DIAGNOSIS OF DIABETES in PREGNANCY- RANDOM GLUCOSE vs OGTT

DIAGNOSIS OF DIABETES in PREGNANCY- RANDOM GLUCOSE  vs OGTT
QUESTION-i have question concerning diagnosis of gestational diabetes millitus , according to recent screening strategy , if for example a patient didn't make screening in her first trimester , and than after we find in a routin biological assessement a random glycemia at 1.39 g/l , in his second trimester , do we made a OGTT or not, i mean , can we made  diagnosis only with GPP, or we have to make OGTT  in all cases. DR Nadjib Kaouache, .Universitary   Hospital. . Algeria
RESPONSE-I am assuming he means 139 mg/dl.  A random of 139 mg/dl does NOT make the diagnosis of GDM.  A fasting of >125 mg/dl would make the diagnosis of overt (or pre-existing) diabetes but only a random of 200 mg/dl makes a diagnosis of overt diabetes.  Furthermore, the diagnosis is made using plasma glucoses, not those obtained by a fingerstick glucose using a glucose meter since meters only have to be within 15% of a plasma glucose to be on the market.  There is no random value by which a glucose makes criteria for GDM (except one of 200 which also makes criteria for overt diabetes).  Therefore an OGTT would be required. Linda Barbour, MD, MSPH