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Shortly, at the first prenatal visit, all (universal) or high-risk (selective) women should be tested for either fasting plasma glucose (FPG), glycosylated hemoglobin A1c, or random plasma glucose. The choice for screening is based on the background frequency of abnormal glucose metabolism and on local circumstances. Criteria for low-risk women for GDM include all of the following: absence of diabetes in first-degree relatives, age <25 years, normal prepregnancy weight, no history of poor carbohydrate metabolism, and no history of adverse pregnancy outcome. High-risk criteria include one of the following: prepregnancy obesity, family history T2DM, GDM in a prior pregnancy, and known carbohydrate intolerance or glucosuria. To diagnose GDM at 24–28 weeks of gestation, a 2-h 75 g OGTT is recommended to be performed after overnight fasting for all women not previously found to have overt diabetes or GDM during earlier testing [32].

Table 4. Threshold values for diagnosis of overt diabetes and gestational diabetes