Editorial
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jul 25, 2016; 7(14): 279-289
Published online Jul 25, 2016. doi: 10.4239/wjd.v7.i14.279
Gestational diabetes mellitus: Screening with fasting plasma glucose
Mukesh M Agarwal
Mukesh M Agarwal, Department of Pathology, College of Medicine, UAE University, PO Box 17666, Al Ain, United Arab Emirates
Author contributions: Agarwal MM did the literature search, selected the relevant studies and wrote the manuscript.
Conflict-of-interest statement: Agarwal MM declares no conflict of interest related to this publication.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mukesh M Agarwal, MD, FCAP, Professor, Department of Pathology, College of Medicine, UAE University, Khalifa Bin Zayed Street, Tawam Hospital Campus, PO Box 17666, Al Ain, United Arab Emirates. magarwal7@gmail.com
Telephone: +971-3-7672000 Fax: +971-3-7671966
Received: April 3, 2016
Peer-review started: April 6, 2016
First decision: May 17, 2016
Revised: May 30, 2016
Accepted: June 27, 2016
Article in press: June 29, 2016
Published online: July 25, 2016
Abstract

Fasting plasma glucose (FPG) as a screening test for gestational diabetes mellitus (GDM) has had a checkered history. During the last three decades, a few initial anecdotal reports have given way to the recent well-conducted studies. This review: (1) traces the history; (2) weighs the advantages and disadvantages; (3) addresses the significance in early pregnancy; (4) underscores the benefits after delivery; and (5) emphasizes the cost savings of using the FPG in the screening of GDM. It also highlights the utility of fasting capillary glucose and stresses the value of the FPG in circumventing the cumbersome oral glucose tolerance test. An understanding of all the caveats is crucial to be able to use the FPG for investigating glucose intolerance in pregnancy. Thus, all health professionals can use the patient-friendly FPG to simplify the onerous algorithms available for the screening and diagnosis of GDM - thereby helping each and every pregnant woman.

Keywords: Gestational diabetes mellitus, Screening, Diagnosis, Fasting capillary glucose, Fasting plasma glucose

Core tip: The algorithms for the screening and diagnosis of gestational diabetes mellitus (GDM), advocated by various expert panels, are demanding for both the caregiver and the care-receiver: The widely accepted approach of screening all pregnant women with the oral glucose tolerance test is time-consuming, expensive and unfeasible in most countries. Over three decades of research, summarized in this review, suggests that the fasting plasma glucose can simplify the approach to GDM - only if all the limitations of using it are clearly understood.