Gestational diabetes mellitus: Screening with fasting plasma glucose

Abstract

Fasting plasma glucose (FPG) as a screening test for gestational diabetes mellitus (GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-conducted studies. This review: (1) traces the history; (2) weighs the advantages and disadvantages; (3) addresses the significance in early pregnancy; (4) underscores the benefits after delivery; and (5) emphasizes the cost savings of using the FPG in the screening of GDM. It also highlights the utility of fasting capillary glucose and stresses the value of the FPG in circumventing the cumbersome oral glucose tolerance test. An understanding of all the caveats is crucial to be able to use the FPG for investigating glucose intolerance in pregnancy. Thus, all health professionals can use the patient-friendly FPG to simplify the onerous algorithms available for the screening and diagnosis of GDM - thereby helping each and every pregnant woman.

Keywords: Diagnosis; Fasting capillary glucose; Fasting plasma glucose; Gestational diabetes mellitus; Screening.

Figure 1

Effect healthy and diseased populations overlap on screening test performance (A-C). GDM: Gestational diabetes mellitus.

Figure 2

Suggested algorithm for gestational diabetes mellitus screening. OGTT: Oral glucose tolerance test; FPG: Fasting plasma glucose; GDM: Gestational diabetes mellitus; DM: Diabetes mellitus.