Random Blood Glucose Measurement at Antenatal Booking to Screen for Overt Diabetes in Pregnancy

OBJECTIVE: To assess random venous blood glucose (RBG) measurement at antenatal booking to detect "overt diabetes in pregnancy" (ODIP). RESEARCH DESIGN AND METHODS: A retrospective analysis of regional hospital obstetric data from 2004-2008 was performed. Universal RBG screening was included at booking. Oral glucose tolerance test (OGTT) was administered if RBG >7.0 mmol/L or other indications, e.g., if a 50-g glucose challenge test was >7.7 mmol/L at 26-28 weeks. ODIP was based upon World Health Organization plasma glucose criteria for diabetes. RESULTS: RBG data were collected from 17,852/26,369 (67.7%) pregnancies around the initial antenatal visit; 3,007 women had an OGTT. The receiver operator curve area under the curve for RBG to detect ODIP was 0.86 (0.80-0.92) (assuming women without an OGTT did not have ODIP). CONCLUSIONS: RBG at booking may provide a sufficiently sensitive screening tool for the detection of ODIP. We recommend further studies and comparison with fasting glucose and HbA(1c).