Gestational diabetes screening could be easier thanks to COVID
Current screening for Gestational Diabetes Melitus (GDM) requires a two-to-three-hour oral glucose tolerance test, but because of a research team at Royal Brisbane and Women’s Hospital, could there be an easier way?
Dr Susan de Jersey and her research team to investigated whether the more rapid test used in 2020 during COVID might represent a better alternative for gestational diabetes screening.
Under the present approach, women need to attend a pathology lab before they have consumed any food or drink that day, undergo a blood test, then have a sweet drink before taking two more blood tests, one and two hours later.
In 2020, the requirement changed to just the fasting blood glucose test to reduce the number of women attending pathology centres and risking exposure to COVID-19. This approach found that some women could be diagnosed with GDM based on this fasting level alone and only a smaller group of women with a blood glucose level within a certain range would need to have the full oral glucose tolerance test.
This discovery led dietitian Associate Professor Susan de Jersey and her research team to investigate whether this more rapid test used in 2020 might represent a better alternative for women. The team, based at Royal Brisbane and Women’s Hospital, partnered with QUT, University of Queensland, Queensland Health Statistical Services and Data Linkage Branch, and private pathology labs QML and Sullivan and Nicolaides.
“Our research team wanted to understand if this different way of testing for GDM changed the outcomes for the mother and baby in Queensland. We also wanted to know what women and health professionals thought about the different way of testing,” Assoc Prof de Jersey said.
She said it was important to understand how modifications to the screening process could impact the outcomes for mothers and babies, with many women finding the two-to-three hour test inconvenient, and poorly tolerated or uncomfortable. If the simpler test was found to be effective it could make the screening process easier and more accessible for pregnant women.
The research comparing the tests used information pre-COVID in 2019 and during COVID in 2020, showing that the number of GDM diagnoses was similar in both years. For women not diagnosed with GDM, the outcomes were generally the same in both years, except for a slight increase in caesarean deliveries during the COVID-19 pandemic in 2020. For women with GDM in 2020, birth weight was higher, and there was a slightly higher chance of having a large baby, but a lower chance of having a small baby compared to 2019.
“These findings suggest that the new test used in 2020 was effective in excluding GDM in women with a low risk of GDM related complications,” Dr de Jersey said.
“This could potentially save thousands of women every year from undergoing the full testing and consequently save the health system a lot of money. We are confident that revising the method will not adversely impact mothers or their babies.”