## Screening for Gestational Diabetes in India **Key Point:** The ICMR (Indian Council of Medical Research) recommends a **universal screening approach** using a 75 g OGTT at 24–28 weeks of gestation for all pregnant women in India. ### Rationale for 75 g OGTT **High-Yield:** The 75 g OGTT is the gold standard for GDM diagnosis because: - Single-step test (no need for 50 g screening followed by 100 g confirmatory test) - Aligns with WHO diagnostic criteria - Cost-effective for resource-limited settings like India - Identifies both fasting and postprandial hyperglycemia ### Diagnostic Criteria (75 g OGTT at 24–28 weeks) | Time Point | Threshold (mg/dL) | Threshold (mmol/L) | | --- | --- | --- | | Fasting | ≥92 | ≥5.1 | | 1 hour | ≥180 | ≥10.0 | | 2 hour | ≥153 | ≥8.5 | **Clinical Pearl:** A single abnormal value on 75 g OGTT is sufficient to diagnose GDM in India; diagnosis does not require two abnormal values. ### Timing **Key Point:** Screening is done at **24–28 weeks** because: - Insulin resistance peaks in the third trimester - Allows time for intervention before fetal complications - Balances detection rate with maternal safety [cite:ICMR Guidelines on GDM, Indian Journal of Medical Research]
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