GDM Screening during the COVID Pandemic (Summary of SOGC Urgent Update – April 8, 2020)
Continue to encourage a healthy diet, exercise and appropriate weight gain in pregnancy
Current GDM screening, as per 2018 CPG (1) may continue if there are only minimal disruptions to capacity for lab testing or treatment of GDM.
- These recommend screening all pregnant women without pre-existing diabetes using a 50 g glucose challenge followed by a 75 g OGTT in those with a 1-hour glucose of 7.8-11.0 mmol/L (1).
This ALTERNATIVE SCREENING STRATEGY should be used if the COVID-19 pandemic causes severe disruptions to laboratory testing and treatment, and/or patient refusal.:
- All pregnant women without pre-existing diabetes will be SCREENED WITH AN A1c & NON-FASTING, RANDOM PLASMA GLUCOSE
- Women with an A1c of < 5.7% and a random plasma glucose < 11.1 mmol/L require no further testing or treatment.
- Those with an A1c of ≥ 5.7% or a random plasma glucose of ≥ 11.1 mmol/L are identified as having GDM and should be referred to the interprofessional diabetes and pregnancy healthcare team.
ALTERNATIVE SCREENING STRATEGY: Severe disruption to service, suspension of dynamic glucose testing, or patient refusal.
*This is a non-fasting random glucose.
- Postpartum screening in women who had GDM should be delayed until the pandemic is resolved