Italian recommendations for the diagnosis of gestational diabetes during COVID-19 pandemic: Position statement AMD-SID, Diabetes and Pregnancy Study Group

Torlone, Elisabetta; Festa, Camilla; Formoso, Gloria; Scavini, Marina; Sculli, Maria Angela; Succurro, Elena; Sciacca, Laura; Di Bartolo, Paolo; Purrello, Francesco; Lapolla, Annunziata

Abstract Aim In response to the COVID-19 pandemic, there is a need for substantial changes in the procedures for accessing healthcare services. Even in the current pandemic, we should not reduce our attention towards the diagnosis and treatment of GDM. The purpose of this document is to provide a temporary guide for GDM screening, replacing the current guidelines because of an unfavorable risk/benefit ratio for pregnant women or when usual laboratory facilities are not available. Data Synthesis At the first visit during pregnancy, in all women we must exclude the presence of an "Overt diabetes". The criteria for the diagnosis of overt diabetes are either one fasting plasma glucose ≥ 126 mg/dL, or one random plasma glucose ≥ 200 mg/dL, or one glycated hemoglobin ≥ 6.5% When the screening procedure (OGTT) cannot be safely performed, the diagnosis of GDM is acceptable, if fasting plasma glucose is ≥ 92 mg/dL. In order to consider the impaired fasting glucose an acceptable surrogate for the diagnosis of GDM, the fasting glucose measurement should be performed within the recommended time windows for the risk level (high or medium risk). Conclusions The changes to the screening procedure for GDM reported below are specifically produced in response to the health emergency of the COVID-19 pandemic. Therefore, these recommended changes should cease in effect and replaced by current national guidelines when the healthcare authorities declare the end of this emergency.