[AlexT]

Сообщение от Anna_Shvedova

Двухэтапный весь мир уже отменил. Даже ADA, которая его и выдвинула и держалась за него дольше всех. Не думаю, что стоит о нем сожалеть..

ACOG не поддержал одноэтапный скрининг. Оставлен 2-этапный подход.

August 24, 2011 — The American College of Obstetricians (ACOG) is standing by its recommendation for a 2-step approach to screening and diagnosis for gestational diabetes mellitus (GDM) in the continued absence of an international consensus on whether the benefits of some screening approaches outweigh the costs, according to a committee opinion published in the September issue of Obstetrics & Gynecology.
In 2001, the group recommended a "2-step" approach for screening and diagnosing for the disease, and ACOG's Committee on Obstetric Practice reiterated its guidelines this week, adding a third recommendation against an alternative approach outlined by the International Association of Diabetes in Pregnancy Study Group.

The recommendations are as follows:

"All pregnant women should be screened for GDM by patient history, clinical risk factors, or a 50-g, 1-hour loading test to determine blood glucose levels."
"The diagnosis of GDM can be made based on the result of the 100-g, 3-hour oral glucose tolerance test, for which there is evidence that treatment improves outcome. Either the plasma or serum glucose level established by Carpenter and Coustan or the plasma level designated by the National Diabetes Data Group is appropriate to use. A positive diagnosis requires that 2 or more thresholds be met or exceeded."
"Diagnosis of GDM based on the 1-step screening and diagnosis test outlined in the International Association of Diabetes in Pregnancy Study Group guidelines is not recommended at this time because there is no evidence that diagnosis using these criteria leads to clinically significant improvements in maternal or newborn outcomes, and it would lead to a significant increase in healthcare costs."
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