A study from Kobe University indicates that casual blood glucose testing fails to identify 70% of gestational diabetes cases, underscoring the need for obstetricians to utilize more reliable screening methods to prevent pregnancy complications and future type II diabetes for both mothers and children.
Gestational diabetes mellitus occurs when previously healthy women experience elevated blood sugar levels during pregnancy. While treatment typically leads to healthy deliveries, unmanaged cases can result in complications and increased risks of type II diabetes. The International Association of the Diabetes and Pregnancy Study Groups recommends that all women undergo an oral glucose tolerance test between weeks 24 and 28.
This procedure requires fasting for 8-12 hours, followed by drinking a glucose solution and subsequent blood tests to assess sugar metabolism. However, many health facilities opt for a simpler casual blood glucose test, which measures glucose levels at any time without considering prior food intake, making it cheaper and quicker. Women who test positive in this initial screening are then referred for the more comprehensive glucose tolerance test.
Concerned that this approach might miss diabetes cases, Kobe University obstetrician TANIMURA Kenji and graduate student TOMIMOTO Masako combined the casual blood glucose screening with a more sensitive glucose challenge test at their perinatal center. They found that 71.7% of the 99 women diagnosed with gestational diabetes had initial blood sugar levels that would have led to a negative diagnosis using the casual test. “While previous studies indicated the lower sensitivity of casual testing, ours directly compared results within the same individuals,” Tomimoto noted.
To assess the prevalence of this issue, the team surveyed healthcare facilities in Hyogo Prefecture and found that 43% relied solely on the casual screening. “In Japan, many deliveries occur in obstetric clinics where the more accurate tests are not widely used,” Tomimoto explained. This concern is echoed in the UK, where 48% of clinics also depend only on casual testing.
Tanimura emphasized the importance of their findings: “We aim to educate healthcare professionals and patients about the risks of relying on casual tests and advocate for the adoption of more accurate glucose tolerance screenings. Our goal is to enhance gestational diabetes management and reduce the long-term risks associated with the condition.”
