{
  "release_id": "c7fb95f1d15a7d13",
  "id": "maternal:bottleneck-gdm-diagnostic-criteria",
  "owner": "maternal",
  "kind": "bottleneck",
  "slug": "bottleneck-gdm-diagnostic-criteria",
  "name": "No single agreed way to diagnose gestational diabetes",
  "aliases": [],
  "atlases": [
    "maternal"
  ],
  "summary_plain": "Doctors use two main ways to test for gestational diabetes, a one-step and a two-step approach, and they do not label the same women. In a large US trial, about 16.5% of women were diagnosed with the one-step approach and about 8.5% with the two-step approach. The trial found no significant difference in the main pregnancy outcomes between the two, so it is still debated which approach is better.",
  "summary_technical": "The ScreenR2GDM abstract (NEJM 2021) states that experts recommend universal screening but that consensus is lacking on which of the two recommended approaches to use. Diagnosis rates were 16.5% and 8.5% (unadjusted relative risk 1.94, 97.5% CI 1.79 to 2.11); adherence to the assigned approach was 66% and 92%; the primary outcomes did not differ significantly. The IADPSG consensus report recommends a one-step 75-g test; a 2021 US screening statement does not choose a test. Current efforts listed are the screening test page and that statement.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-14",
  "last_evidence_check": "2026-10-14",
  "next_review_due": null,
  "identifiers": [],
  "navigation": {
    "maternal": {
      "life-stage": [
        "pregnancy"
      ],
      "care-area": [
        "pregnancy-conditions"
      ]
    }
  },
  "payload": {
    "stage": "Screening and diagnosis at 24 to 28 weeks of gestation",
    "scope": "Pregnant people tested for gestational diabetes; the criteria differ between professional bodies and health systems.",
    "severity_rationale": "The approach chosen changes how many women are diagnosed (16.5% against 8.5% in one trial), and so how many are treated, yet the trial found no significant difference in the primary pregnancy outcomes.",
    "burden_claims": [
      "maternal:claim-screenr2gdm-maternal-outcomes"
    ],
    "current_efforts": [
      "maternal:gdm-glucose-screening-test",
      "maternal:guideline-uspstf-2021-gestational-diabetes"
    ]
  },
  "content_digest": "50502d93fc1532cb7ba4f59aeecda26a80308440a22dcc804e19719a19d2e8c2",
  "review": {
    "content_digest": "50502d93fc1532cb7ba4f59aeecda26a80308440a22dcc804e19719a19d2e8c2",
    "current": [],
    "conflicting": [],
    "stale": [],
    "inactive": []
  },
  "claims": [],
  "decisions": [],
  "milestones": [],
  "relationships": {
    "outgoing": [
      {
        "predicate": "part_of",
        "label": "Filed under this front",
        "clinical_claim_not_fact": false,
        "family": "navigation",
        "other_entity_id": "maternal:front-screening-and-tests",
        "other_entity_in_atlas": true,
        "claim_id": null,
        "evidence": null,
        "primary": true,
        "role": null,
        "valid_from": null,
        "valid_to": null
      },
      {
        "predicate": "related_to",
        "label": "Choice of test and thresholds",
        "clinical_claim_not_fact": false,
        "family": "navigation",
        "other_entity_id": "maternal:gdm-glucose-screening-test",
        "other_entity_in_atlas": true,
        "claim_id": null,
        "evidence": null,
        "primary": false,
        "role": null,
        "valid_from": null,
        "valid_to": null
      }
    ],
    "incoming": []
  },
  "page_path": "bottlenecks/bottleneck-gdm-diagnostic-criteria/",
  "context_path": "api/v1/context/maternal--bottleneck-gdm-diagnostic-criteria.md"
}