The 2024 Flemish consensus on screening for gestational diabetes mellitus early and later in pregnancy.
Level 5 - mechanism / opinion, no new human data
Expert consensus statement without new primary clinical trial data or systematic review
PubMed 39068500 · doi:10.1080/17843286.2024.2384258
What was done
A multidisciplinary panel of Flemish medical and allied health societies (including general practitioners, obstetricians, midwives, diabetes educators, dieticians, and clinical chemists) updated the 2019 Flemish consensus on screening for gestational diabetes mellitus (GDM) in response to recent randomized trial data (TOBOGM).
What was found
The updated consensus recommends: - Early pregnancy (<20 weeks): Universal screening for overt diabetes using standard non-pregnant fasting plasma glucose (FPG) criteria. Early GDM is diagnosed if FPG is 95–125 mg/dL (5.3–6.9 mmol/L). - High-risk early screening (6–20 weeks): In women with obesity or a history of GDM, a 75 g oral glucose tolerance test (OGTT) is recommended using higher cut-offs: fasting ≥95 mg/dL (5.3 mmol/L), 1-hour ≥19 mg/dL (reported alongside 10.6 mmol/L, reflecting a typo in the source), and/or 2-hour ≥162 mg/dL (9.0 mmol/L). - Later pregnancy (24–28 weeks): Standard screening remains unchanged using a 75 g OGTT with IADPSG criteria: fasting ≥92 mg/dL (5.1 mmol/L), 1-hour ≥180 mg/dL (10.0 mmol/L), and/or 2-hour ≥153 mg/dL (8.5 mmol/L).
Why it matters
This guidance shifts regional clinical practice by establishing defined glucose thresholds for early GDM diagnosis and treatment in high-risk women prior to 20 weeks of gestation, aiming to lower neonatal complication rates.
Limits
This publication is a regional consensus guideline and does not report primary patient data, sample sizes, or a formal systematic review. The abstract contains a typographical error in the 1-hour OGTT mg/dL value (listing 19 mg/dL alongside 10.6 mmol/L). Recommendations are tailored specifically to the Flemish healthcare infrastructure.
Cited by
- supports The standard fasting blood glucose cutoff between healthy and prediabetes is 100 mg/dL in non-pregnant adults, whereas in pregnancy a fasting level above 92 mg/dL indicates gestational diabetes.