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A critical appraisal and potentially new conceptual approach to screening and diagnosis of gestational diabetes

The aim of this article was a critical appraisal of current GDM screening and diagnosis tests as well as a presentation of a potentially new approach to this perinatologic and public health problem of increasing clinical significance. Medline, EMBASE and Cochrane databases were searched. Most professional organisations recommend universal screening at 24-28 weeks of gestation, while some of them state that selective screening could also be recommended. Expert opinions regarding GDM diagnosis significantly differ throughout the world. Authors call for an open and broad professional and scientific discussion and suggest a combination of screening and diagnosis procedures in a form of one-step 1-h screening method, creation of regional GDM diagnostic criteria and standardization of outcome-based randomized control trials. They also advise introduction of a conceptually new approach, where the risk of hyperglycemia rather than insisting on GDM diagnosis itself be detected.

diagnosis ; gestational diabetes ; hyperglycemia in pregnancy ; outcome-based study ; public health ; screening

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