At which antenatal visit is the routine oral glucose tolerance test (OGTT) or random blood glucose screening recommended in India?

Question

Accepted Answer

A. 24–28 weeks of gestation. ## Timing of Gestational Diabetes Screening

**Key Point:** The oral glucose tolerance test (OGTT) or random blood glucose screening for gestational diabetes mellitus (GDM) is performed at **24–28 weeks of gestation** in India, as per ICMR and FOGSI guidelines.

### Rationale for 24–28 Weeks

1. **Physiological basis**: Insulin resistance peaks in the second and third trimester, making this the optimal window to detect GDM.
2. **Clinical outcome**: Early detection allows time for dietary and lifestyle interventions before fetal complications arise.
3. **Standard practice**: This timing aligns with international guidelines (WHO, ACOG) and is universally adopted in Indian antenatal care.

### Screening Protocol in India

| Gestational Age | Test | Method |
| --- | --- | --- |
| 24–28 weeks | Random blood glucose or OGTT | Fasting + 2-hour post-load |
| If RBG ≥140 mg/dL | Confirmatory OGTT | 75 g, 2-hour OGTT |
| Diagnostic criteria | OGTT ≥140 mg/dL (2-hour value) | ICMR criteria |

**High-Yield:** GDM screening at 24–28 weeks is a **cornerstone of antenatal care** in India; missing this window delays diagnosis and increases risk of macrosomia, polyhydramnios, and neonatal hypoglycemia.

**Clinical Pearl:** Women with risk factors (obesity, family history of diabetes, previous GDM) may warrant earlier screening at 16–18 weeks, but routine screening remains 24–28 weeks.

Answer

B. 32–34 weeks of gestation

Answer

C. 36–38 weeks of gestation

Answer

D. 12–14 weeks of gestation

At which antenatal visit is the routine oral glucose tolerance test (OGTT) or random blood glucose screening recommended in India?

Explanation

Timing of Gestational Diabetes Screening

Rationale for 24–28 Weeks

Screening Protocol in India

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Gestational Age	Test	Method
24–28 weeks	Random blood glucose or OGTT	Fasting + 2-hour post-load
If RBG ≥140 mg/dL	Confirmatory OGTT	75 g, 2-hour OGTT
Diagnostic criteria	OGTT ≥140 mg/dL (2-hour value)	ICMR criteria