Which of the following is the recommended screening test for gestational diabetes mellitus in India as per ICMR guidelines?

Question

Accepted Answer

D. 75 g oral glucose tolerance test (OGTT) at 24–28 weeks of gestation. ## 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]

Answer

A. Random blood glucose at first antenatal visit

Answer

B. Fasting blood glucose alone at 24 weeks

Answer

C. 2-hour postprandial glucose at 16 weeks

Which of the following is the recommended screening test for gestational diabetes mellitus in India as per ICMR guidelines?

Explanation

Screening for Gestational Diabetes in India

Rationale for 75 g OGTT

Diagnostic Criteria (75 g OGTT at 24–28 weeks)

Timing

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