram oral glucose tolerance test.
While other tests for the disease exist, such as fasting plasma glucose or conducting screenings based on other risk factors, USPSTF said evidence for those methods is limited. If a woman is found to have gestational diabetes, the panel said she should undergo a treatment regimen consisting of regular glucose monitoring, moderate physical activity, dietary changes, and support from diabetes educators and nutritionists (Fiore, MedPage Today, 1/13).
USPSTF noted that certain groups of women have an elevated risk for developing the condition, including those who are obese, older, are members of an ethnic group with an increased risk of type 2 diabetes, or have a personal history of gestational diabetes or family history of diabetes (Reuters, 1/13).