The Clinical and Financial Effects of Replacing the 1 h 50 g Screening Test for Gestational Diabetes Mellitus by the Stick Method

Background. Gestational diabetes is connected with fetal macrosomia and higher perinatal mortality and morbidity rates. The usually quoted literature, which causes so much anxiety among pregnant women and an increased number of cesarean sections, is often dated, from the times when pregnancy monitoring methods were not as highly developed as they are now, comes from heterogeneous populations, and does not take into consideration the age and ethnicity of women. Screening for gestational diabetes mellitus (GDM), diagnostic tests, and special programs for diabetic pregnant women are very expensive and time consuming. It is worthwhile then to try to evaluate their cost and see if reducing it would affect the clinical results. Objectives. The aim of this study was to identify the real cost reduction and clinical advantages/disadvantages of replacing the 1-hr 50-g glucose challenge test (GCT) with the glucometer (stick method). Material and Methods. Two hundred and two pregnant women from the population of this clinic attended screening for GDM by both enzymatic and stick method. The criteria for both measurements were the same. The positively screened women received a one-step diagnostic test and only they participated in the clinic's diabetic program. Results. The results showed that replacing the enzymatic method by the stick method would reduce the total cost of screening for GDM by 90%. It was also calculated that the total cost of screening by this method followed by the diagnostic test would be 9.5 times lower than screening by the enzymatic method. It would have no harmful effects on perinatal outcome and would even make it possible to shorten the time between screening and treatment of GDM by about 7 days. Conclusions. Although identifying GDM is important because of possible perinatal complications, the same aim can be achieved by replacing the GCT with the glucometer (Adv Clin Exp Med 2009, 18, 6, 601-607).