New GDM screening set to reduce COVID-19 risk - Diabetes WA
 In COVID-19, Frontpage, News

Pregnant women now have more choice when it comes to testing for GDM.

Thousands of pregnant Western Australians will now be able to avoid lengthy spells sitting in pathology centres thanks to temporary new guidelines for the screening and diagnosis of gestational diabetes (GDM).

Devised by four of the country’s peak diabetes bodies, and supported by Diabetes WA, the changes will reduce both the number of visits to pathology centres, and the length of the visits.

Australian standards recommend that all pregnant women undergo an oral glucose tolerance test (OGTT) between 24 and 28 weeks to screen for gestational diabetes. This involves women drinking a glucose solution and then waiting for two hours at the pathology centre for further blood tests.

The temporary guidelines have introduced some flexibility into the testing process to minimise the need for pregnant women to attend pathology centres.

Now, women can have a single blood test (fasting blood glucose test) at the 24 to 28 weeks stage, and if their results are within a normal range, they may not need to return for the full OGTT allowing them to avoid a two-hour long test at the pathology centre.

Additionally, women who are at high risk of developing GDM can now have a single blood test (HbA1c test) earlier on – in the first trimester – and if this result is higher than the normal range, they may choose to assume they have the condition and begin GDM care and blood glucose monitoring, again without returning for the OGTT

Women who are at risk of GDM include those who are older than 40, are obese, or who have an Asian, Indian Subcontinent, non-white African, Aboriginal and Torres Strait Islander background. Women who are expecting a multiple birth (twins or triplets) are also at higher risk of developing GDM.

Women who have previously had GDM can choose to forgo all testing and simply assume they have the condition again and commence GDM care and blood glucose monitoring straight away.

However, if they wish, they still have the choice of going through the testing process in the same way as women who have never had GDM.

Following the birth of their children, women with gestational diabetes are typically asked to have another OGTT to confirm that their gestational diabetes has resolved. The temporary guidelines suggest this test be delayed by six to 12 months (but before their child’s first birthday).

In recognition of these temporary guidelines, the National Diabetes Services Scheme (NDSS) has amended its criteria so now any pregnant woman who has previously had gestational diabetes will be able to immediately access subsidised products they need to self-monitor their blood glucose.

Diabetes WA General Manager Health Services Deborah Schofield applauded the moves, which would see thousands of local women reduce their risk of potential exposure to COVID-19.

“Our guidelines for screening and diagnosing gestational diabetes are in line with international best practice – we are very good at detecting those women who experience gestational diabetes and supporting them through their pregnancies. We always encourage women to come forward for GDM assessment, for their health and their bubs,” she said.

“But at this time, it makes sense to pause and consider a temporary adjustment. Pregnant women are among our most vulnerable, and we don’t wish to expose them to unnecessary risks,” she said.

She noted that health professionals caring for pregnant women were being urged to use their best judgement when recommending tests to women and that women who wanted to undertake both the FBG test and the OGTT would still be able to.

“It should also be noted that the bodies involved in drafting these guidelines have been very clear in stating that these are temporary measures, and that we will revert to usual testing procedures once the COVID-19 situation resolves.”

Further information on the changes can be found here:

Diagnostic Testing for Gestational Diabetes Mellitus (GDM) during the COVID-19 Pandemic (PDF)

NDSS Gestational Diabetes Registration and Changes during the COVID-19 Pandemic

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