Individual research recommendation details

Recommendation ID

NG3/2

Question

When should testing for gestational diabetes take place – in the first or second trimester?

Any explanatory notes
(if applicable)

Conventionally, testing for gestational diabetes takes place in the second trimester. Intervention
has been shown to improve outcomes for women diagnosed with gestational diabetes. However,
maternal age and obesity are increasing, and some women (especially those from populations with
a high incidence of type 2 diabetes) enter pregnancy with undiagnosed type 2 diabetes, but may not be tested for diabetes until the second trimester. This exposes the woman and the fetus to risks resulting from early and prolonged maternal hyperglycaemia. It is presumed that this is associated with increased morbidity. UK population studies are needed to establish the incidence of glucose intolerance in women in the first trimester Well-designed randomised controlled trials are needed to establish if testing, diagnosis and intervention in the first rather than the second trimester improves maternal, fetal and neonatal outcomes, including fetal hyperinsulinaemia.

Source guidance details

Comes from guidance

Diabetes in pregnancy: management from preconception to the postnatal period

Number

NG3

Date issued

February 2015

Other details