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The U.S. Preventive Services Task Force recommends screening pregnant women for gestational diabetes mellitus (GDM). It can be diagnosed with a one-step approach, favored by the American Diabetes Association, or a two-step approach, favored by the American College of Obstetricians and Gynecologists. To evaluate associated clinical outcomes, investigators randomized 23,792 pregnant women at 24 to 28 weeks gestation to the one- or two-step approach.
The one-step process involved a fasting 75-g glucose load, with 2 hours of glucose measurements. GDM was defined as glucose levels of ≥92 mg/dL at baseline, ≥180 mg/dL at 1 hour after glucose load, or ≥153 mg/dL at 2 hours. The two-step process involved an initial nonfasting 50-g glucose load. GDM …